Honest Presence

End-of-Life Doula for Older Adults, Coming to You

Advance care planning and candid conversation, so a terminal diagnosis comes with a plan the whole family understands

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Jones Van Astro, end-of-life doula in San Rafael
My Approach

Doula Support for Your Last Chapter

Honest guidance that turns uncertainty into a shared family plan

Visits in Your Own Home

You set the pace and decide who sits at the table

Honest Talk, Your Wishes First

My father wanted home and died under fluorescent lights instead

Location Information

My office is at 1000 Fourth Street in San Rafael, CA. It is a quiet place to meet if being away from home feels easier, or if your family needs neutral ground for a hard talk. Most often, I travel to you. I visit homes across central and southern Marin County, including San Anselmo, Fairfax, Larkspur, Corte Madera, Mill Valley, Novato, Tiburon and Sausalito, along with towns within about 40 miles. That way the person at the center of the plan can stay in their own chair, with their own things around them.

Map of the service area

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Why Work With Me

What May Feel Better

  • Your wishes about where you spend your final weeks are written down and known by the people who matter
  • You no longer hold the hard truth alone, because someone will talk about it honestly
  • Adult children, near or far, work from the same plan instead of guessing or arguing
  • Fears about what dying may feel like can be named and talked through calmly
  • Words you have held for your children can find a time and a form
  • Family visits can center on being together, not on phone calls and decisions
  • When the last days come, your family already knows what you wanted
About Me

I Help Families Plan Before the Crisis

I am a Certified End-of-Life Doula through INELDA. I support older adults with a terminal diagnosis and the people who love them. Losing my father taught me how much is left unsaid when no one has a plan. Sitting with a neighbor later, I saw how calm a prepared family can be. Now I listen closely, speak plainly, and help put wishes in writing, so your family can spend the last weeks together.

Your Options

Three Ways We Can Work Together

A free first talk, a focused planning visit, or six home visits that carry the whole plan through

Free Consultation
Free

Meet with me for 30 minutes to discuss how doula support works with hospice.

  • 30-minute call or visit
  • Hear what's going on
  • Learn how doula works alongside hospice
Book Now
Planning Conversation
$185

Write down your wishes for your final weeks with guidance.

  • 90-minute visit
  • Clarify where you want to be
  • Decide who you want near you
  • Document your choices
Your Wishes Program
$1,000

Get your end-of-life wishes clear, written down, and shared with family.

  • 6 home visits over 6 weeks
  • Family conversation at visit 3
  • Written vigil plan at visit 6
Policies

Booking & Billing

Payment

You book and pay securely through my booking app. Your session is paid in full when you book. You can pay out of pocket.

Package and Membership Payments

Your Wishes Program: You can pay $900 in full when you book, which saves you $100. Or pay in two parts: $500 when you book and $500 at your third visit.

Cancellation and Rescheduling

Please give me at least 48 hours' notice to cancel or reschedule so I can offer the time to another family. Your session is paid in full when you book. With proper notice, I will move it to a new time or refund it. Your first late cancellation is forgiven, and I will make room for illness and real emergencies. After that, a late cancellation means the session is forfeited.

Late Arrivals

This applies to clients who come to my location. If you are running late, please call or text me and I will do my best to keep your full time. If I have another commitment, we will use the time remaining, and your first late arrival is never counted against you.

No-Shows

This applies to clients who come to my location. If you do not arrive and I have not heard from you within 15 minutes, I will treat it as a no-show. Your first no-show is forgiven, and I make room for illness and real emergencies. After that, the session you paid for at booking is forfeited.

If I'm Running Late

This applies to visits at your home. If I am running late, I will let you know as early as I can and make up the time when my schedule allows. If you are not ready when I arrive, I will wait up to 15 minutes, and the visit will then end at its scheduled time.

If You're Not There When I Arrive

This applies to visits at your home. If no one is there, I will call and wait up to 15 minutes before leaving. Your first missed visit is forgiven, and I make room for illness and real emergencies. After that, the session you paid for at booking is forfeited, as I have already made the trip and held the time.

Refunds for Single Sessions

If you cancel your Planning Conversation at least 48 hours ahead, I will refund your payment in full to your card. Inside that window, I will move the session once for illness or an emergency, and otherwise the payment is not refunded. Once a session has taken place, it is not refundable.

Refunds for Packages

If you stop the Your Wishes Program before the third visit, I will refund your payment minus the visits already held, calculated at $185 per visit. If you are paying in two parts, the second payment is not charged if you end the program before visit three. After the third visit, the program is not refunded, but I will work with you to finish the remaining visits when you are ready. Your six visits are meant to be held across six weeks. If illness or an emergency interrupts the schedule, I will extend the time so you do not lose a visit. Visits left unused at the end of the extended time are not refunded.

Common Questions

Frequently Asked Questions

References are available on request. When you get in touch, I can share contacts for professional references, such as teachers and colleagues, who can speak to my training and how I work. To protect client privacy, I never share a client's details without their permission.
I help older adults facing a terminal diagnosis and their loved ones navigate this time. Working with hospice and family members, I listen to what's most important to the dying person and help create practical plans so families aren't making difficult decisions during a crisis.
I support older adults with terminal diagnoses and their loved ones. Many of my clients struggle with anxiety about dying in a hospital, concerns about becoming a burden to family, or uncertainty about what their final weeks might look like.
The Free Consultation is a 30-minute call or short visit to meet, hear what's going on and explain how a doula works alongside hospice and family.
Your initial Planning Conversation is a 90-minute session where we explore your preferences for your final weeks—including where you'd like to be, who you want present, and we document these important choices for you.
It is built around the goal of having your wishes for the end of life clear, written down and understood by family. It includes 6 home visits over 6 weeks. We begin with a first visit to hear fears and wishes, then a check-in at visit 3 that includes a family conversation, and a review at visit 6 to go over the written vigil plan.
I travel to clients, so we meet where you are, including at home.
I work with the family to carry out their wishes and continue supporting them through transition.
More details
What approaches do you use?
I use Advance care planning, Legacy projects, Vigil planning, Family caregiver coaching and Grief support.
Do you work with hospice?
Yes. I work alongside hospice and family, and I explain how that works in the free 30-minute call or visit.
Can my family be part of the process?
Yes. In the Your Wishes Program, visit 3 includes a family conversation. I also offer family caregiver coaching, and the plan is reviewed at visit 6.
Can you help with legacy and unfinished words?
Yes. I offer Legacy projects and listen to what matters most to you, including words you want to say to the people you love.
Do you offer support after a death?
Yes. Grief support is one of the approaches I offer.
How should I prepare for a visit?
There's nothing special you need to do to prepare for our visit. Simply come as you are, and we can talk about what's on your mind and heart. I'm here to support you in whatever way feels right for you.
What do you bring to a home visit?
I bring a notebook and planning forms to help us organize your thoughts and wishes during our time together. These tools help us document what matters most to you and create a clear record of your preferences and values.
Do I need a quiet space at home?
You can choose any room in your home that feels right for you. If you'd like family members to be present, they're welcome to join us during our time together.
How far ahead should I book?
There's no set timeline for booking with me—we work it out together based on what feels right for you and your situation.
What days and hours are you available?
I'm available on weekdays during daytime hours and some evenings, with weekend appointments available by arrangement. I work flexibly around your care needs and schedule. Please reach out to discuss what works best for you.
Is this right if I'm not ready to talk?
You don't need to have everything figured out before reaching out—I offer a free call where there's no pressure to decide anything. If you're not ready to talk yet, your family can begin the conversation, and we'll move forward at whatever pace feels right for you.
What languages do you offer sessions in?
I offer my end-of-life doula sessions in English only. If you have questions about whether we can work together, please feel free to reach out and we can discuss your needs.
Can I be there if the person is unwell?
Yes, you can be there if the person is unwell. As an end-of-life doula, I'm here to support you and your loved one during this time, regardless of their health status. I can help create a meaningful and compassionate presence for both of you.
Testimonials

What People Say

"I live in Seattle, and when my mother's cancer came back, I felt useless from a thousand miles away. Jones sat with her at her kitchen table and helped her put what she wanted in writing. Then he helped my brother and me hear it. When the end came, she was at home in her own bed with the window open, just as she'd asked. I got to be her daughter in those last days instead of her case manager."

M
Maya R.
Daughter of a client, San Anselmo

"I can only be at a bedside for a short visit. Jones is there for everything that happens between visits. Families he's worked with are calmer, they call me with better questions, and they already know what they want. I've watched him sit quietly through a long night with a frightened husband, and I've watched him know when to step back. I'd want him with my own family."

D
Daniel K., RN
Hospice nurse, Marin County
Take the First Step

When You Are Ready, Let's Talk

Start with a free consultation, or book the Planning Conversation if you or your family feel ready

Book a Free Consultation