They served the nation on distant and often hostile shores, putting their bodies and minds in harm’s way for their country.
Now, in the twilight of their lives, the residents of Napa County’s Yountville Veterans Home are asking for the option to end their lives if they are terminally ill, in peace, at home, in their own bed.
The 625 residents and their spouses are denied access to the state’s aid-in-dying law. A group representing residents of the home went to court to try to change that.
Life-ending medication is also off-limits to the other 2,000 aging and disabled veterans and spouses at the state’s facilities in Fresno, Barstow, Redding and other cities. That’s because California’s End of Life Option Act conflicts with federal law – so the state’s veterans agency bans it, fearing the loss of millions of dollars in federal funding.
Without the same rights afforded other Californians under the Act, the veterans’ only option is to leave – or stay, and risk misery. If the veteran leaves, their spouse must leave too, and cannot return.
“I’ve watched three of my friends die here, who were in pain and suffering. It’s unacceptable,” said Jim Thomas, 86, a decorated Vietnam War-era U.S. Air Force officer and pilot who lives with his wife, Jensena, 80, at Napa County’s Yountville Veterans Home, the oldest and largest residential setting for vets in the nation.
”The last thing someone needs, when you’re terminally ill, is to be told you need to move out. And you can’t protect your spouse,” said Thomas, one of the residents who sued to try to end the policy. While he’s still in good health, he wants future access to the option. “You’re already suffering.”
They don’t want to ask friends, children or grandchildren to take them in during such a sad and profoundly personal experience, which also requires many procedural steps to execute, added Jensena. And leaving means the surviving spouse loses not only a partner but their home.
The Yountville home, a red-tiled Mission Revival complex nestled against the oak-studded Mayacamas Mountains, offers an affordable retirement for aging, disabled or homeless veterans of World War II, the Korean War, Vietnam War, Gulf War, War in Afghanistan, and Operation Iraqi Freedom. Founded in 1884, the home has a year-long wait for admission; the average age of residents is 80.
The home offers a secure retirement for Jim Thomas, who as an Air Force captain, flew missions to Japan, Southeast Asia and remote Pacific Islands. Awarded two Commendation Medals for meritorious achievement, he repeatedly navigated big Douglas C-124 propeller transport planes, dubbed “Old Shakey,” through perilous fog. Once, after his plane’s engine exploded over the ocean and he lost navigational abilities, he safely landed the aircraft on a small atoll. Another time, after taking off with a dangerously overloaded cargo of anti-aircraft Nike missiles, he saved his crew by narrowly missing a cliff.
Now his life is quieter and more cozy, in a room decorated with matching blue bedspreads, stuffed teddy bears, Bibles and family photos. On the wall hangs a pair of faded pink pointe shoes, a memento from Jensena’s career as a professional ballerina.
“One of the reasons we moved here is to ensure that my wife,” a breast cancer survivor, “had a place to live for the rest of her life,” he said.
Fellow plaintiff James Musson, a former special agent with the U.S. Army Intelligence Corps in Frankfurt, Germany, also cherishes his room. On display is his Vietnam War-era military dog tag, a diploma from the Intelligence School and his discharge papers.
“It’s home. It’s familiar,” said Musson, 79, who suffers from rheumatoid arthritis, interstitial lung disease, gout and shoulder bursitis. “You look out and see the gorgeous campus and the grand Napa Valley. It doesn’t really get any better than that.”
Musson also worries that if veterans leave the home to die, they would lose the right to be buried in its historic 11-acre cemetery, a resting place for combatants dating back to the Seminole Wars. The cemetery accepts only the interment of the Veteran Home’s residents and their eligible dependents.
“It’s important to me because it’s not just for myself, but for other home members,” said Musson.
The aid-in-dying ban was enacted within weeks of passage of the state’s aid-in-dying law. The law – inspired after East Bay resident Brittany Maynard, 29, had to move to Oregon to end her life and prevent suffering from brain cancer – was created specifically to allow California residents who are terminally ill to obtain drugs to hasten their death, and to die at home.
California’s Department of Veterans Affairs, known as CalVet, issued an emergency regulation stating that any terminally ill resident intending to take the drug “shall discharge from the Veterans Home.” If a veteran changes their mind, they could be readmitted, it says.
CalVet homes are not required to participate in the law, used by 1,816 Californians since it went into effect in 2016, said Simona Taylor, deputy attorney general for CalVet, at a hearing earlier this month at Napa County Superior Court. The end-of-life law has a specific “opt-out” provision, she noted.
“No facility, no physician, can be mandated to provide that service,” said Taylor. “There is not a right for anyone to receive medical aid-in-dying in any particular place.”
The problem, according to CalVet officials, is that the state’s law conflicts with federal law. They say the agency could lose funding if it violates the 1997 Assisted Suicide Funding Restriction Act, which prohibits money from being used “to pay for items and services (including assistance) the purpose of which is to cause (or assist in causing) the suicide, euthanasia, or mercy killing of any individual.”
Though funded largely by the state’s taxpayers, about one-quarter of the homes’ total budget comes from the U.S. Department of Veterans Affairs.
The veterans would not use CalVet physicians, staff or resources to obtain and use the life-ending drugs, said attorney Matthew Vafidis of the San Francisco firm Holland & Knight LLP, who represents the veterans. Instead, the residents would hire outside physicians.
The end-of-life law’s “opt-out” provision, he added, was intended for facilities with religious objections, such as Catholic hospitals, not state agencies.
Like California, Colorado and Vermont require residents of veteran homes to leave the facilities if they wish to end their lives, according to Kaiser Health News. In Washington, veterans can stay if the facility allows it, according to Judy Kinney of End of Life Washington.
Vafidis said CalVet could honor the vets’ wishes and still comply with federal rules by keeping any end-of-life funds in a separate operational and financial system. But in an August court brief, state attorneys said it’s not practical to create and maintain an account paid for solely by non-federal funds, and dedicated solely to aid-in-dying care.
So far, the court is siding with the state. In a tentative ruling issued Oct. 13, “this is an emotionally and morally charged issue, but I have to set that aside and focus on the law,” said Judge Monique Langhorne of Napa County Superior Court.
The veterans say they are now deciding their next step, in the time they have left. Already, one of the original plaintiffs has died, after a slow decline from congestive heart failure.
“It’s kind of a hopeless feeling,” said Jensena. “Can you imagine going to a dreary hotel room? No.”
