Services For People With Critical Illness and Their Caregivers

The Living/Dying Project offers two programs to explore healing in the context of critical illness: Open Circle and Next Step. Both programs are free of charge. Open Circle and Next Step are available to Marin and Sonoma County residents. If you’re interested in our Client Programs, please contact our office.

Open Circle

The focus of Open Circle is to respond to the opportunities for transformation and healing that critical illness offers – to include the possibilities of spiritual awakening, conscious dying, remarkable remission, and freedom, without avoiding the physical and emotional needs that illness presents. Opening to this investigation, we have the opportunity to go beyond attachment, contraction, and denial – entering the path to healing.

Each client is matched with a trained volunteer who meets with the client on a free-of-charge, ongoing basis. Volunteers meet in support groups and receive ongoing training. They are encouraged to have a contemplative spiritual practice to nurture their work with clients.

We serve clients at all stages of illness, from diagnosis to recovery or death. Our intention is to be together with awareness, compassion and empowerment.

Next Step

Next Step is a four-week, one-to-one support program for people newly diagnosed with a life-threatening illness. We teach skills to cope with stress and begin the journey of spiritual healing. We believe that critical illness allows opportunities for transformation and healing.

The program includes:

Spiritual counseling, identifying and organizing a support system, evaluation and discussion of the client’s spiritual needs, learning meditation, relaxation, and centering, discussion of the meaning of healing, learning to connect with caregivers, and becoming aware of the obstacles to healing.

Each client is matched with a trained volunteer who meets with the client on a free-of-charge, ongoing basis. Volunteers meet in support groups and receive ongoing training. They are encouraged to have a contemplative spiritual practice to nurture their work with clients.

Ongoing Small Groups – HEALING AT THE EDGE

Find meditation, devotional, and energy practices that will make available meaningful change in your life. Together we will explore how our emotional patterns, reactions to life situations, and meditation experiences can reveal what is asking to be healed. Eastern contemplative practices assume that the practitioner loves himself, is relatively free from doubt and guilt, and is basically not neurotic. In our experience many people harbor unconscious assumptions regarding their ability to significantly deepen their relationship with self, with truth, with Presence. Being in a supportive, small group setting will allow the uncovering of these assumptions and the discovery of the way to healing for each individual. These will not be meditation groups, but groups which use meditation to facilitate deep inner work bringing a sense of connection, connection with other and with self. These will not be therapy groups, but groups that that support opening directly to patterns that previously have blocked the experience of Presence. All that is asked of the participants is a desire to awaken.

Facilitated by Dale Borglum, PhD, Executive Director of the Living/Dying Project

Dale has extensively practiced in the Vipassana, Zen, Tibetan Vajrayana, and Dzogchen Buddhist traditions. Dale’s core practice is devotional, drawing from both his Christian roots and his immersion into Hinduism to a depth which is too personal to share in these few words. Having guided many hundreds of people approaching death, Dale developed the ability, in most cases, to see clearly what blocks the next step toward freedom, insight that enables a person to touch Awakened Mind. The groups explore deeply this inner work, this practical healing, this intersection of the spiritual and the psychological, and in this process awaken gratitude for the preciousness of life.

Clients may also meet with Dale on an individual basis, exploring the intersection of spirituality and psychology as mentioned above and/or working with end-of-life issues.

Both the small groups and the individual sessions are for a fee at the moderate end of the scale.

Current Groups:

Berkeley, California

Marin County, California

Sebastopol, California Day Group

Sebastopol, California Evening Group

Overview of What We Do in These Groups (click here for larger PDF)


Dale Borglum offers counseling services either in person or via telephone or via Skype. This counseling can focus on end-of-life issues and/or on the area of inner work/spiritual healing/meditation/the interface where our psychology limits our spiritual progress. Fully realizing the unity of our humanity and our divinity is the core of this work. Please feel free to email to explore the suitability of this work for you or to set up an appointment. Dale’s counseling is by fee on a sliding scale basis.

The Open Circle program of the Living/Dying Project offers free-of-charge, one-to-one, face-to-face emotional and spiritual support for people with life-threatening illnesses in Alameda, Marin, Contra Costa, and Sonoma Counties. This service is provided by our trained volunteers.


Please look at our educational services page for articles, interviews with local professionals, and a recommended reading list.

Practical Matters

Often there can be a gap between seeing a possible need for further intervention and creating it. Looking ahead and preparing now will reduce stress and frustration for both the caregiver and the one being cared for. It will also reduce unnecessary discomfort for the patient. The following are things to consider. If you would like to discuss any of these or other matters please contact our Caregiving Program.

Pain Management:Find medical care (doctor, hospice, nurse) that knows a lot about pain relief. Create a relationship with a healthcare provider early in the diagnosis. If you sense that the patient is having increasing pain or staying at a level the patient is complaining about, then they are not getting the pain relief they need. Keep a record of the patient’s pain by asking them several times a day what their level of pain is on a scale of 1-10. Share this with your health care provider. If the health care provider does not address the pain the patient is enduring, it is time to get someone who can manage the pain. Your health care provider should be sufficiently concerned about the patient’s pain level. No patient should suffer unnecessary pain.

Hospice Care: 
Hospice requires a 6-month prognosis and patients who are no longer pursuing life saving treatments; however, treatment for palliative care is encouraged. Hospice offers many services and should be utilized as soon as is appropriate. They can provide nursing, counseling, and help with practical issues.

Getting a Commode: Do not wait until it’s exhausting and painful for the patient to go to the bathroom to get a bedpan, commode, and/or Foley catheter. Get these things before they are totally needed.

Hospital Bed: It is time to consider a hospital bed when the patient is staying in bed most of the day. A hospital bed will make being in bed more comfortable for the patient. Being in bed for prolonged periods of time can cause bed sores. Make sure you and your health care provider are checking for bed sores. Turning the patient frequently and investing in an egg crate mattress can reduce bed sores.

Medication Chart: 
If your loved one is taking medication you should create a medication chart, especially if they’re taking pain medication and/or being cared for by more than one person. List the medications, their purpose, and how they should be administered (how much and how often). Make a chart of the day and fill in the hours when medications should be given. Have anyone that gives medication “sign off” on the chart so that no dose is missed or given twice. A simple chart creates safety and peace of mind.

Caregivers as “Gatekeeper”:
People are going to want to visit and call to be friendly. The patient can get exhausted by having to participate in ongoing social visits. The caregiver needs to act as gatekeeper. Ask your loved one how much time she wants to spend with people and with whom. Remember that the “schedule” of visits she may want now can change quickly. The patient should not have to be responsible for disappointing people and should be able to refer people to the caregiver.

Develop a Caregiver Team: Are you getting tired, or burnt out? A part of taking care of yourself is looking ahead. You can’t be there 24 hours a day. You must take care of yourself if you want to give the best care to your loved one. Keep in mind you do not know how long you will be caregiving; plan long term. Who are the people that can help you? Find out what family and friends are willing to do. Help comes in many forms: visiting with your loved one so you can get out of the house for awhile, someone to help with the bills, the legal issues, kitchen help, helping with the chores, and the list is endless. Consider getting a nursing agency to help with the care needed, even for evening shifts so you can get some sleep. Helpful assistance from your friends and family can reduce stress and provide respite.

Caregiver Meetings: 
Have regular meetings with all the people who are helping in your caregiver team. Discuss how the situation has changed, schedules, changes in medicines or medical care, and if possible, have your loved one share her needs with the group. Make sure caregivers are informed.

Emotional Needs: The caregiver and the patient need breaks from each other. The patient needs someone, other than you, to communicate her needs to. Ask your loved one if they have someone they want to have visit (maybe on a regular basis) for sharing her emotions. She may want a friend, counselor, or a volunteer from our Open Circle Program to talk with. The caregiver also needs someone to talk with about the emotional issues that are arising. Reaching out can be helpful for both of you.

Please look at our Referrals pages for information about Marin County Services.

 © Living/Dying Project 2013