A well-planned end of life

Walking into Tim and Jane Killefer's home feels like putting on a comfy robe before settling in to have a nice long chat, with Kenzie the black Lab at your feet. It doesn't feel like a place where death and dying are prominent features of each day.

Photo provided

Tim Killefer had one last hug with his niece before she left after visiting.

Tim and Jane have always considered themselves athletes, moving from Salem to Sisters in 2019 to partake of all the outdoor recreation opportunities, now that they were both retired from teaching middle school.

Jane describes her husband as the poster child for meeting people. Tim says his self-worth has always been related to an attitude of coy "how can I help you?"

His two greatest loves are travel and the ocean. He has been to every state in the U.S. and 25 foreign countries. Working for FedEx for a long time facilitated his travels, sitting in the jump seat.

After they retired, and before their move to Sisters, they took a five-month road trip around the perimeter of the U.S., staying in 71 different places, always with a view, by water, or both. They left on July 18 and returned to their new home in Sisters on December 21, 2019, to find their adult children had completely decorated their house for Christmas, down to setting the table with the dishes Jane always uses at Christmas.

Life was good. After remodeling and adding onto the house, they were ready for the next chapter of their life together when Tim began to have some physical symptoms that signaled all was not well.

In 1997, Tim had undergone surgery for testicular cancer, followed by massive radiation treatment to both his abdomen and back; the cancer arrested. Barely recovered from that he began a 10-month Master of Arts program at Willamette University to become a teacher. It was there he met Jane, a single mom of two young children, also enrolled in the program. Despite the professor's warning that the intensive program would take all their time, and his advice to not become involved with anyone in the program, Jane spotted Tim as he walked in the door. After they read their thesis papers to each other, the flame was lit, and four years later they were married when Tim was 45 years old.

After moving to Sisters and becoming aware of strange symptoms, Tim saw several different doctors. In 2020, Dr. Priscilla Pang, a spine and functional neurosurgery specialist at The Center, told Tim that the radiation treatments almost three decades ago had left him with radiation-induced, late-onset spinal muscle atrophy. The muscles in his back and spine had wasted away. The radiation also impacted the muscles of his internal organs - heart, stomach, diaphragm, etc.

This condition has significantly shortened his life expectancy and created serious impacts on his quality of life. Extreme physical fatigue, limited mobility, steadily increasing pain, difficulty breathing, weight loss, and mental fatigue are part of Tim's every day.

"Options, pain management, extent of physical limitations, quality of life, and mental health are part of our daily conversations," Tim said. "Both Jane and I share the deeply held belief of one's individual right of Death with Dignity (assistance in dying) that has been legal in Oregon since 1997 for folks just like me, who have failing bodies and sound minds. This is a value that I have had all my life, even prior to my cancer diagnosis in 1997."

Tim was on palliative care through Partners in Care Hospice where they were able to be of assistance with pain meds and coordinating doctors and appointments. After six-to-eight months of palliative care, Dr. Ashley Michael of the Summit Health Pain Management team told Tim she thought it was probably time to go onto hospice, saying, "I'm sorry science failed you."

Tim has been on and off hospice several times, which is not unusual. In November 2023, the Killefers had a trip back east where they gathered with Tim's three brothers and celebrated Thanksgiving, ending their trip in New York City. They also went to Maui and upon their return in February 2024, Tim started on hospice for the last time.

As Tim's symptoms worsened in early 2024, he and Jane made the decision to initiate the process which would provide the option to hasten the end of his life through Death with Dignity.

Tim explained one of the important factors that figured into his decision when he said, "I can no longer live my best life and be who I have always been, enjoying everything."

"While this is my decision, it has been made with deep conversations with my family, friends, our mental health providers, and all of the medical doctors. Jane and I discuss my quality of life, my pain, my joys, and we are on the same page, and she is incredibly supportive of my decision...Currently, I cannot answer the question of when I might decide to do this," Tim explained.

When Tim's three brothers came out to Sisters together for a goodbye, Tim told them to ask him anything they wanted. They were able to have meaningful conversations, and some family healing took place. Since then, his brothers have come again one by one as have his nieces.

The most important memories as Tim reviews his life are personal family growing up stories, family gatherings through the years, and where he has traveled and the people he has met.

"It's the experiences I have had, the connections with other people - not things," he said.

The process of saying goodbye has included a recent visit to Crater Lake where Tim had always wanted to stay in the lodge. They have made their last trip to their cabin in the High Sierras. Everything is in place and ready for when Tim and Jane decide the time is right to say goodbye to each other.

"Death is a difficult topic in our culture and yet it has given me an unexpected opportunity to really think about what makes life so grand and so wonderful. Being in control of how I choose to leave this world gives me a sense of empowerment and control over my otherwise powerless health prognosis," Tim said.

The Killefers have invited friends, family, and anyone wanting to explore the topic of dying to join them via Zoom to share what they have learned about intentional dying, and to share Tim's personal story in hopes that it will be helpful to others.

Join the conversation on Monday, September 23, at 6 p.m. The Zoom link is https://bit.ly/4gsItvN.

Kellen Klein, Executive Director of Citizens for Community, will moderate the evening. Besides Tim and Jane, panelists will include Jenny Blechman, M.D., Hospice and Palliative Care Associate Medical Director, Partners in Care Hospice, Bend, OR; Elizabeth Johnson, MA, Co-founder and Executive Director, Peaceful Presence Project, Sisters, OR; and Mark Greene, M.D., End of Life Choices Oregon.

Tim and Jane welcome your questions and comments. They can be reached at [email protected].