HANDS ON work with people in states of altered consciousness including: metabolic coma and delirium near death; those in end stage dementia; also those with traumatic brain injury, stroke, and drug overdose.

COUNSELLING families of those in coma and dementia and people formerly in altered consciousness and coma.

FACULTY with the Sacred Art of Living Center and the Anamcara Project. 
Teaching: "Coma Communication Therapy; Healing the Unconscious" in Oregon, California, and Ohio.

FACULTY (Stan) with the Process Work Institute Graduate School in Portland, Oregon. Instructing: "Sacred Depths" for caregivers and family who tend people with memory loss, dementia, traumatic brain injury, coma, and near death states.

ComaCARE, Consultants and Directors, Cape Town, South Africa.

PRESENTATION of workshops, seminars, and inservices across North America to nurses, care aids, volunteers, social workers, clergy, body workers, physiotherapists, occupational therapists, speech therapists, counsellors, psychologists, physicians, teachers, and families. 

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VENUES AND APPRECIATIIONS ~ Ann Jacob & Stan Tomandl

Whiterock Hospice BC “Comforting and Supporting People Near End of Life in Nonordinary States of Consciousness: Dementia, Delirium, Coma”
Thanks you so much for sharing with our volunteers, the wonderful gifts you have learned working with those in altered states. The understanding and awareness of those magical places we travel in and out of, highlights our humanity and enhances our compassionate presence in each others' lives.
Again many thanks, Karen Brown, Volunteer Coordinator

Swedish Medical Center Seattle WA ”Touching the Soul in Dementia, Delirium, and Coma
This has been one of the best offerings I’ve attended ever for chaplains—Stan and Ann’s presentations and stories were incredibly helpful for me in my clinical work—I am already aware of the many ways I can utilize new ways of communication with patients in altered states.  This material is cutting edge, related directly and intimately to spiritual care, and sorely needed as we see an epidemic rise in Alzheimer’s, delirium and dementia.  Please offer a Part 2 offered by Stan and Ann.  This was excellent! 

Process Work Institute Graduate School, Portland OR “Deep Inner States of Awareness: Delirium, Dementia, Coma”
The information has continued to shape and transform every encounter I've had with patients. I certainly would love to attend the course again. ~
Lora Johnson, hospice chaplain
”Our Lady’s Hospice, Dublin Ireland, (first modern hospice ~ established during 1879 smallpox epidemic) “Coma Communication: Healing the Unconscious”

San Diego Hospice & The Institute for Palliative Medicine: Education and Research, San Diego CA, (United States’ largest physician specialty training program) “Coma Communication: Healing the Unconscious”

Hospice of the Western Reserve, Cleveland OH, (one of the foremost hospice and palliative care programs in the US) “Coma Communication: Healing the Unconscious”

California Men’s Colony, San Luis Obispo CA (medium security prison) “Communication while Attending End of Life Vigil with Fellow Inmates”
Several of our Hospice trainees expressed how much your workshop meant to them as new volunteers, and in response to familily members who are struggling with the challenges of a n inmate with dementia, and who know the powerless feeling when a loved one is in coma. ~
Lorie Adolf, MA, Director of Spiritual Care, Supportive Services

Japan Lutheran College, Tokyo Japan, “Coma Communication: Healing the Unconscious”

Silverado Hospice, San Juan Capistrano CA, “Sacred Essence: practicalities and spirituality of communicating with those in altered consciousness” (year long monthly telephone classes with eight hospices)
Learning how to respect patients' processes as unique. ~ Enables common courtesy and common sense: introducing myself, telling patients what I am going to do, giving notice that I am going to leave and encouraging any last communication. ~ I am much much more aware now; Iook for communication where no one else would see it. ~ from two chaplains and a social worker

Canadian Hospice Palliative Care Association Conference 2007, Toronto ON, five presentations on: Delirium; Dementia; Coma Communication; Coma and Remote State Directive; Innerwork 

BC Hospice Palliative Care Association Conferences 2004-2010, Surrey BC,  eleven different workshop presentations on caregiving for those in states of altered consciousness at end of life.
Finally someone is communication with those deemed noncommunicative. ~ Loved your workshop. I can't wait to learn more. As a nurse, I have always felt the need to communicate with those with dementia and in coma. ~ Your workshop on nonverbal communication opened up a door that I didn't know existed. This work is so critical to being a more effective hospice person! Thank you, Ann & Stan. ~
Comments from three workshop participants.

Catholic Community Care, Cleveland OH, "Compassionate Communication with those in Altered Consciousness"

Home Care Association of Washington, Edmonds WA, "Coma Communication: Allaying Agitation; Enhancing Decision Making"

Cook County Hospital, Chicago IL. “Traumatic Brain Injury and Remote States of Consciousness”

Lake County Association for the Retarded, Gary Indiana, “Process Work with Challenged Individuals”
Our experience with 'George' was remarkable and inspiring. It was apparent that he knew what he was dong and understood and sensed that he was given the opportunity to be understood in terms of his own expression! ~
Nancy Vaught, Director Client Services

Alzheimer's Association and Hospice of Bend La-Pine, Bend OR “Beyond Words: Compassionate Communication with People with Dementia or in Coma States”
FJC Christian Life Centre, Calgary AB. “Relating to People in Remote States of Consciousness”

Five Seattle Hospices, Volunteer Celebration Day training, Seattle WA. “Coma Communication”

Lions Gate Hospice, North Vancouver BC, “Coma and Remote States”

Lutheran General Hospital, Department of Pastoral Care, Park Ridge IL. “Relating to Patients in Coma and Remote States”

Gerontological Nurses Conference, Victoria BC. “Relating to People in Remote States”

Brandel Care Center and Covenant Home, Northbrook IL. “Communicating with Residents in States of Confusion”, “Symbolic Language and Dementia”, “An Alzheimer’s Surprise Party”

Rest Haven Lodge, Sidney BC. “Remote States of Consciousness”

Queen Alexandra Centre for Children’s Health, Victoria BC. “Communicating with Extremely Challenged Children”

Glendale Lodge for the Severely Physically and Mentally Handicapped, Victoria BC. “Psychological Interventions in Extreme Altered States”

Sacred Art of Live Center for Spirtual Formation, Redmond OR. “Coma Communication: Healing the Unconscious”
I was totally unfamiliar with coma work prior to hearing your presentation at the Sacred Art of Living seminar, and now I feel compelled to share the information with many. I whole heartedly thank you as you continue on with your important work! ~ Nancy Beach

Really offered hope and reality of inner life. ~ Open accessible, wonderful demonstrations, powerful. ~ Super presenters, very creative. ~ Carried the heart of those in different states of consciousness home to me. ~
comments from various participants

Anamcara (soul friend of the dying) Project, Bend OR
Many people can benefit from being given permission to: Say what you need to say; believe in your experience. Something as simple as responding to a person with Mmmm or Ahhh can be such a positive experience. Working with the breath of patients can be a gift that ties souls together. ~
Betty Kibble, music thanatologist

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More Comments:

The three way phone call between my sister at a distance, you in Victoria, and me at dad's bedside, was one of the hardest things I'd ever done, and one of the richest: I'm very, very grateful to you. I learned from you to read and name and understand my dad's new ways of communicating, and to not fear his powerful emotions which had looked like anxiety and distress to me ,and I just wanted them to go away.  I modeled what I'd learned from you to my siblings, and some of them were able to feel comforted that communication was not one way...that Dad had ways to let us know that he was listening. You were kind and encouraging and confident and understanding that this was all new ground for me. My only wish is that we could have had you come in person and help us all.
Your phone call was on Saturday morning, and Dad died on Monday, early in the morning, peacefully. I feel so grateful that I got to say all I wished to say to him before he died...lucky me. Thank you very much for your pivotal role in his dying process.

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Thanks for the seeds of hope and courage you have sown in many corners of altered consciousness, and particularly for those seeds which are taking root and bearing fruit in me. ~
Marshall Wattman-Turner, hospice chaplain

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When my mother in law was experiencing dementia, the family consulted Stan and Ann and we learned so many helpful things to support her through her last months and days. ~
Susan Tyche

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Thanks for the telephone courses. Over the past five months they have helped me, along with our family members, learn many things about this part of my mother's journey through Alzheimer's. ~ Jim Bodeen


For more information contact:

Stan Tomandl, MA, PWD ~ Ann Jacob, BA Ed
COMA COMMUNICATION ~ PROCESS ORIENTED FACILITATION
#502--620 View Street, Victoria, BC, Canada V8W 1J6
1.250.383.5677     annstan@islandnet.com     www.comacommunication.com