Water cremation and human composting…

The new, eco-friendly frontier of dying

by Eillie Anzilotti

We are running out of space to bury people, and cremation has an enormous carbon footprint. So people are finding new ways to dispose of the bodies of their loved ones.

Matt Baskerville has served as a licensed funeral director in Illinois for the past 24 years. In that time, he’s seen his industry—and what people want after their deaths—change dramatically.

For instance, when Baskerville entered the business in the mid-’90s, the cremation rate was roughly 10%. Now, when he looks at the records of recent years at his own businesses (he directs at four funeral homes in towns of 10,000 people or less), he sees that more than 40% of people are opting for cremation.

According to new findings from the National Funeral Directors Association, for which Baskerville serves as a spokesperson, the national cremation rate is projected to be around 54% (“The Midwest tends to be a bit more traditional,” he says). Burial, once the far-dominant option for end-of-life services, has dropped to just around 41%, and Baskerville expects it will continue to decline in popularity.

Many factors are driving this shift. For one, Baskerville says, “we’re a much more mobile society.” When families tended to live and die in the same place for generations, burial was a way to keep everyone together. But now, he’s seeing that in his hometown of Wilmington, Illinois, the younger generation is dispersing, and the ties to location are not as strong. Services like cremation better meet the needs of families who are spread out geographically. It’s becoming so much more commonplace that a new set of startups now exist to cater to families whose loved ones opt for cremation. One Portland-based company called Solace, for instance, operates as a direct-to-consumer cremation service that manages the transport, storage, cremation, and return of the remains for a flat fee.

There’s also a growing awareness that traditional burial is incompatible with the state of the planet. We are, quite simply, running out of space to devote plots of land to people who are no longer living. In cities, space for necessities like housing and parks is already in short supply, and many cities like Berlin are beginning to convert old cemeteries to other land uses. But even in places where space is not so crunched, like Baskerville’s hometown, there’s a growing recognition that the burial process—from the chemicals used to embalm a body to the wood used to create caskets—is environmentally damaging, and people are beginning to seek out alternatives.

“People like the concept of going green,” Baskerville says. But even traditional flame cremation does not exactly meet that need. Cremating a single body emits as much carbon as an 1,000-mile car trip.

So increasingly, people are seeking out greener alternatives for their afterlife. A process called alkaline hydrolysis is now legal in 15 states, including Baskerville’s home of Illinois. He describes it as “flameless cremation” because what it entails is using the gentle flow of warm water mixed with alkali (usually sodium hydroxide or potassium hydroxide) to naturally liquefy a body over the course of several hours. The process creates relatively little emissions and leaves behind no waste. The leftover liquid can be disposed down the drain, and the remaining bones and metal can then go in an urn, like a traditional cremation. In Baskerville’s businesses, around 40% of people who chose cremation are opting for the flameless process.

Another emerging alternative is human composting, which was legalized in Washington (the first state to do so) in spring 2019. Through exposure to microbes, bodies can be naturally broken down and turned into soil—around one cubic yard per person, to be precise. A Seattle-based company called Recompose is pioneering the service, which will be available as an option to Washington residents beginning May 2020. Katrina Spade, Recompose’s founder and CEO, previously founded the Urban Death Project to advocate for the practice as both more sustainable and more practical in terms of land use. Recompose has proposed memorial sites where family members could come visit the bodies as they were decomposing. The dirt could then be given to families to save or to use to grow trees or plants. The company plans to open its first site in 2020.

While body composting is limited to Washington for the time being, Baskerville would not be surprised if it became more widespread. “Trends in burials tend to begin on the west coast and spread from there,” he says. Cremation, for instance, first overtook burials in popularity on the west coast, and interest in greener options, he believes, will continue to grow.

Moving away from traditional burials also tracks with a shift in American attitudes toward death on the whole. The rising “death wellness” movement encourages a more open and accepting approach to death and mortality, whether that be through dinner parties built around the discussion of death, or through hiring “death doulas” to coach people as they approach the end of life. HBO recently released a documentary called Alternate Endings that explores the different ways in which people in the U.S. are opting to memorialize themselves. Certainly, the availability of a wider range of funeral options necessitates a more open conversation around end-of-life planning and what death and burial means to individuals. To Baskerville, this is a good thing. “In years past in the American culture, death has been a topic that was not talked about,” he says. Now, though, “end of life is more of an open topic of conversation in most families now.”

Complete Article HERE!

We’re All Gonna Die!

How Fear Of Death Drives Our Behavior

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Many people tend to push frightening realities out of mind, rather than face them head on. That’s especially true when it comes to the terrifying event that no one can escape—death. Psychologist Sheldon Solomon says people may suppress conscious thoughts about their mortality, but unconscious ones still seep through.

In the book The Worm at the Core: On the Role of Death in Life, Solomon, along with psychologists Jeff Greenberg and Tom Pyszczynski, illustrate how death anxiety influences people’s behavior in ways they would never suspect. The fear of death is so overwhelming, they say, that people go to great lengths to seek security; they embrace belief systems that give them a sense of meaning—religion, values, community.

Through decades of studies, Solomon and his colleagues have shown that people suppress their fear of mortality by supporting those who are similar to themselves. “If somebody does something that’s in accord with your belief system then being reminded of death should make you like them more so,” Solomon says.

People don’t just respond by clinging to their in-group. They act in ways that make them feel better about themselves, whether that’s demonstrating their physical prowess or buying status goods. In short, Solomon says, “we shore up our self-esteem in response to existential anxieties.”

This week on Hidden Brain, we learn how the specter of death hovers in the background, shaping everything from the risks we take to the politicians we elect.

Hidden Brain is hosted by Shankar Vedantam and produced by Jennifer Schmidt, Rhaina Cohen, Parth Shah, Laura Kwerel, and Thomas Lu. Our supervising producer is Tara Boyle. You can follow us on Twitter @hiddenbrain, and listen for Hidden Brain stories on your local public radio station.

Additional Resources:

The Worm at the Core: On the Role of Death in Life, by Sheldon Solomon, Jeff Greenberg, and Tom Pyszczynski, 2015.

The Birth and Death of Meaning, by Ernest Becker, 1971.

The Denial of Death, by Ernest Becker, 1973.

These articles describe how death reminders influence the following behaviors and preferences:

Bond recommendations by municipal court judges

Germans’ preference for German vs. non-German items

Reckless driving

Tanning habits

Support for charismatic politicians

Desire to harm someone who doesn’t share your beliefs

Complete Article HERE!

The Cost of Dying in All 50 States

By Gabrielle Olya

There are many reasons to celebrate getting older, but having to think about the cost of death isn’t one of them.

For starters, funeral costs can add up fast. The National Funeral Directors Association cited the median out-of-pocket funeral expenses for 2016 — including viewing and cremation costs — at $7,360. On top of that, the average out-of-pocket expenditure for end-of-life necessities is $11,618, according to the National Bureau of Economic Research.

One of the biggest factors impacting funeral expenses — and the cost of dying, in general — is the state where the death certificate is issued. Just like the cost of living, the cost of dying depends on where you reside.

GOBankingRates calculated the average costs for end-of-life medical care and funeral expenses in each state by multiplying the national averages for those services by every state’s cost-of-living index. The study also considered 2018 inheritance tax and estate tax data, sourced from the Tax Foundation.

50. Mississippi — $18,509

Average funeral expenses: $6,684
Average end-of-life medical costs: $11,825

The cheapest state to die in, Mississippi, has no estate tax or inheritance tax. Average funeral expenses total $6,684, and average medical costs associated with dying come out to $11,825 — both well below the national average. This is unsurprising because Mississippi also has the cheapest cost of living in America, according to a separate GOBankingRates study.

49. Arkansas — $18,681

Average funeral expenses: $6,746
Average end-of-life medical costs: $11,934

The cost of dying in Arkansas is similar to that in Alabama. Funeral expenses in Arkansas average $6,746, while medical costs associated with dying hover around $11,934. The state has no estate tax or inheritance tax.

48. Oklahoma — $18,702

Average funeral expenses: $6,754
Average end-of-life medical costs: $11,948

Medical costs associated with dying in Oklahoma are typically around $11,948, and the average cost of a funeral is $6,754 — notably below national figures. You won’t have to pay inheritance or estate taxes when you die in Oklahoma.

47. Missouri — $18,724

Average funeral expenses: $6,762
Average end-of-life medical costs: $11,962

In Missouri, the cost of a funeral averages $6,762, and the medical costs related to dying average $11,962. Neither estate taxes nor inheritance taxes are imposed.

46. New Mexico — $18,810

Average funeral expenses: $6,793
Average end-of-life medical costs: $12,017

The cost of a funeral in New Mexico averages $6,793, while medical expenses related to dying typically total $12,017. New Mexico doesn’t levy an estate tax or an inheritance tax.

45. Tennessee — $19,068

Average funeral expenses: $6,886
Average end-of-life medical costs: $12,182

Funeral costs average $6,886 in Tennessee, and medical costs related to dying are normally around $12,182. One of the most tax-friendly states for retirees, Tennessee doesn’t have an estate tax or an inheritance tax.

44. Michigan — $19,111

Average funeral expenses: $6,902
Average end-of-life medical costs: $12,209

As the seventh-cheapest state to die in, Michigan doesn’t impose an estate or inheritance tax. The average cost of a funeral in the state is low at $6,902, and medical costs associated with dying are typically around $12,209.

43. Kansas — $19,132

Average funeral expenses: $6,909
Average end-of-life medical costs: $12,223

The cost of a funeral in Kansas averages $6,909, and medical expenses related to death total approximately $12,223. No inheritance tax or estate tax is collected in the state.

42. Georgia — $19,175

Average funeral expenses: $6,925
Average end-of-life medical costs: $12,250

Falling below the national average, the standard cost for funeral expenses in Georgia is $6,925, while medical costs associated with dying are usually around $12,250. Georgia has no estate tax or inheritance tax.

41. Alabama — $19,197

Average funeral expenses: $6,933
Average end-of-life medical costs: $12,264

The average cost of a funeral in Alabama is $6,933, and medical costs associated with dying typically total $12,264. Like the other members of the 10 cheapest states to die in, Alabama doesn’t have an estate tax or an inheritance tax.

40. Wyoming — $19,197

Average funeral expenses: $6,933
Average end-of-life medical costs: $12,264

The average cost of a funeral in Wyoming is $6,933, and medical expenses associated with dying total $12,264, on average. Neither an estate tax nor an inheritance tax is collected in Wyoming.

39. Indiana — $19,347

Average funeral expenses: $6,987
Average end-of-life medical costs: $12,360

Medical costs related to dying in Indiana average $12,360, and the standard for funeral expenses is $6,987. There’s no inheritance tax or estate tax in Indiana.

38. Iowa — $19,369

Average funeral expenses: $6,995
Average end-of-life medical costs: $12,374

Iowa has no estate tax, but unlike many other states, it does have an inheritance tax of up to 15%. The average cost of a funeral is $6,995, and medical expenses related to dying hover around $12,374.

37. Nebraska — $19,519

Average funeral expenses: $7,049
Average end-of-life medical costs: $12,470

If you’re inheriting from a deceased family member in Nebraska, you’ll be taxed at a rate between 1% and 18%. However, the state doesn’t impose an estate tax. The cost of a funeral in Nebraska averages $7,049, and medical expenses associated with dying are typically around $12,470.

36. Ohio — $19,519

Average funeral expenses: $7,049
Average end-of-life medical costs: $12,470

Coming in below the national average, funeral costs in Ohio run approximately $7,049, and medical costs associated with dying total $12,470, on average. Ohio doesn’t have an estate tax or an inheritance tax.

35. Kentucky — $19,541

Average funeral expenses: $7,057
Average end-of-life medical costs: $12,484

Funeral costs in Kentucky total approximately $7,057, while medical expenses related to dying average $12,484. The state doesn’t have an estate tax, but its inheritance tax can be as much as 16%.

34. West Virginia — $19,584

Average funeral expenses: $7,072
Average end-of-life medical costs: $12,511

Dying in West Virginia will cost close to the national average, at around $12,511 in medical costs and $7,072 in funeral expenses. There’s no estate tax or inheritance tax in West Virginia.

33. Texas — $19,669

Average funeral expenses: $7,103
Average end-of-life medical costs: $12,566

The average cost of a funeral in Texas is $7,103, while medical costs associated with death are typically around $12,566. Texans don’t pay an estate tax or an inheritance tax.

32. Idaho — $19,841

Average funeral expenses: $7,165
Average end-of-life medical costs: $12,676

You won’t be charged an estate tax or an inheritance tax in Idaho, which is good news if you are the executor of a will. Plan for around $7,165 in funeral costs and approximately $12,676 in medical expenses associated with dying.

31. Louisiana — $20,185

Average funeral expenses: $7,290
Average end-of-life medical costs: $12,896

There’s no estate tax or inheritance tax in Louisiana. Medical costs related to death average $12,896, and funeral expenses run approximately $7,290.

30. Illinois — $20,314

Average funeral expenses: $7,336
Average end-of-life medical costs: $12,978

Like most states, Illinois doesn’t have an inheritance tax. However, estates worth more than $4 million are taxed at a rate of 0.8%-16%. Funeral costs average $7,336, and medical costs related to dying are typically around $12,978.

29. North Carolina — $20,400

Average funeral expenses: $7,367
Average end-of-life medical costs: $13,033

In North Carolina, there’s no estate tax or inheritance tax, so you won’t have to worry too much about what might happen to your money after you die. The average cost of a funeral is $7,367, and medical expenses associated with dying tend to total $13,033.

28. South Carolina — $20,615

Average funeral expenses: $7,445
Average end-of-life medical costs: $13,170

In South Carolina, the average cost of a funeral is $7,445, and medical costs associated with dying average $13,170. There’s no estate tax or inheritance tax.

27. Arizona — $20,852

Average funeral expenses: $7,530
Average end-of-life medical costs: $13,321

There’s no estate tax or inheritance tax in the Grand Canyon State. The average cost of a funeral is $7,530 in Arizona, and medical expenses related to death tend to add up to $13,321.

26. Wisconsin — $20,916

Average funeral expenses: $7,554
Average end-of-life medical costs: $13,363

Funeral costs in Wisconsin tend to total around $7,554, while medical expenses associated with dying average $13,363 — which are both on the cheaper side for the U.S. as a whole. No inheritance tax or estate tax is instituted, but Wisconsin is one of the most expensive states to file taxes, in general.

25. Florida — $21,045

Average funeral expenses: $7,600
Average end-of-life medical costs: $13,445

The cost of a funeral in Florida is typically around $7,600, and medical expenses associated with death average $13,445. No estate tax or inheritance tax is levied in the Sunshine State.

24. Utah — $21,153

Average funeral expenses: $7,639
Average end-of-life medical costs: $13,514

Still under the U.S. benchmark, medical costs associated with dying in Utah average $13,514, and funeral expenses are approximately $7,639. The state doesn’t impose an inheritance tax or an estate tax.

23. North Dakota — $21,239

Average funeral expenses: $7,670
Average end-of-life medical costs: $13,569

North Dakota doesn’t have an inheritance tax or an estate tax. Medical expenses associated with dying are usually around $13,569, and the average cost of a funeral is $7,670.

22. South Dakota — $21,454

Average funeral expenses: $7,748
Average end-of-life medical costs: $13,706

No estate tax or inheritance tax is imposed in South Dakota. Funeral expenses average $7,748, and medical costs related to dying are typically around $13,706 — just above the U.S. average.

21. Virginia — $21,647

Average funeral expenses: $7,818
Average end-of-life medical costs: $13,830

There’s no estate tax or inheritance tax in Virginia. Medical costs related to death hover around $13,830, and funeral expenses average $7,818.

20. Minnesota — $21,841

Average funeral expenses: $7,887
Average end-of-life medical costs: $13,953

Slightly above the national average, standard funeral costs in Minnesota come out to $7,887, and medical expenses associated with dying are approximately $13,953. The state has no inheritance tax, but if the value of your estate is above $2.4 million, you will be subject to an estate tax between 13% and 16%.

19. Pennsylvania — $21,862

Average funeral expenses: $7,895
Average end-of-life medical costs: $13,967

Pennsylvania doesn’t have an estate tax, but it does levy up to 15% in inheritance taxes. Medical expenses related to dying total approximately $13,967, and the average cost of a funeral is $7,895.

18. Colorado — $22,701

Average funeral expenses: $8,198
Average end-of-life medical costs: $14,503

There’s no need to stress about an estate tax or inheritance tax in Colorado, as neither is imposed. Funeral costs average $8,198, and medical expenses correlated with dying generally total $14,503.

17. Montana — $22,980

Average funeral expenses: $8,299
Average end-of-life medical costs: $14,681

The standard cost of a funeral in Montana is approximately $8,299, while medical costs related to dying typically average $14,681. You can keep any gold and jewels passed down to you in the Treasure State free of estate or inheritance taxes.

16. Delaware — $23,238

Average funeral expenses: $8,392
Average end-of-life medical costs: $14,846

You won’t pay an inheritance tax or estate tax in Delaware. Funeral costs average $8,392, and medical expenses related to death tend to fall around $14,846.

15. Nevada — $23,324

Average funeral expenses: $8,423
Average end-of-life medical costs: $14,901

Expect to spend about $8,423 on funeral costs in Nevada. Typical medical expenses involved with dying are $14,901, and there’s no estate tax or inheritance tax. Nevada is also one of the states with no income tax.

14. New Hampshire — $23,582

Average funeral expenses: $8,516
Average end-of-life medical costs: $15,066

Medical costs related to dying in New Hampshire average $15,066. Funeral expenses add up to $8,516, on average, but there’s no estate or inheritance tax in the Granite State.

13. Washington — $23,797

Average funeral expenses: $8,594
Average end-of-life medical costs: $15,203

In Washington, funeral expenses average $8,594, and medical expenses related to dying typically hover around $15,203. There’s no inheritance tax, but estates worth more than $2.19 million are taxed between 10% and 20%.

12. Vermont — $24,614

Average funeral expenses: $8,889
Average end-of-life medical costs: $15,725

Vermont has a 16% tax on estates worth more than $2.75 million. There’s no inheritance tax, but funeral costs average $8,889, and medical expenses related to death are typically around $15,725.

11. Maine — $25,259

Average funeral expenses: $9,122
Average end-of-life medical costs: $16,137

Maine estates valued at more than $5.6 million are taxed between 8% and 12%. There’s no inheritance tax, but the average cost of a funeral is $9,122, and $16,137 is the standard for medical expenses associated with end-of-life care.

10. Rhode Island — $25,667

Average funeral expenses: $9,269
Average end-of-life medical costs: $16,398

The average cost of a funeral in Rhode Island is $9,269, and medical expenses associated with death typically amount to $16,398. There’s no inheritance tax, but a 0.8%-16% tax is levied on estates worth more than $1.54 million.

9. New Jersey — $26,892

Average funeral expenses: $9,712
Average end-of-life medical costs: $17,181

In New Jersey, the standard funeral costs $9,712, and medical expenses correlated with dying average $17,181. There’s no estate tax, but you’ll face an inheritance tax of up to 16%.

8. Connecticut — $27,451

Average funeral expenses: $9,914
Average end-of-life medical costs: $17,538

In Connecticut, funeral costs are typically around $9,914, and medical expenses related to end-of-life care average $17,538. There’s no inheritance tax, but a 7.2%-12% tax is levied against estates valued at over $2.6 million.

7. Maryland — $27,881

Average funeral expenses: $10,069
Average end-of-life medical costs: $17,812

Funeral expenses in Maryland average $10,069, and medical bills associated with dying typically add up to $17,812. Maryland is one of the few states with both an estate tax and an inheritance tax. Inheritances are taxed up to 10%, and estates worth more than $4 million are taxed at a 16% rate.

6. Alaska — $27,924

Average funeral expenses: $10,084
Average end-of-life medical costs: $17,840

The average cost of a funeral in Alaska is $10,084, while medical expenses associated with dying hover around $17,840 — both of which are much higher than the national average. On the plus side, the state doesn’t have an inheritance tax or an estate tax.

5. Massachusetts — $28,290

Average funeral expenses: $10,216
Average end-of-life medical costs: $18,073

At around $10,216, funeral costs in Massachusetts are well above the national average. Medical expenses related to end-of-life care average $18,073. No inheritance tax is levied in Massachusetts, but estates worth more than $1 million are taxed at a 0.8%-16% rate.

4. Oregon — $28,849

Average funeral expenses: $10,418
Average end-of-life medical costs: $18,430

There’s no inheritance tax in Oregon, but if you own property in the Beaver State, plan your estate carefully — those worth more than $1 million will be taxed at a 10%-16% rate. Funeral expenses average $10,418, and medical costs related to death tend to be around $18,430.

3. New York — $29,902

Average funeral expenses: $10,799
Average end-of-life medical costs: $19,103

In New York, you won’t pay an inheritance tax, but estates worth more than $5.25 million are taxed at a 3.06%-16% rate. Funeral expenses average $10,799, and medical costs correlated with dying are $19,103.

2. California — $32,611

Average funeral expenses: $11,777
Average end-of-life medical costs: $20,834

Though it’s the second-most expensive state to die in, California doesn’t levy an estate tax or an inheritance tax. The standard cost of funeral activities is around $11,777, and medical expenses related to dying average $20,834.

1. Hawaii — $41,467

Average funeral expenses: $14,975
Average end-of-life medical costs: $26,492

Death in Hawaii is by far the priciest among all the states, as funeral costs average $14,975 and the benchmark for medical expenses correlated with end-of-life care is $26,492. The Aloha State doesn’t have an inheritance tax, but estates worth more than $11.2 million are taxed at a 10%-15.7% rate.

Where You Die Impacts the Financial Burden You Leave Behind

Fortunately for people who have to face the death of a loved one, many states don’t add an additional financial burden on the deceased’s family by levying taxes. However, this wasn’t always the case, as many states have removed estate and inheritance taxes in recent years. Others have left taxes in place but raised the exemption levels:

  • Indiana repealed its inheritance tax in 2013.
  • Tennessee repealed its estate tax in 2016.
  • New York raised its exemption level to $5.25 million and will match the federal exemption level in 2019.
  • New Jersey fully phased out its estate tax in 2018.
  • Delaware repealed its estate tax in 2018.

Overall, the cheapest places to die are Mississippi, Arkansas, Oklahoma, Missouri and New Mexico. The most expensive places to die are Hawaii, California, New York, Oregon and Massachusetts.

Complete Article HERE!

What happens as we die?

As with birth, dying is a process. How does it unfold? Can you prepare for it? And why should you keep talking to a dying person even if they don’t talk back?

By Sophie Aubrey

We’re born, we live, we die. Few things are so concrete. And yet, while we swap countless stories about the start of life, the end is a subject we’re less inclined to talk about.

Conversations about death – what it is, what it looks like – are scarce until we suddenly face it head on, often for the first time with the loss of a loved one.

“We hold a lot of anxiety about what death means and I think that’s just part of the human experience,” says Associate Professor Mark Boughey, director of palliative medicine at Melbourne’s St Vincent’s Hospital. “Some people just really push it away and don’t think about it until it’s immediately in front of them.”

But it doesn’t need to be this way, he says.

“The more people engage and understand death and know where it’s heading … the better prepared the person is to be able to let go to the process, and the better prepared the family is to reconcile with it, for a more peaceful death.”

Of course, not everyone ends up in palliative care or even in a hospital. For some people, death can be shockingly sudden, as in an accident or from a cardiac arrest or massive stroke. Death can follow a brief decline, as with some cancers; or a prolonged one, as with frailty; or it can come after a series of serious episodes, such as heart failure. And different illnesses, such as dementia and cancer, can also cause particular symptoms prior to death.

But there are key physical processes that are commonly experienced by many people as they die – whether from “old age”, or indeed from cancer, or even following a major physical trauma.

What is the process of dying? How can you prepare for it? And how should you be with someone who is nearing the end of their life?

What are the earliest signs a person is going to die?

The point of no return, when a person begins deteriorating towards their final breath, can start weeks or months before someone dies.

Professor Boughey says refractory symptoms – stubborn and irreversible despite medical treatment – offer the earliest signs that the dying process is beginning: breathlessness, severe appetite and weight loss, fluid retention, fatigue, drowsiness, delirium, jaundice and nausea, and an overall drop in physical function.

Simple actions, such as going from a bed to a chair, can become exhausting. A dying person often starts to withdraw from the news, some activities and other people, to talk less or have trouble with conversation, and to sleep more.

This all ties in with a drop in energy levels caused by a deterioration in the body’s brain function and metabolic processes.

Predicting exactly when a person will die is, of course, nearly impossible and depends on factors ranging from the health issues they have to whether they are choosing to accept more medical interventions.

“The journey for everyone towards dying is so variable,” Professor Boughey says.

What happens in someone’s final days?

As the body continues to wind down, various other reflexes and functions will also slow. A dying person will become progressively more fatigued, their sleep-wake patterns more random, their coughing and swallowing reflexes slower. They will start to respond less to verbal commands and gentle touch.

Reduced blood flow to the brain or chemical imbalances can also cause a dying person to become disoriented, confused or detached from reality and time. Visions or hallucinations often come into play.

“A lot of people have hallucinations or dreams where they see loved ones,” Professor Boughey says. “It’s a real signal that, even if we can’t see they’re dying, they might be.”

But Professor Boughey says the hallucinations often help a person die more peacefully so it’s best not to “correct” them. “Visions, especially of long-gone loved ones, can be comforting.”

Instead of simply sleeping more, the person’s consciousness may begin to fluctuate, making them nearly impossible to wake at times, even when there is a lot of stimulation around them.

With the slowing in blood circulation, body temperature can begin to seesaw, so a person can be cool to the touch at one point and then hot later on.

Their senses of taste and smell diminish. “People become no longer interested in eating … they physically don’t want to,” Professor Boughey says.

This means urine and bowel movements become less frequent, and urine will be much darker than usual due to lower fluid intake. Some people might start to experience incontinence as muscles deteriorate but absorbent pads and sheets help minimise discomfort.

What happens when death is just hours or minutes away?

As death nears, it’s very common for a person’s breathing to change, sometimes slowing, other times speeding up or becoming noisy and shallow. The changes are triggered by reduction in blood flow, and they’re not painful.

Some people will experience a gurgle-like “death rattle”. “It’s really some secretions sitting in the back of the throat, and the body can no longer shift them,” Professor Boughey says.

An irregular breathing pattern known as Cheyne-Stokes is also often seen in people approaching death: taking one or several breaths followed by a long pause with no breathing at all, then another breath.

“It doesn’t happen to everybody, but it happens in the last hours of life and indicates dying is really front and centre. It usually happens when someone is profoundly unconscious,” Professor Boughey says.

Restlessness affects nearly half of all people who are dying. “The confusion [experienced earlier] can cause restlessness right at the end of life,” Professor Boughey says. “It’s just the natural physiology, the brain is trying to keep functioning.”

Circulation changes also mean a person’s heartbeat becomes fainter while their skin can become mottled or pale grey-blue, particularly on the knees, feet and hands.

Professor Boughey says more perspiration or clamminess may be present, and a person’s eyes can begin to tear or appear glazed over.

Gradually, the person drifts in and out or slips into complete unconsciousness.

How long does dying take? Is it painful?

UNSW Professor of Intensive Care Ken Hillman says when he is treating someone who is going to die, one of the first questions he is inevitably asked is how long the person has to live.

“That is such a difficult question to answer with accuracy. I always put a rider at the end saying it’s unpredictable,” he says.

“Even when we stop treatment, the body can draw on reserves we didn’t know it had. They might live another day, or two days, or two weeks. All we know is, in long-term speaking, they certainly are going to die very soon.”

But he stresses that most expected deaths are not painful. “You gradually become confused, you lose your level of consciousness, and you fade away.”

Should there be any pain, it is relieved with medications such as morphine, which do not interfere with natural dying processes.

“If there is any sign of pain or discomfort, we would always reassure relatives and carers that they will die with dignity, that we don’t stop caring, that we know how to treat it and we continue treatment.”

Professor Boughey agrees, saying the pain instead tends to sit with the loved ones.

“For a dying person there can be a real sense of readiness, like they’re in this safe cocoon, in the last day or two of life.”

Professor Boughey believes there is an element of “letting go” to death.

“We see situations where people seem to hang on for certain things to occur, or to see somebody significant, which then allows them to let go,” he says.

“I’ve seen someone talk to a sibling overseas and then they put the phone down and die.”

How can you ‘prepare’ for death?

Firstly, there is your frame of mind. In thinking about death, it helps to compare it to birth, Professor Boughey says.

“The time of dying is like birth, it can happen over a day or two, but it’s actually the time leading up to it that is the most critical part of the equation,” he says.

With birth, what happens in the nine months leading to the day a baby is born – from the doctor’s appointments to the birth classes – can make a huge difference. And Professor Boughey says it’s “absolutely similar” when someone is facing the end of life.

To Professor Hillman, better understanding the dying process can help us stop treating death as a medical problem to be fixed, and instead as an inevitability that should be as comfortable and peaceful as possible.

Then there are some practicalities to discuss. Seventy per cent of Australians would prefer to die at home but, according to a 2018 Productivity Commission report, less than 10 per cent do. Instead, about half die in hospitals, ending up there because of an illness triggered by disease or age-related frailty (a small percentage die in accident and emergency departments). Another third die in residential aged care, according to data from the Australian Institute of Health and Welfare.

Professor Hillman believes death is over-medicalised, particularly in old age, and he urges families to acknowledge when a loved one is dying and to discuss their wishes: where they want to die, whether they want medical interventions, what they don’t want to happen.

“[Discussing this] can empower people to make their own decisions about how they die,” says Professor Hillman.

Palliative Care Nurses Australia president Jane Phillips says someone’s end-of-life preferences should be understood early but also revisited throughout the dying process as things can change. With the right support systems in place, dying at home can be an option.

“People are not being asked enough where they want to be cared for and where they want to die,” Professor Phillips says. “One of the most important things for families and patients is to have conversations about what their care preferences are.”

How can you help a loved one in their final hours?

Studies show that hearing is the last sense to fade, so people are urged to keep talking calmly and reassuringly to a dying person as it can bring great comfort even if they do not appear to be responding.

“Many people will be unconscious, not able to be roused – but be mindful they can still hear,” Professor Phillips says.

“As a nurse caring for the person, I let them know when I’m there, when I’m about to touch them, I keep talking to them. And I would advise the same to the family as well.”

On his ICU ward, Professor Hillman encourages relatives to “not be afraid of the person on all these machines”.

“Sit next to them, hold their hands, stroke their forehead, talk to them about their garden and pets and assume they are listening,” he says.

Remember that while the physical or mental changes can be distressing to observe, they’re not generally troubling for the person dying. Once families accept this, they can focus on being with their dying loved one.

Professor Boughey says people should think about how the person would habitually like them to act.

“What would you normally do when you’re caring for your loved one? If you like to hold and touch and communicate, do what you would normally do,” he says.

Other things that can comfort a dying person are playing their favourite music, sharing memories, moistening their mouth if it becomes dry, covering them with light blankets if they get cold or damp cloths if they feel hot, keeping the room air fresh, repositioning pillows if they get uncomfortable and gently massaging them. These gestures are simple but their significance should not be underestimated.

What is the moment of death?

In Australia, the moment of death is defined as when either blood circulation or brain function irreversibly cease in a person. Both will eventually happen when someone dies, it’s just a matter of what happens first.

Brain death is less common, and occurs after the brain has been so badly damaged that it swells, cutting off blood flow, and permanently stops, for example following a head injury or a stroke.

The more widespread type of death is circulatory death, where the heart comes to a standstill.

After circulation ceases, the brain then becomes deprived of oxygenated blood and stops functioning.

The precise time it takes for this to happen depends on an individual’s prior condition, says intensive care specialist Dr Matthew Anstey, a clinical senior lecturer at University of Western Australia.

“Let’s say you start slowly getting worse and worse, where your blood pressure is gradually falling before it stops, in that situation your brain is vulnerable already [from reduced blood flow], so it won’t take much to stop the brain,” Dr Anstey says.

“But if it’s a sudden cardiac arrest, the brain could go on a bit longer. It can take a minute or two minutes for brain cells to die when they have no blood flow.”

This means, on some level, the brain remains momentarily active after a circulatory death. And while research in this space is ongoing, Dr Anstey does not believe people would be conscious at this point.

“There is a difference between consciousness and some degree of cellular function,” he says. “I think consciousness is a very complicated higher-order function.”

Cells in other organs – such as the liver and kidneys – are comparatively more resilient and can survive longer without oxygen, Dr Anstey says. This is essential for organ donation, as the organs can remain viable hours after death.

In a palliative care setting, Professor Boughey says the brain usually becomes inactive around the same time as the heart.

But he says that, ultimately, it is the brain’s gradual switching off of various processes – including breathing and circulation – that leads to most deaths.

“Your whole metabolic system is run out of the brain… [It is] directing everything.”

He says it’s why sometimes, just before death, a person can snap into a moment of clarity where they say something to their family. “It can be very profound … it’s like the brain trying one more time.”

What does a dead person look like?

“There is a perceptible change between the living and dying,” Professor Boughey says.

“Often people are watching the breathing and don’t see it. But there is this change where the body no longer is in the presence of the living. It’s still, its colour changes. Things just stop. And it’s usually very, very gentle. It’s not dramatic. I reassure families of that beforehand.”

A typical sign that death has just happened, apart from an absence of breathing and heartbeat, is fixed pupils, which indicate no brain activity. A person’s eyelids may also be half-open, their skin may be pale and waxy-looking, and their mouth may fall open as the jaw relaxes.

Professor Boughey says that only very occasionally will there be an unpleasant occurrence, such as a person vomiting or releasing their bowels but, in most cases, death is peaceful.

And while most loved ones want to be present when death occurs, Professor Boughey says it’s important not to feel guilty if you’re not because it can sometimes happen very suddenly. What’s more important is being present during the lead-up.

What happens next?

Once a person dies, a medical professional must verify the death and sign a certificate confirming it.

“It’s absolutely critical for the family to see … because it signals very clearly the person has died,” says Professor Boughey. “The family may not have started grieving until that point.”

In some cases, organ and tissue donation occurs, but only if the person is eligible and wished to do so. The complexity of the process means it usually only happens out of an intensive care ward.

Professor Boughey stresses that an expected death is not an emergency – police and paramedics don’t need to be called.

After the doctor’s certificate is issued, a funeral company takes the dead person into their care and collects the information needed to register the death. They can also help with newspaper notices or flowers.

But all of this does not need to happen right away, Professor Boughey says. Do what feels right. The moments after death can be tranquil, and you may just want to sit with the person. Or you might want to call others to come, or fulfil cultural wishes.

“There is no reason to take the body away suddenly,” Professor Boughey says.

You might feel despair, you might feel numb, you might feel relief. There is no right or wrong way to feel. As loved ones move through the grieving process, they are reminded support is available – be it from friends, family or health professionals.

Complete Article HERE!

Living with death

Joan Pillsbury attaches the supports for the handles from the inside of the coffin during the coffin building workshop last month.


The only guarantees in life are taxation and death, according to Benjamin Franklin. For Ellen Arrison of New Salem, that reality is literally sitting inside her living room right now — in the form of a rectangular pinewood coffin.

“I hope it has lots of coffee rings and wine stains on it before I have to use it,” said Arrison, who was one of a dozen participants who took part in a recent coffin-making workshop in Greenfield that was co-sponsored by was co-sponsored by Green Burial Massachusetts and the Funeral Consumers Alliance of Western Massachusetts. According to Arrison, an experienced hospice nurse, making a coffin “made death more real” and caused her to confront end-of-life questions — a subject that she says is taboo in western culture.

“We’re all going to die, but we don’t believe it. Part of life is appreciating the time there is,” said Arrison. Housing the coffin in her living room serves as “a conversation starter” and is a constant reminder of her own mortality. She intends to keep it there until it needs to be used for its intended purpose.

“I knew I wanted a green burial, so that’s part of it too,” Arrison said. “I live in a rural area and I’d like to be buried in my own land. I love it and I’ve spent a lot of time and energy and money — I’d like to give back to the land.”

The coffin making workshop, which was led by Joan Pillsbury of Greenfield, treasurer of Green Burial Massachusetts, a nonprofit advocacy group, cost $210 and covered about two to three hours. Participants made “quick coffins” with pine provided by carpenter Chuck Lakin of Waterville, Maine, who also provided the tools and oversaw the construction process, Pillsbury said. The workshop drew people from varied walks of life.

“Everyone’s skilled were varied. Some people had no experience with tools, some could have finished the project in an hour,” Lakin said. “I tried to explain and guide people through the process.”

Afterward, the group, like pallbearers, “made a ceremony out of carrying their coffins to their vehicles,” Lakin said.“Everyone would carry a coffin to someone’s car, then that person would drive and park. Then they would do the same thing with someone else’s coffin. It must have been a sight for someone just passing by.”

Don Joralemon, a retired Smith College anthropology professor, is keeping his coffin in the basement of his home in Conway. He said he decided to make a coffin because he “isn’t a fan of the funeral industry” and he wanted to take the burden away from his family when the time comes.

“I hope to make use of it in land in Conway,” Joralemon said. “It’s a simple process. You have to get permission from the Board of Health and there needs to be a permanent indication that there’s a grave on the property.”
He said the experience of building the coffin was wonderful and he would recommend it to anyone.

The craft of coffin making

Before making coffins, Lakin, who said he’s been a woodworker since he was 26 when he got out of the United States Navy, made a living as a librarian at Colby College. When his father was dying, Lakin said he spent the last six weeks of his life surrounded by family and loved ones. It was a very personal and moving experience, Lakin said.

“He was in his own bed with each of his family touching him when he passed,” he recalled.

After, his family called a funeral home and his father’s body was taken away.

“He was hauled away and I hated it because it had been so personal and all of a sudden he was gone,” said Lakin.

Later on, Lakin read a manual about how to take care of a loved one after they have died. The book included instruction on how to wash, present and bury someone after death. Before, Lakin noted, “I hadn’t thought of what was next.”

“That’s when I began talking about these things with people,” he continued. “Not to convince them of what to do, but to provide information so they can have the experience I wanted to have.”

He decided to try his hand at making coffins so that others wouldn’t experience the emptiness that he felt. These days, Lakin says he makes between three and five coffins a year and uses the money he makes to travel to events throughout Maine and talk about the options people have funerals.

“People have no idea they have as many options as they do,” Lakin said.

He met Pillsbury at one of these events, the annual Funeral Consumers of Maine, and agreed to hold the coffin-making workshop. If there was enough interest, Lakin says he’d be willing to put on another workshop in the future.

A healing endeavor

For Lakin and the workshop participants, building the coffins was a way of confronting their mortality head-on. According to Lakin, Americans are proficient at ignoring the reality that they are going to die someday.

“You have to recognize and admit it is going to happen,” Lakin said. “It’s a natural part of life; there’s a transition in and there’s a transition out. It happens to everyone. … Your attitude toward it and preparation makes all the difference. It turns what could be a tragedy into a spiritual experience.”

Lakin was speaking from personal experience. When his wife, Penny, died in 2017, Lakin held the funeral at their home. He said he wife was in their house for the last five weeks of her life and, for the duration of those weeks, it was like a “long party.”

“We have a good support group, and we told them to stop by anytime,” Lakin said. “Sometimes there would be 12 people in the living room.”

After her death, Lakin said that two of her best friends anointed and dressed the body. Lakin built her coffin and invited guests to come over and draw and write messages on it. Then after four days, which included a time to display the body, they held a burial ceremony followed by dinner at her favorite restaurant.

“We offered people the ability to do something physical — writing or drawing something — to help them (grieve),” said Lakin. “They were grieving and I don’t think they knew what they were going through.”

Arrison had a similar experience with a home burial as a child after a friend’s grandfather died.

“He was laid out in the living room for three days,” Arrison said, noting, “I, personally, find the idea of viewing a body when it’s presented in an artificial way macabre. It makes it seem disconnected in some way.”

Green burials and the death positive movement

The term “death positive” might seem like an oxymoron, but those who are a part of a growing movement of the same name say it’s an effort to demystify mortality in American culture.

Joralemon, the retired Smith professor who attended the workshop, covered the topic in his book titled “Mortal Dilemmas: The Troubled Landscape of Death in America.” Americans have made death into a taboo subject, he says. But it hasn’t always been that way.

“It didn’t use to be so bad. Deaths would happen in the home. The body would be washed, coffins would be made by a carpenter. It wasn’t a surprise or taboo,” Joralemon said. “Then the profession of funeral director was made when more people were dying in hospitals.”

In contrast to culture’s perspectives on death, he said it’s imperative that people confront their own mortality.

“Life is a transformation and death is part of it,” Joralemon said. “Bit by bit, hopefully, we can start to recover the comfort with death and celebrate the moments before that.”

Along with the workshop, Arrison noted that her experience as a nurse has helped normalize the idea of death.

“I did hospice care for some time and I’ve been with people in the process of dying,” Arrison said. “It was valuable and a privilege. It also makes the inevitability (of death) more real. It’s familiar when it’s happening to someone else. I think that the experience is not difficult or frightening, it’s interesting and curious.”

“You get a health care proxy, a will, build your coffin,” Arrison said. “These activities take some of the dread out of it. It normalizes it and you appreciate the time you have — it’s a procrastination deterrent.”

More than preparation for the end of her life, knowing that she’s going to die someday “softens my heart,” Arrison said. “I know that every person is going to die, too. It enhances the experience of life. I have a more positive perspective. It’s actually life-affirming.”

Lakin said he learned about the term “death positive” from Caitlin Doughty, a mortician and funeral home director in Los Angeles, California, who made videos answering questions about death and dying.

“She started by answering people’s basic questions about death, then she ran out of common questions and had to look for topics,” Lakin said. “I found it informative and entertaining because she has a sarcastic sense of humor. I don’t think she coined the term ‘death positive,’ but I think she popularized it.”

He said the death positive movement coincides with a similar trend called the “green burial movement.” Both stress a more personal quality to end-of-life care.

Green Burial Massachusetts is a grassroots organization that educates people about green burials — where a person is not embalmed and put into a coffin or shroud that will biodegrade along with the body. The person is buried about 3 ½ feet in the ground, where aerobic decomposition can occur.

“A burial will happen on a piece of land 3 ½ feet under the ground, where the person isn’t embalmed and there’s no concrete,” Lakin said. “Everything is biodegradable — the person can be buried in a shroud, a coffin, a cardboard box. They also typically use stone from the area as monuments, engraved with the names and dates.”

Joralemon said his philosophies align with the green burial movement because “this is what we did for millennia and there’s no reason not to set aside land for people who would like a green burial.”

Complete Article HERE!

3 Benefits Of Thinking About Your Mortality At Least Once A Day

By Shoshana Ungerleider, M.D.

As a culture, Americans—more often than not—have a tendency to avoid thinking and talking about death and dying. Yet pondering our mortality can have a profound impact on our lives.

Our health care system is set up with a single, default pathway for all medical care: aggressive, invasive treatment, no matter how old or how sick you are. For some people, this makes perfect sense and can save lives. For others, a different approach to care is required. But it starts with having a relationship with our own mortality and reflecting on what matters most in our own lives. I have seen far too many people suffer by receiving treatment that is not in line with their goals and values.

In our modern era of fast-paced life, constant digital connectedness, and a culture striving to be “doing” all the time, it’s easy to get caught up in things that don’t matter. If we can reflect on the bigger picture in life, the preciousness of each moment, we can more easily let go of things that aren’t important. I believe there are three key benefits to thinking about our mortality at least once a day:

1. You’ll be motivated to leave a legacy.

Ask yourself, what do you want to leave behind? The idea of legacy awareness is a way to connect with our own mortality as it relates to our work, loved ones, and creative endeavors. If we think about legacy as a means to transcend death, we may be more likely to invest in our health and personal development throughout life. 

Artists, for example, live on long after they’re gone thanks to their creative legacy. That’s just one way of forming a legacy. Whether you are creating art, giving back to your community, raising a family, or making a positive impact on the lives of others, these are all powerful ways to leave a legacy for generations to come.

2. Life will instantly feel more precious.

Too much of a good thing decreases its value. Life is precious. It’s also temporary. Even when you’re young and healthy, your life could end unexpectedly at any time. Recognizing that life is fleeting helps us find joy and meaning in the small things—sunset and sunrise, a smile on your child’s face, a tree in the park—that sometimes get lost in the day-to-day. The people in your life can take on a new value because we realize that their lives are also temporary.

3. You’ll learn not to sweat the small stuff.

Thinking about our mortality can serve as inspiration to think more holistically about what it means to live our best life. In other words, it can move us to exercise and eat well because we only get one body. And at the same time, it’s an invaluable reminder that we only get one life, and we better enjoy it. So many of us are on a quest to find balance in our lives and define our own priorities. Remembering that we have this one life to live can help when weighing where we want to put our energy and attention.

Countless psychological studies have shown that a recognition of our own eventual ending can allow us to live a richer life—one filled with gratitude, presence of mind, and happiness. As you go through the checklist of factors contributing to your overall well-being—getting quality sleep, eating healthy food, exercising regularly, and sustaining meaningful relationships—make sure that forming a relationship with your own mortality is high on the list.

No one knew how important this practice was better than Apple’s Steve Jobs who, during his 2005 commencement speech at Stanford University, said, “Almost everything—all external expectations, all pride, all fear of embarrassment or failure—these things just fall away in the face of death, leaving only what is truly important.”

If contemplating your mortality triggers fear, consider this.

Does thinking about our own death trigger fear? According to the 2017 Survey of American Fears conducted by Chapman University, 20.3% of Americans are “afraid” or “very afraid” of dying. While for some, fear of death is healthy as it makes us more cautious (such as wearing seat belts and minimizing high-risk behaviors), some people may also have an unhealthy fear of dying, which interferes with their daily life.

Psychologist and spirituality expert Stephen Taylor looked at those who lost loved ones, and many tend to have a more accepting attitude toward death. This may result from “post-traumatic growth,” or personal growth from trauma. Others suggest that much of our fear of death stems from not wanting to lose the things we’ve built up (i.e., relationships, possessions, or status). By letting go (even a little) of fierce attachments, it can allow for valuable shifts in perspective and benefits to our well-being. 

My friend and colleague, B.J. Miller, M.D., puts this in a different light. “Death is not at odds with living. You can’t get one without the other.” Whether we like it or not, death is always present. Connecting to the fact that life is defined by the fact that it will end one day will allow you to live more fully, experience deeper relationships, and provide new meaning to your days.

Next time you have the opportunity to reflect on your mortality, think about how it might enrich your life today.

Complete Article HERE!

Five Wishes

A Simple Tool to Write Your Living Will

By Taylor Schulte, CFP,

End-of-life planning is more than just what kind of care you want in your final days. It’s about such personal choices as who you want with you when the time comes and what will bring you and your family comfort and peace.

As a financial adviser, one thing I do is assist my clients with end-of-life documents that determine how their estates will be handled upon death. But there’s more to end-of-life planning than deciding who gets what and minimizing estate and inheritance taxes. There are also the emotional aspects of death to deal with … and those details can be more important than anything else.

Want proof? Ask anyone on their deathbed what they really want people to know.

Chances are good their answers will have nothing to do with the S&P 500 or the size of their portfolio. Instead, final thoughts tend to be about loved ones, missed opportunities and forgiveness for things that cannot be undone.

This is where Five Wishes comes in and why I interviewed Paul Malley — president of Aging with Dignity, the organization that created Five Wishes — on the Stay Wealthy Retirement Podcast.

In case you’ve never heard of it, Five Wishes is a document that lets you decide your final wishes as well as how you’ll be treated if you ever become seriously ill. The main point of Five Wishes is letting you make decisions about the end of your life just in case you cannot make them yourself. After all, you may wind up knowing months ahead of time that you’re at death’s door, but the worst can also happen in the blink of an eye.

How Does Five Wishes Work?

Think of it as a living will — or as a conversation piece you can use to collect all your end-of-life wishes in a single place. Five Wishes is a legal document in all states but eight. Alabama, Indiana, Kansas, New Hampshire, Ohio, Oregon, Texas and Utah all require their own official documentation.

Once you get started filling out your own Five Wishes document, you’ll have many important decisions to make. For example, you’ll be asked to name someone you trust to act as your health care agent, but you’ll also be asked to leave instructions for the types of medical care you want (and don’t want).

In addition, you get to make decisions surrounding your comfort, your dignity and other requests you have — no matter how specific they are.

Paul Malley told me during our interview that often the questions that seem the least important wind up impacting families most. Examples include questions regarding pain management and what it takes for someone to feel comfortable, clean and warm.

For example, would you rather die at home if given the choice? Do you want music playing? Do you want people with you?

“Those little things may sound small, but I can tell you from the messages we receive that this is where the true gift is,” says Malley.

Five Wishes in Practice

Malley says he has heard many stories over the years that have proven just how important having a living will is, but one that comes to mind involves a gentleman who had a stroke and became incapacitated overnight. After speaking to the wife of this man (let’s call her Mrs. Smith) once final arrangements were made, Malley learned all the different ways Five Wishes made Mr. Smith’s passing more bearable.

After her husband’s first day in intensive care, for example, Mrs. Smith noticed in her husband’s Five Wishes profile that he wanted pictures of his grandchildren in the room. Reading that detail, she suddenly felt good about leaving him long enough to go home and get cleaned up, knowing she could bring back all the family photos he wanted to be surrounded with.

At one point, there was a disagreement among her children over whether their father should be taken off life support. But thanks to the details in the Five Wishes document, the entire family learned together that he didn’t want to remain on life support if doctors were sure he would never “come back.”

Thanks to Five Wishes, they all left the room in agreement to do “what dad wanted” — a result Mrs. Smith says would have been unlikely if her husband hadn’t formally expressed his wishes himself.

Finally, Mr. Smith had taken the time to note in his living will that his family members should make peace with each other before he died. The couple’s two sons spoke after a long-term estrangement as a result, which brought Mrs. Smith an immense amount of peace at a very trying time. Not only did she get to see her sons begin speaking again, but she knew her husband’s final wishes were being fulfilled.

This is a good example of how a living will can be much more than a legal document — it can be something that “hits in the heart and soul,” says Malley.

In the end, Five Wishes helps us understand that life is about a lot more than money.

How to Get Started with Five Wishes

If you’re on board with creating a legal document that contains this important information, there’s no reason to delay creating a Five Wishes document as soon as you can — and no matter your age. Unfortunately, it can be difficult to get your family to talk about death in any capacity when they’re just not ready to or have no desire to.

Malley says sometimes it takes several tries for people to get their parents or spouse to make end-of-life decisions regarding their health care, their comfort and their final wishes — but it’s important enough that it’s worth trying as many times as it takes.

If you’re worried about how your family members will react if you broach the subject, consider filling out your own Five Wishes document then asking your family members to talk it over with you. This may prompt them to think over what they will want when the time comes, and it can be a “softer approach” that makes it easier to bring up matters as sensitive as death.

Whether for yourself or someone else, you can access a few different versions of Five Wishes — a hard copy format or an online version. Both options are $5 each, although you can order Five Wishes for as little as $1 per document with a minimum order of 25.

Malley says that, if you already have an advance directive set up, you can use Five Wishes in conjunction with your other documents. Still, you should take the time to go over all your end-of-life information, but especially if your situation has changed over the years — if you were divorced, remarried or your health has deteriorated.

If you live in a state where Five Wishes isn’t recognized as a legal document, you can still fill it out and use it alongside with your state’s form. Fives Wishes even offers specific instructions on how to use both your state form and this document successfully on their FAQ page.

The Bottom Line

At the end of the day, people should be able to explain their end of life wishes in their own words, says Malley. They should be given the time and space to decide how they want the end of their life to look, what kind of care they want to receive, and who they want by their side.

When you don’t make these decisions ahead of time, you’re agreeing to let the chips fall where they may. This may or may not work in your favor, but one thing is for certain — you won’t get a second chance.

Complete Article HERE!