Navigating End-of-Life Decisions: MAID, VSED, and Beyond
Making decisions about what the end of life will look like can be an enormous, and sometimes overwhelming responsibility, especially when there is pain, confusion, or uncertainty. In my work as an end-of-life therapist in Ontario, I meet people and families approaching decisions they might never have expected to face. Whether considering palliative care, hospice, Medical Assistance in Dying (MAID), Voluntary Stopping of Eating and Drinking (VSED), or all the choices that can be part of dying at home or being cared for at home after death, my role is to help bring clarity and wisdom to the process.
What Can Enhance Medical Care
Physicians, nurses, social workers, and MAID coordinators bring tremendous skill and compassion to the complex medical and legal requirements of end-of-life care. What can enhance this clinical support is having space to explore the questions, fears, and relational complexities that arise when facing mortality—and having someone who can be present to the whole picture, not just the medical decisions, but the emotional and existential dimensions of this time. In listening to those who have walked this path, one thing becomes clear: having this kind of support matters deeply. Survivors often say they didn't realize how much it would matter until the moment was upon them.
My Background in End-of-Life Care
This work represents a deepening of my private practice as a Registered Psychotherapist, bringing together more than a decade of hospital-based end-of-life experience with my ongoing study of MAID in Canada. I've followed the evolution of medical assistance in dying since its earliest days, listening carefully to the experiences of individuals, families, and clinicians. I approach this work as a student of dying—curious, grounded, and committed to supporting people of diverse backgrounds and worldviews.
End-of-Life Support and MAID
Here in Canada, more people than ever see MAID as an end-of-life option that makes sense to them. Some are certain about what they want; MAID aligns well with their values and wishes around autonomy, pain, and suffering, and therefore meets their goals of care. Others can feel pressure to decide in unfamiliar territory.
People seeking MAID support in Ontario might be newly diagnosed and wondering about their options. They might be someone who has received MAID approval but feels uncertain about timing or what the process will involve. Sometimes it's a family member struggling with a loved one's MAID decision, needing space to process their own grief, fear, or confusion. Others come after a MAID death, navigating bereavement that feels different from other losses—marked by the abruptness of the dying, the weight of having chosen a date, or the complexity of mixed emotions.
With dying and death having become so removed from our everyday lives in North America over recent generations, many have little real knowledge of what the final weeks and days of life might look like. Who will care for me? What if I am in unbearable pain? What if my dying is prolonged and my family and friends suffer as a result? For some, the structures and certainty MAID provides bring relief. For others, having space to explore these questions - and to understand what palliative care can offer - is what's needed. Both deserve thoughtful support.
How This Work Unfolds
My role is to listen and to be curious—about where you are, what might not be getting expressed, what might not feel complete. I help create space for you to explore your experience of illness, dying, or grief without parts of yourself needing to be kept separate or hidden away. How someone experiences illness or end of life can be shaped by their worldview, culture, community, faith or spirituality, mental health, and family dynamics. I ask questions that can help connect what's happening now with all of who you are:
How have you imagined your dying?
What is scaring you?
What is intriguing you, or calling you?
What feels unanswered or incomplete?
What are you discovering?
Common Conversations
One conversation that often comes up is about not wanting to be a burden to others. Very often it is people who have devoted their lives to caring for others who especially cannot imagine asking others to bear the weight of caring for them. When we explore this together, we talk about how allowing ourselves to be cared for can actually be a gift—that it can be a life-changing privilege to care for someone you love. That the act of caring and seeing another to their death can in fact be a milestone of adulthood; can expand and make a life feel richer and more complete. This shift in perspective—from burden to gift—can open up new possibilities for connection in the time that remains.
I also work with families who are distressed by what they perceive as a loved one's suffering, especially when dying is taking time. In my experience, dying is work, no easier or less messy than being born. When pain is well-controlled, what families are often witnessing isn't suffering in the way they fear—it's the body doing what bodies do in the process of moving from living to death. There can be value in being present to this, in staying with the uncertainty and unknown of how this dying will unfold. Some people want that experience; others don't, and both are fine.
MAID-Specific Support
For some people considering MAID, I'm curious about how to create space for the sacred even when so much is known and planned. The days or hours before might become a kind of vigil—a container marked by intention, ritual, presence. This might look like particular lighting, music, silence, or meditation. Not everyone resonates with this way of seeing, and that's completely fine. But for those who do, thinking about how to create conditions for reverence alongside the medical process can feel meaningful.
Grief after MAID often carries unique qualities. The abruptness of the dying—having chosen a date, having gathered, having said goodbye in a compressed timeline—can stir feelings that differ from deaths that unfold more gradually. Family members sometimes carry complex emotions: relief that suffering has ended, guilt about that relief, anger at feeling pressured, or profound sadness at what feels like an abbreviated goodbye.
I work with individuals and families in whatever constellation suits them. This might mean individual sessions for the person considering MAID, or family meetings to support shared decision-making and help loved ones prepare. After a MAID death, bereavement support—whether individual or in groups—can provide essential space to process what has been lost, what has been gained, and how to integrate an experience that can feel both sacred and bewildering.
What to Expect in Our Time Together
My role is to witness wherever you find yourself—which is always changing, especially during illness or approaching end of life. Through careful listening and precise reflection, I offer language and expression for what I hear you saying that perhaps deepens understanding or lets what you already know be fully felt, held, and appreciated—in mind, heart, and body.
While physicians, nurses, and coordinators bring tremendous skill to their roles, the nature of therapeutic work is different. I don't have medications to manage, forms to complete, or eligibility requirements to assess. What I bring is time—time without agenda or expectation. This allows for a depth of exploration and presence that, while not more important than medical care, is simply outside the scope of what other clinicians can offer within their roles.
There is no agenda except to create space for whatever is present. Some sessions might involve tears or anger; others might feel surprisingly light or even joyful. You might come with questions, or you might simply need to sit with someone who can be present to the uncertainty. There's no pressure to have things figured out, to feel a certain way, or to make progress. The work unfolds at whatever pace feels right for you.
What I don't do is tell you what to think, feel, or decide. My commitment is to support you in discovering what's true for you, whatever that turns out to be.
Accessing Support Throughout Ontario
I offer MAID counseling and end-of-life support throughout Ontario via secure video sessions, serving Kingston, Prince Edward County, the Quinte region, and communities across the province. Virtual care means you can connect from wherever you are—at home, in hospital, while traveling, or after relocating. For clients in the Kingston area and surrounding regions, in-person sessions may also be possible depending on your needs and location.
Beginning When You're Ready
If you have questions or want space to reflect, you're welcome to reach out. We'll start with a conversation to get a sense of whether working together feels like a good fit. There is no pressure to have everything figured out before we begin.
If you are experiencing acute distress, including severe grief, spiritual crisis, meditation-related challenges, or confusion at end of life, please reach out for gentle support when you feel ready. For urgent needs—including risk of harm — call 911 or visit your local Emergency Department.