Showing posts with label end of life planning. Show all posts
Showing posts with label end of life planning. Show all posts

Tuesday, April 24, 2018

'Being Mortal' and End of Life Planning

We are all going to die.  Most of us do not want to think about this.  We admire people who fight bravely against the ravages of disease, even if it only means they have extended their lives a few weeks or months.  At the same time, we rarely envision that we may be tethered to machines at the end of our life.  When we do think about the end of our life, we have a pretty image of ourselves living until an extremely old age, then dying at home in our bed, surrounded by our loved ones, saying our gentle good-byes.  Most of the time, however, we prefer not to think at all about the end our life.

However, we need to remember that we are all going to die and DEATH IS NOT A FAILURE.  It is a perfectly natural part of life and something for which we need to prepare, for our own sake as well as the sake of our loved ones.

Review of "Being Mortal" by Dr. Atul Gawande

Only rarely have I recommended a book in this blog.  However, I believe it would be helpful for anyone who is over the age of 60, or who has a loved one over the age of 60, to read "Being Mortal" by Dr. Atul Gawande. I believe they would find it very helpful and eye-opening.  It will help you make smarter decisions for yourself and your loved ones concerning the best types of assisted living and medical treatments for the very elderly or sick.

This book is easy to read and contains a large number of case studies which illustrate the various points made by the author, Dr. Atul Gawande, an American surgeon at Brigham and Women's Hospital in Boston. He is also a professor at Harvard Medical School.

Early in the book, he talks about the normal aging process and the types of illnesses and disabilities which are common.  Dr. Gawande notes that the normal decline in our health due to aging often results in losing our independence and being placed in traditional American nursing homes.

In the opening sections of "Being Mortal: Medicine and What Matters in the End," Dr. Gawande discusses the problems with normal nursing homes and their desire to put our medical care and safety above any other consideration.  However, he then shares information about a variety of developers of assisted living facilities who also take into consideration our very human desire to have privacy, independence, pets and a variety of activities available to us as we age, even if this means we are not always bubble-wrapped in the name of "safety."

Later in the book, Dr. Gawande discusses the value of hospice and palliative care, whether or not a terminal patient decides to continue to try various treatments for their illness.  He explains that it is important for the family and care providers to take the time to learn how the patient wants to spend their final days or weeks.  Often, in an attempt to avoid telling the patient they are dying, doctors subject their patients to a series of worthless treatments which may make them miserable or even shorten their lives!

This book covers a great deal of helpful information which will make it much easier for you and your loved ones to make more informed decisions about where they want to live during the final years of their lives and the types of treatments they wish to try.  In many cases, it will enable families to improve the quality of the time they spend with a loved one who is dying.  This is a book which every family will be able to use as a helpful guide when they have aging family members.

The book, "Being Mortal: Medicine and What Matters in the End" is available in hardback, paperback, audio, Kindle, and large print editions in bookstores and from Amazon.

To learn more about common medical issues which affect us as we age, suggestions on where to retire, Social Security, Medicare, changing family relations, financial planning and more, use the tabs or pull-down menu to find links to hundreds of additional helpful articles.

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Wednesday, January 10, 2018

End of Life Planning for Baby Boomers

While many of the posts in this blog are about how to live the longest, healthiest life possible, eventually all of us are going to face a time when we eventually decline in health and die.  Even before our death, we could experience a period of time when we are incapacitated because of a heart attack, stroke or dementia and become unable to handle our bills and other responsibilities.  The kindest thing we can do for our families is to gather our documents in one place and have an end-of-life plan.

How to Begin Planning the End of Your Life

You may be surprised to know that both you and your loved ones will have greater peace-of-mind once you have made an end-of-life plan.  After you have accomplished this, you can set it aside and hope it does not need to be activated for years or even decades.

In order to be prepared, you should contact a lawyer, write a will, set up a trust, and complete an advanced healthcare directive. You should also talk to a mortuary, prepay your funeral, if possible, and leave instructions with your heirs. You will need to choose a trustee to carry out your will, someone who will have a financial power of attorney to handle your finances if you are unable to, and a person who will carry out your medical wishes, as specified in your advanced healthcare directive.  These do not have to be the same people.

Making the decisions involved with writing these documents will help you clarify your thinking about who should be your trustee and who should make healthcare decisions for you, in the event you become incapacitated.

Create two Notebooks with Copies of Important Documents

Once you have completed the paperwork, you will want to get two three-ring binders and insert copies of your important documents.  Among the things you will want to include are copies of your:

Will and Trust
Advanced healthcare directive
Driver's License
Social Security card
Insurance policies, including health, life and long-term care
Bank account information
Property title, mortgage documents, etc.
Titles to your cars and other vehicles
Personal property inventory, pictures and bequests
Military ID, Military service records, veteran disability status
Passport or citizenship papers
Marriage or domestic partnership certificate
Divorce decrees, pre-marital or post-marital agreements
Spouse's death certificate
List of your diseases or health issues
List of doctors, pharmacies and medications
List of friends, family members, church, employer, etc. and their contact info
Information on what to do with your pets
Advanced funeral planning information
Computer passwords for bank, brokerage or other important accounts, or instructions on where your heirs can find these passwords

Keep one of these notebooks for yourself and your spouse to use.  Give the other notebook to the family member or other person who will handle your affairs in the event you die or become temporarily incapacitated. 

What to Tell Your Other Family Members

Once you have made your plans, put them in writing, and assembled your notebooks, tell your trustee and other family members about your plans.  Let them know how you would like things handled if you become seriously ill or die.  Then, reassure your loved ones that you are not currently ill and you hope these instructions are not needed for many years.  Make sure your family members are all aware of your desires, long before the time comes.

Maintain your End of Life Planning

Things may change over the years.  Your trustee may become ill and unable to fulfill their role in the future.  Your insurance policies, names of doctors, and the medications you are taking could change.  Periodically you will need to review your notebook and update it.  When you update your own notebook, make sure you also update the one in the possession of your trustee, to reduce any confusion in the future.

If you take these steps, you and your heirs will discover you have much less to worry about when you do become seriously ill and the end of your life seems imminent.

If you are interested in more information about retirement planning, where to retire, common medical issues, Social Security, Medicare, and more, use the tabs or pull-down menu at the top of the page to find links to hundreds of additional articles.

Watch for my book, Retirement Awareness: 10 Steps to a Comfortable Retirement, which will be published by Griffin Publishing in 2018.

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Wednesday, August 19, 2015

Redesigning Death - Bring Joy to Your Final Days

While most of us do not want to think about it, we are all going to die.  It could happen at home, in a hospital or while out in public.  If we are lucky, we may have the time to say good-bye to our loved ones and spend time with them during the last few days of our lives.  However, death does not always come gradually.  Sometimes it happens with the speed of a heart attack or an auto accident. 

Most of us will have some type of funeral or memorial service; we will probably be interred in a cemetery or cremated, with our ashes distributed according to our instructions.  If we are leaving family and loved ones behind, there are likely to be sad relatives and lots of tears.  It all seems very simple, clear and preordained.  However, are there ways to change the feelings surrounding our death?

Death Redesigned

What if we could completely alter the process?  No, there is no way to prevent our death.  We may not even be able to predict when it will happen or postpone it.  However, with a little creativity, planning and forethought, we can change the way both we and our loved ones will experience our death.  What are some ways we can do that?

Plan the End of Your Life

One of the first things you can do is think about how you want to spend your final days, should you be given the opportunity to choose.  Do you want to die at home or in a hospital?  Would you prefer to cease treatment and get palliative, hospice care, instead?  Do you want your loved ones to be with you at the end?

What type of atmosphere do you want?  You can set the mood.  Do you want those last few days to be sad and tearful, or would you rather spend the time talking about all the happy memories of your life?

How to Change the Mood Surrounding Your Death

I love my children enough that it would break my heart to see them in tears while I was dying.  I would rather have them focus on the happy and funny experiences we have enjoyed together.  When I die, my goal will be to provide all the comfort I can to them.  What are some ways to do that?

1.  Put together photo albums to share with your loved ones at the end of your life.  Personalize them with photos of specific memories you had with each of them.  This could be a wonderful way to keep the conversation light and happy.  I went to a memorial service recently at which I was handed a DVD of the slide show about the deceased that was shown during the service.  The man had volunteered as a hospital clown through his church, and it was very touching to be able to play the DVD at home and see all the joy that had been part of his life.

2.  Write letters to the people you care about ... and it doesn't have to be only your family members.  One of our friends died of lung cancer a few years ago.  He owned a construction company and, during the last few weeks of his life, he wrote a letter to each of his sub-contractors, telling them how much he appreciated their years of service and giving them each one final payment.

I have also heard of parents who were dying far too young, who wrote a series of letters to their children that they could read each year on their birthdays.  The letters are usually meant to encourage them and include the things you would like to say to your children at each age.  In some cases, parents have even made DVDs for their children, so they can speak to them in a more personal way.

3.  After gifting - This was an idea I found in an article called "Death Redesigned," in the April 5, 2015 issue of The California Sunday Magazine.   You can arrange to have birthday gifts sent to family members for years after you die.  The gifts could even be something you made for each of them or a special item for a grandchild you have never met.  I think this is an especially caring thing to do if you are leaving behind young children.  It will bring them comfort to know that you were thinking of them and planning for them, even during the final few weeks of your life.

You don't have to limit yourself to family.  I recently read about a man in Great Britain who had a group of close friends that he would go with to the local pub.  He left them 3500 pounds (about $5000) so they could have a trip and a big party, at his expense.  This seemed like so much more fun for them than a terribly sad wake back at home.

4.  Messages from Beyond - The "Death Redesigned" article mentioned above also speculated about the idea of arranging for text messages to be sent to loved ones after your death.  This might work in some families; in others it might seem creepy or make it hard for them to move on.  Only you can decide whether this would be the right move for your family.  One of the points they made was how a widow would feel if she was on a date three years later and received a text message from her deceased husband.  If you decide to try this, make sure you write something loving and supportive; you will also not want these messages to go on for more than a few weeks or months. We all need to find a good time to let go of our loved ones.

5.  Share Your Story - So many times I have heard people say that they wished they had written down the stories that their grandparents shared about their lives.  Why don't you do it for your descendants?  Write down your memories and pass them on.  You can do something as simple as a typed document that you print out at home.  Or, you can get more elaborate and write it in book form, using a free service like Amazon's CreateSpace website.  They will produce paperback books that you and your family members can order for $5 or $6.  Order a couple of dozen of them yourself to be given out at your funeral.  Your descendants will appreciate knowing more about the lives of their ancestors and you will feel good knowing that your memories, experiences and dreams will not die with you.

One of our neighbors, who grew up in Korea before he and his wife moved to the United States, wrote a biography of their early years for his children and grandchildren. He also had extra copies printed out and gave them to his neighbors and friends.  I enjoyed reading about his early life and I am sure his descendants really appreciated the fact that he made the effort to do this.  

Taking Care of Your Will and Basic Funeral Plans

If you want to lighten the load on your family members, you will want to take care of all the basics, as well.  Make sure you have consulted with an attorney and written your will, trust, and advance directive.  Be sure you have put together a list of bank accounts, life-insurance policy numbers, user names and passwords for Facebook and other social media you use and put this information with your will.  In addition, you should give this information to the executor of your will.

You may also want to include any special instructions you have for where you want to be buried, specific requests for your funeral service, and any other messages you want to leave your loved ones.  We wrote a message to our daughters that we want them to read upon our death.

My husband and I have put together a notebook labeled "In The Event of Our Deaths."  We set it out whenever we are on a trip ... just in case something happens.  We have included copies of all our important information in our notebook, including copies of our will, special instructions, insurance information and anything else we thought would be helpful to them.  In addition, we made a copy of the information in this notebook and gave it to the daughters we chose to be our co-executors.  We wanted to make life as simple for them as possible.

While you may not want to do everything listed in this article, hopefully it will inspire you to redesign your own death in such a way that, while you cannot prevent your death, you feel as if you are going out on your own terms ... and that is the best any of us can do.

If you are looking for more information about aging and retirement, use the tabs or the pull-down menu at the top of this article to find links to hundreds of additional articles.

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