End-Of-Life Planning Is A ‘Lifetime Gift’ To Your Loved Ones

By Kavitha Cardoza

Talking about death makes most of us uncomfortable, so we don’t plan for it.

That’s a big mistake, because if you don’t have an end-of-life plan, your state’s laws decide who gets everything you own. A doctor you’ve never met could decide how you spend your last moments, and your loved ones could be saddled with untangling an expensive legal mess after you die.

Betsy Simmons Hannibal, a senior legal editor at legal website Nolo, puts it this way: Planning for the end of life isn’t about you. “You’re never going to really get the benefit of it. So you might as well think about how it’s going to be a lifetime gift that you’re giving now to your parents or your partner or your children. It really is for the people you love.”

Here are some simple, practical steps to planning for the end of life. These tips aren’t meant to be legal or medical advice, but rather a guide to ease you into getting started.

1. Name an executor.

If you’re an adult, you should have a will, says Hannibal. Estate planning is not just for the rich. “It’s not just about the value of what you own. It’s also the feelings that you and your loved ones have about what you own.”

If you own lots of valuable stuff — real estate, trust funds, yachts — you probably need a lawyer. But for most of us, a simple document could do. Your state or county bar associations usually keep a list of lawyers who do this pro bono. Or you could download an online form like Quicken WillMaker & Trust for less than $100. (Full disclosure: Hannibal works for Nolo, which owns Quicken WillMaker & Trust.)

She says the first thing you do is name (in writing) a person whom you trust to take care of everything when you die. In most states that person is called an executor; in some they’re called a personal representative.

Hannibal says it’s a good idea to choose someone from your family. “The most important thing is that you have a good relationship with them — and also that they have a good attention to detail, because it’s a lot of work to be someone’s executor.”

An executor would have to, for example, find all your financial assets and communicate with everyone you’ve named in your will. It’s a big ask, so Hannibal says just be upfront. She suggests asking the person directly, “Would you be comfortable wrapping up my estate when I die?”

2. Take an inventory.

List everything you own, not just things that are financially valuable — such as your bank accounts, retirement savings or car — but also those things that have sentimental value: a music or book collection, jewelry, furniture. Then list whom you want to leave what to.

If you have young children, name a guardian for them. Choose carefully, because that person will be responsible for your child’s schooling, health care decisions and value system.

Hannibal says pets are considered property under the law, so she suggests naming a new owner so that the state doesn’t do it for you.

Digital accounts are also part of your property. This includes social media accounts, online photos, everything in, say, your Google Drive or iCloud, online subscriptions, dating site profiles, credit card rewards, a business on Etsy or Amazon. Hannibal suggests keeping a secure list of all those accounts and the login and password details. Let your executor know where the list is.

Just as you write out specific instructions about your physical belongings, be clear about what you’d like to happen with your online information.

She says it’s better not to have a handwritten will, because proving you wrote it will require a handwriting expert. So keep it simple. Just type out your wishes and have two witnesses watch you sign and date it. Then have them do the same. Hannibal says by signing it, “they believe that the person who made the will is of sound mind, and that’s a pretty low bar.”

You don’t need to file your will anywhere; neither do you need to get it notarized for it to be legally binding. And don’t hide it. Hannibal says just tell your executor where you’ve kept a copy.

Remember that your decisions will change over time. So if you have a child, buy a house or fall out with a family member, update your will.

3. Think about health care decisions.

Your will takes care of what happens after you die. An advance directive is a legal document that covers health care and protects your wishes at the end of your life.

There are two parts to an advance directive. The first is giving someone your medical power of attorney so the person can make decisions for you if you can’t. The other part is called a living will. That’s a document where you can put in writing how you should be cared for by health professionals.

Jessica Zitter is an ICU and palliative care physician in Oakland, California. She says that we’ve become experts at keeping people alive but that quality of life can be forgotten.

She has seen thousands of situations of loved ones making difficult and emotional decisions around a hospital bed. It’s worse when family members disagree about a course of action.

You know the saying “The best time to plant a tree was 20 years ago. The second best time is now”? Zitter says with the coronavirus in the news every day, more people are realizing that these end-of-life conversations are important. “That tree was always important to plant. But now we really have a reason to really, really plant it. … That time is now.”

You may have heard of Five Wishes, which costs $5 and will walk you through choices, or Our Care Wishes, which is free.

4. Name a medical proxy.

Pallavi Kumar is a medical oncologist and palliative care physician at the University of Pennsylvania. Kumar says the most important medical decision you can make is to choose a person who can legally make health care decisions for you if you can’t. This person is sometimes called a medical proxy or a health care agent. Naming the person is the first part of the advance directive.

“Think about the person in your life who understands you, your goals, your values, your priorities and then is able to set aside their own wishes and be a voice for you,” she says. You want someone you trust who can handle stress, in case your loved ones disagree on what to do.

5. Fill out a living will.

After you’ve chosen your medical proxy (and named a backup), you need to think about what kind of care you want to receive. There’s no right or wrong; it’s very personal. The document that helps you do that is called a living will. It’s part two of the advance directive.

A living will addresses questions such as “Would you want pain medication?”; “Do you want to be resuscitated?”; and “Would you be OK being hooked up to a ventilator?”

Kumar says she asks her patients what’s important to them and what their goals are. For some with young children, it means trying every treatment possible for as long as possible, no matter how grueling.

“They would say, ‘If you’re telling me that a chemotherapy could give me another month, I want that month. Because that’s another month I have with my 6-year-old.’ ”

Other patients might want the exact opposite. “They would say, ‘I’ve gone through a lot of treatments and I … feel I’m not having as many good days with my kids. So if the disease gets worse, I want to spend that time at home.’ ”

Kumar says even among patients who are very sick with cancer, fewer than half have had conversations about how they want to die. So talk about your wishes. Once you’ve filled out the advance directive forms, share your decisions with your medical proxy, your loved ones and your doctor.

6. Don’t forget the emotional and spiritual aspects of death.

How you want to die is personal and about much more than just the medical aspect. For some, it’s about being at peace with God; for others, it’s being kept clean. Still others don’t want to be left alone, or they want their pets close by.

Angel Grant and Michael Hebb founded the project Death Over Dinner to make it easier for people to talk about different aspects of death as they eat. “The dinner table is a very forgiving place for conversation. You’re breaking bread together. And there’s this warmth and connection,” says Grant.

Some of the emotional and spiritual questions people talk about are “You were just in a big quake and death is imminent. What are you concerned about not having done?”; “What do you want to be remembered for?”; and “If you could have any musician play at your funeral, who would it be?”

Grant says reflecting on death automatically forces you to think about your life. “That’s the magic of it,” she says.

“We think it’s going to be morbid and heavy. But what these conversations do is they narrow down our understanding of what matters most to us in this life, which then gives us actionable steps to go forward living.”

Grant doesn’t believe a “good death” is an oxymoron. “A good death is subjective, but there are some things that I have heard over and over again for many years at death dinners. … A good death is being surrounded by love, knowing you have no emotional or spiritual unfinished business.”

Complete Article HERE!

Last wishes and clear choices

– Learning how to talk about end-of-life care

Before patients can state their preferences about dying, they need to talk about them first.

By

Conversations around end-of-life medical care can be challenging. Consider someone I’ll call Mrs. Jones, an elderly patient with advanced heart disease. When her doctor asked her to discuss the kind of care she wanted to receive at the end of her life, Mrs. Jones said that she had devoted a lot of thought to the matter and had clear instructions she wanted her family to follow.

First Mrs. Jones wanted to be buried near her family – above ground – and she wanted her grave to be covered with yellow and white flowers. Second, she wanted to be laid out not in a dress but in her nightgown and robe. And finally, she wanted to be buried with a treasured photograph of her boyfriend, which showed a handsome young man in military uniform.

But her doctor was asking a different question. Specifically, she needed to know how Mrs. Jones wanted the medical team to care for her as she was dying. Mrs. Jones said that she hadn’t thought about end-of-life care, but she would like to learn more about her options.

After discussing the choices, Mrs. Jones expressed some clear preferences. “I know for a fact that I not want to undergo chest compressions, and I don’t want anyone using tubes to breathe for me or feed me.” Her doctor arranged for Mrs. Jones’ daughter to join the conversation. The conversation wasn’t easy – Mrs Jones and her daughter cried as they talked – but afterward they were grateful that they had shared everything so openly.

Shilpee Sinha, MD, Mrs. Jones’ doctor, has these conversations every day. She is the lead physician for palliative care at Methodist Hospital in Indianapolis, where she specializes in the care of dying patients. She also teaches medical students and residents how to provide better care for patients at the end of life.

Sinha is part of a relatively small cadre of such doctors nationwide. It is estimated that only about 4,400 doctors specialize in the care of terminally ill and dying patients. The US is currently facing a shortage of as many as 18,000 of these specialists. There is only one palliative care specialist for 20,000 older adults living with severe chronic illness.

On average, 6,800 Americans die every day. The majority of deaths are anticipated. Consider that about 1.5 million people enter hospice care each year. This means there is ample opportunity for many patients to talk with their doctors and family members about end-of-life care.

Before patients can explore and express their preferences about dying they first need to have a conversation like the one between Sinha and Mrs. Jones. In too many cases, no such conversation ever takes place. Patients often don’t know what to ask, or they may feel uncomfortable discussing the matter. And doctors may never broach the subject.

At one end of the spectrum, doctors can do everything possible to forestall death, including the use of chest compressions, breathing tubes, and electrical shocks to get the heart beating normally again. Of course, such actions can be traumatic for frail and dying patients. At the opposite end, doctors can focus on keeping the patient comfortable, while allowing death to proceed naturally.

And of course, end-of-life care can involve more than just making patients comfortable. Some patients lose the ability to eat and drink, raising the question of whether to use tubes to provide artificial hydration and feedings. Another issue is how aggressively to promote the patient’s comfort. For example, when patients are in pain or having trouble breathing, doctors can provide medications that ease the distress.

Another issue is ensuring that the patient’s wishes are followed. This does not always happen, as orders can be lost when patients are transferred between facilities such as hospitals and nursing homes.

Fortunately, most states across the country are beginning to make available a new tool that helps doctors and patients avoid such unfortunate outcomes. It is called POLST, for Physician Orders for Limiting Scope of Treatment. First envisioned in Oregon in the early 1990s, it grew out of a recognition that patient preferences for end-of-life care were too frequently not being honored. Typically, the doctor is the one to introduce POLST into the conversation, but there is no reason patients and family members cannot do so.

The cornerstone of the program is a one-page form known in Indiana as POST. It consists of six sections, including cardiopulmonary resuscitation (CPR); a range of other medical interventions, from admission to the intensive care unit to allowing natural death; antibiotics; artificial nutrition; documentation of the person with whom the doctor discussed the options; and the doctor’s signature.

The POST form helps to initiate and focus conversations between patients, families, and doctors around end-of-life care. It also fosters shared decision making, helping to ensure that all perspectives are taken into account, and ensuring that patient wishes are honored.

POST can be applied across all settings, from the hospital to the nursing home to the patient’s home. It can be scanned into the patient’s electronic medical record, ensuring that it is available to every health professional caring for the patient. And it does not require a notary or an attorney (or the associated fees), because it is a doctor’s order.

Of course, merely filling out the form is not enough. The patient’s wishes can be truly honored only if the patient and family understand the options, have the opportunity to pose questions, and trust that their wishes will be followed. In other words, POST achieves its purpose only if it is based on the kind of open and trusting relationship Dr. Sinha had developed with Mrs. Jones.

Providing such care isn’t easy. “Our health care system pays handsomely for curative care,” Sinha says, “but care at the end of life is probably the most poorly compensated kind that doctors provide. This can make it difficult to get hospitals and future doctors interested in it.” Thanks to initiatives such as POLST and doctors such as Sinha, however, such care is finally getting more of the attention it deserves.

Complete Article HERE!

Should diabetes treatment lessen for older adults approaching the end of life?

by American Geriatrics Society

One in four people aged 65 or older has diabetes. The disease is the seventh leading cause of death in the United States and a major contributor to heart disease. Experts have recommended that the best way to slow the progression of diabetes—and help prevent its many complications—is to maintain strict control of blood sugar levels. For healthy younger people, this means keeping the target blood sugar level (known as A1c or HbA1c) lower than 6.5 percent to 7.0 percent.

For older adults who have a limited life expectancy or who have advanced dementia, however, maintaining that target blood sugar level may cause more harm than good. For example, these older adults may not live long enough to experience potential benefits. What’s more, maintaining these strict blood sugar levels can raise the risk of potentially harmful events such as (also known as hypoglycemia). This can cause falls or loss of consciousness.

For these reasons, many guidelines now suggest targeting higher HbA1c targets—such as between 8.0 percent and 9.0 percent—for older adults who have multiple chronic conditions or limited life expectancy, or who live in nursing homes.

There is not much existing research to guide health care practitioners as to what the appropriate levels of diabetes medications are for this group of older adults. There is also little information about the effects for these individuals of taking fewer or lower dose of diabetes medications.

Experts suspect that lessening diabetes treatment in these older adults has the potential to prevent unnecessary hospitalizations due to lowering the risk for harmful drug events and increasing the patients’ comfort.

In order to investigate the issue, a team of researchers conducted a study—one of the first national studies to examine potential overtreatment and deintensification of diabetes management in nursing with limited life expectancy or dementia. The researchers chose nursing home residents to study because admission to a nursing home could give healthcare practitioners a chance to learn more about patient goals and preferences and to review and adjust medications accordingly. The researchers published their results in the Journal of the American Geriatrics Society.

The researchers examined information from Veterans Affairs nursing homes from 2009 to 2015. Their goal was to learn more about older adults with diabetes, particularly those nearing the end of their life or who have dementia. The researchers investigated whether these older adults were overtreated for diabetes, whether they had their diabetes medication regimens lessened, and what effects might result from lowered doses, types and/or different kinds of medication.

The researchers wanted to learn specifically how often diabetes treatments were lessened. Among the nursing home residents identified as potentially overtreated, the researchers examined how much their diabetes treatment regimens were lessened during the 90 days of follow-up.

The researchers did not consider insulin dose changes, because insulin doses may be influenced by factors such as eating habits.

The researchers said they observed potential overtreatment of diabetes in almost 44 percent of nursing home admissions for veterans with diabetes and veterans who had limited life expectancy or dementia. Potentially overtreated residents were about 78 years old and were nearly all male and non-Hispanic white. Two-thirds of the residents had been admitted to nursing homes from hospitals. A total of 29 percent had advanced dementia, almost 14 percent were classified with end-of-life status, and 79 percent had a moderately high risk of dying within six months. Many were physically dependent and had and/or potential diabetes-related complications. In addition, about 9 percent of overtreated residents had a serious low blood sugar episode in the year prior, emphasizing the need for deintensification.

Nearly half of residents received two or more diabetes medications, and those with higher HbA1c values of between 6.5 percent to 7.5 percent received more diabetes medications than those with lower HbA1c.

The researchers concluded that many veteran nursing home residents with limited life expectancy or dementia may be overtreated for their diabetes at the time of admission. The researchers suggested that future studies examine the impact of deintensification on health outcomes and adverse events to better understand the risks and benefits of management strategies in this group of .

Dealing with the Grief of What is Still to Come

Most, if not all of us, have a lingering sense that more loss is still to come.

By Sam Dylan Finch

Most, if not all of us, have a lingering sense that more loss is still to come.

While many of us might think of “grief” as being a response to losing someone we love, grief is actually a much more complex phenomenon.

Grappling with any kind of loss can involve a grief process, even if that loss isn’t exactly tangible.

There’s a lot to be grieving right now with the recent COVID-19 outbreak.

There’s a collective loss of normalcy, and for many of us, we’ve lost a sense of connection, routine, and certainty about the future. Some of us have already lost jobs and even loved ones.

And most, if not all of us, have a lingering sense that more loss is still to come. That sense of fearful anticipation is called “anticipatory grief,” and it can be a doozy.

A mourning process can occur even when we sense that a loss is going to happen, but we don’t know exactly what it is yet. We know the world around us will never be the same — but what exactly we’ve lost and will lose is still largely unknown to us.

This can be difficult to come to terms with.

If you’re wondering if you might be experiencing this kind of grief, here are some signs to look for, as well as some coping skills you can tap into at this time:

Maybe you’re feeling a sense of dread, as though something bad is just around the corner, but it’s unclear what it might be. (This is often described as “waiting for the other shoe to drop.”)

Hypervigilance is also a really common way this shows up. You might be scanning for possible “threats” — for example, reacting strongly whenever someone coughs or sneezes nearby, becoming agitated with a stranger who isn’t properly social distancing, or panicking whenever the phone rings.

This can also manifest as persistent anxiety and overwhelm, like “freezing up” when faced with decision making or planning, or procrastinating more often to avoid complex tasks.

If you’re anticipating danger or doom, it makes sense that staying emotionally regulated would be more challenging right now.

Finding yourself easily and persistently frustrated is a very common manifestation of grief.

For example, working from home might have previously felt like a luxury, but maybe now it feels more like a punishment. Not getting your preferred brand of boxed macaroni and cheese might not have felt like a big deal before, but suddenly you’re irate at your local store for not having ample stock.

If small obstacles suddenly feel intolerable, you’re not alone. These obstacles often serve as unconscious reminders that things aren’t the same — triggering grief and a sense of loss, even when we aren’t aware of it.

If you find yourself getting riled up more often, be gentle with yourself. This is a completely normal reaction during a time of collective trauma.

One of the ways that people often cope with anticipatory grief is to try to mentally and emotionally “prepare” for the worst case scenario.

If we pretend that it’s inevitable, we can trick ourselves into thinking it won’t feel so shocking or painful when it does come to that.

However, this is a bit of a trap. Ruminating about morbid scenarios, feeling hopeless as things unfold, or anxiously spinning out about everything that could go wrong won’t actually keep you safe — instead, it will just keep you emotionally activated.

In fact, chronic stress can impact your immune system in negative ways, which is why it’s so important to practice self-care during this time.

Preparedness is important, but if you find yourself fixated on the most apocalyptic and disastrous possibilities, you may be doing more harm than good. Balance is key.

When we feel overwhelmed, fearful, and triggered, it makes a lot of sense that we might withdraw from others. If we can barely keep ourselves afloat, avoiding other people can feel like we’re protecting ourselves from their stress and anxiety.

This can backfire, though. Isolation can actually increase feelings of depression and anxiety.

Instead, we need to stay connected to others — and we can do that by keeping firm boundaries about what kinds of support we can offer.

Some examples of boundaries you could set right now:

  • I’ve been having a really hard time with this COVID-19 stuff. Can we keep the conversation light today?
  • I don’t think I can talk about this right now. Is there something we can do to distract ourselves right now?
  • I’m struggling at the moment and not able to support you in that way right now. I’m happy to (play a game/send a care package/check in by text later on) instead if that would be helpful.
  • I don’t have a lot of capacity to support you right now, but I’ll email you some links later on that I think could be useful if you’d like that.

Remember, there’s nothing wrong with setting whatever boundaries you need to take care of yourself!

A lot of what we’re talking about with anticipatory grief is really just our body’s trauma response: namely, being in “fight, flight, or freeze” mode.

When we feel threatened, our bodies react by flooding us with stress hormones and amping us up, just in case we need to react quickly to a threat.

One of the side effects of this, though, is that we end up feeling worn down. Being so activated on a daily basis can really tire us out, making exhaustion a pretty universal grief experience.

This is particularly difficult at a time when so many people are talking about how productive they’ve been while self-isolating. It can feel pretty lousy to hear about others starting new hobbies or projects while we can barely get out of bed.

However, you’re far from alone in your pandemic-induced exhaustion. And if all you can do right now is keep yourself safe? That’s more than good enough.

If you’re not sure how to navigate this form of grief, there are a few things you can do:

Validate and affirm your feelings. There’s no reason to feel ashamed or critical of the emotions you’re having. Everyone will experience grief differently, and none of the feelings you’re having are unreasonable during such a difficult time. Be kind to yourself.

Bring it back to basics. It’s especially important to stay fed, hydrated, and rested at this time. If you’re struggling with this, I list some tips on basic self-care in this article and some useful apps to download here.

Connect with others, even when you don’t want to. It can be tempting to shut everyone out when you’re overwhelmed and activated. Please resist the urge! Human connection is a critical part of our well-being, especially now. And if your loved ones are driving you up a wall? There’s also an app to connect with people at this time.

Prioritize rest and relaxation. Yes, it sounds absurd to tell people to relax during a pandemic. However, when our anxiety is so activated, it’s critical to try to deescalate our bodies and brains. This article has a pretty exhaustive list of resources if your anxiety is heightened at this time.

Express yourself. Creative outlets are especially helpful right now. Try journaling, dancing, collaging — whatever helps you to process what’s happening for you emotionally! I’ve also got some journal prompts and self-care exercises in this grief zine if you’re interested.

Talk to a professional. Online therapy is a blessing right now. If you can access it, therapists are a vital resource for moving through grief and anxiety at this time. I’ve included some therapy resources here, and I’ve also shared some of my best teletherapy tips in this article.

In fact, you’re far from it. So many of us are experiencing a grief process around this time of rapid change and collective fearfulness.

You are worthy of support, and the struggles you’re having are completely understandable, especially given everything that’s shifting around us.

Be gentle with yourself — and if you need more support, don’t hesitate to reach out. We may be self-isolating and even lonely in the weeks to come, but none of us have to be alone right now.

Complete Article HERE!

What’s the point of grief?

By

Grieving is an experience almost everyone will go through at some point in their life. And is something we often have no control over.

It isn’t just humans either. There is plenty of evidence, albeit anecdotal, that other mammals, particularly primates, stay close to their dead relatives or babies – even carrying them around for a time before descending into a period of depression.

In terms of evolution, if grief were not helpful, it would long have been bred out of our species. The real question then is not why do we grieve, more what purpose does it serve?

Stages of grief

People often talk of the “stages of grief”. The “five stages” model is the best known, with the stages being denial, anger, bargaining, depression and acceptance – though these were actually written to describe coming to terms with dying rather than bereavement.

For many working in the area of bereavement of counselling, the stages of grief are little more than of historical interest now, as the stages are seen as too rigid and not individualised enough – grief don’t come in fixed stages and everyone feels things differently.

In fact, most of what we understand about grief today, is down to psychologist, John Bowlby’s attachment theory. Essentially, attachment theory focuses on the “psychological connectedness between human beings”.

The theory looks at the quality of the intimate bonds we make during the course of our lives, with a specific focus on parent-child relations. And it seems that grief is the flipside to these very close attachments we, as humans, are able to form.

Every parent knows the ear-splitting protest when their infant is left alone. If they return quickly, peace is restored. Bowlby concluded that this behaviour evolved to keep the infant close to parents and safe from predators.

If, for whatever reason, the parent is unable to return, Bowlby noticed that after a prolonged protest, the child became withdrawn and despairing. Colin Murray Parkes, guru of bereavement theory and research, and a colleague of Bowlby’s, noticed the similarity between this behaviour and grief.

Science of grief

As a bereavement counsellor and researcher this is something I see in my clients. Initially they cry out in protest, but as time passes, they begin to despair, realising their loved one has gone forever.

Grief isn’t just a mental experience either. It also has a physiological effect as it can raise the levels of the stress hormone cortisol. This may explain why many of my clients experience stress reactions in the form of panic attacks, particularly if they attempt to bottle up their emotions.

Modern techniques in neuroscience allow us to see grief in real time. In MRI scans, a brain region called the nucleus accumbens, which lights up when we talk fondly of our love ones, also glows at our grief at losing them.

These reward centres in our brain that make us happy together, keep us bonded by making us sad when we are apart. In this sense, evolutionary biologists have suggested the protest phase of grief lasts long enough for us to search for our loved one, yet is short enough to detach when hope is lost.

The despair phase, a form of depression, follows – and may serve to detach us from the one we have lost. It saves us from an energy-draining and fruitless search for them. And in time, emotional detachment allows us to seek a new breeding partner. It has also been suggested that both protest and despair may function to foster family and tribal cohesion and a sense of shared identity through the act of shared grief.

A changed world

Most people associate grief with losing someone they love, but in reality people can grieve for all sorts of reasons. In essence, knowing what to expect and feeling secure and stable is important for our survival – so when a loss occurs in our lives, our world shifts and is turned upside down.

In grief and trauma work, this is knows this as “assumptive world theory”. In the face of death and trauma, these beliefs are shattered and disorientation and even panic can enter the lives of those affected.

Life is split into two halves – before the loss and after the loss. We grieve for the loss of the safe and familiar and it feels as though things will never be the same again. The loss of a loved one triggers both the grief of separation and the loss of our assumptive world in which they were a part.

But over time, we adapt to our new world. We relearn the world changed by our loss. Indeed, one of the privileges of working with grief is watching how so many clients learn and grow from the experience and emerge from their grief better equipped to deal with future losses.

Complete Article HERE!

Comedian Laurie Kilmartin Live-Tweets Her Mom Dying of COVID-19 With Humor and Grace

By

Laurie Kilmartin is a stand-up comic and longtime writer for Conan O’Brien. When her dad was dying in 2014, she live-tweeted his hospice care with an incredible sense of humor. After he died, she released a comedy special called, 45 Jokes About My Dead Dad, a tender and hilarious special that tackles the issues of dealing with death and dying head-on. Later, she wrote a humorous book about death and grief called, Dead People Suck: A Guide for Survivors of the Newly Departed.

On June 18, 2020, Laurie’s mom died after a short and intense battle with COVID-19. And for a week or so before, Laurie live-tweeted the whole experience of spending her mom’s last moments with her on an iPad. Her tweets are equal parts hilarious and heartbreaking, not to mention full of righteous anger about the COVID-19 crisis and the way some people are denying it’s an issue.

The sense of humor with which she was able to approach the situation is so admirable, and the vast majority of people were extremely supportive. Still, Laurie had to deal with some snide comments from persnickety people in her mentions.

“I hope she doesn’t see your Twitter account,” one person wrote, speaking about Laurie’s mom. “She won’t, because she’d dying,” Laurie simply responded. 

For several days, Laurie and her sister sat with their mom on FaceTime, connected through an iPad. Her mom had entered a skilled nursing home for a bad hip injury, and it was there that she contracted COVID-19. 

“When we knew we had to put her in one for strength building, they’re all closed or they all have had COVID outbreaks, so they’re not taking any people,” Laurie told ABC7. “I was given two options, and one was an hour away and one was kind of close. And I picked the close one, and they had a COVID outbreak.”

“The day after mom entered her nursing facility, there was one case of COVID,” Laurie tweeted. “I just called, now there are 50 cases of COVID associated with this facility, employees and patients. Ten days later. This is Highland Park, in Los Angeles.” In another tweet, she wrote, “Thinking I should have sent my mom to recover at a meat-packing plant instead.”

She and her sister fought extremely hard to get to visit their mom. The hospital she was being treated at stopped allowing visitors because of the pandemic, but Laurie rallied friends and fans to contact the hospital, and eventually, they modified their rules. Laurie and her sister were able to spend about an hour with her mom on the Monday before she died.

The rest of the time, they were stuck on the iPad. Much of Laurie’s very understandable anger about her mom’s death on Twitter has been directed at those who still refuse to wear masks to help prevent the spread of the virus, notably, former baseball played Aubrey Huff.

He tweeted saying that he would no longer wear a mask inside any business because “it’s unconstitutional to enforce.” Laurie wryly responded that she was in the midst of watching her mom die of COVID-19 and that “her bed will be ready for you in 12-24 hours.” She then posted an update once her mom had passed that just said, “The bed’s available.”

Laurie lamented that even after her mom died of COVID-19, she still has family members who believe that the mandate to wear masks in public is “unconstitutional.” Wearing masks has been proven as an effective way to protect communities from the spread of COVID-19. 

It’s a simple, easy thing to do to protect others, and anyone who isn’t willing to is saying that they just don’t care about other people. “In lieu of flowers,” Laurie tweeted after her mom’s death, “the family asks that you throw hot coffee on the face of anyone not wearing a mask.”

Complete Article HERE!

Bali’s open-air burials endure despite COVID-19 crisis

By Brinkwire

For centuries Bali’s Trunyanese people have left their dead to decompose in the open, the bodies placed in bamboo cages until only the skeletons remain.

It is a ritual they haven’t given up — even as the COVID-19 pandemic upends burial practices worldwide with religious leaders in protective gear, cemetary workers in hazmat suits, and mourners banned or unable to comfort each other because of social-distancing rules.

Across Indonesia funeral workers are now required to wear protective equipment and bodies are laid to rest quickly, all in a bid to prevent the spread of the deadly respiratory disease.

But in Bali local officials claim the novel coronavirus, which has infected at least eight million and killed more than 430,000 globally, has yet to reach the remote north east where the Trunyan live.

“The funeral process remains the same but now we have to wear masks,” explained village head Wayan Arjuna.

Tourists are temporarily banned from visiting for fear of them bringing in the disease, he adds.

“We’re afraid of getting COVID-19,” said Arjuna, but added there was no suggestion of stopping the open-air burial process.

Unlike many in the rest of Hindu-majority Bali, the Trunyanese — who fuse animist beliefs and traditional village customs with their own interpretation of Hinduism — do not bury or cremate their dead.

Instead they let nature take its course as the corpses decay in the open, believing it to be a way to keep a link with the deceased.

“This makes us feel connected to our loved ones,” Arjuna said.

“Like when my grandmother died, I felt like she was close”, he added.

– Skull Island –

It is a short boat ride to their open-air cemetery from tiny Trunyan village, overlooked by volcano Mount Batur and a sprawling Hindu temple carved out of volcanic rock.

There are 11 cages for the corpses — placed close to a fragrant banyan tree that hides the putrid smell of death, locals say.

In one cage, a recently deceased woman could almost have been mistaken for someone sleeping, but her waxy greying complexion revealed the truth.

Nearby, a flesh-less foot poked out of clothing left on the bodies, while a skeletal jaw lay agape in another cage.

“I used to be a little scared working here, but it’s been so long now that I’m used to it,” said veteran guide Wayan Sukarmin, who was spent 20 years showing people the custom on what outsiders have dubbed “Skull Island”.

When AFP visited in February before the World Health Organisation declared a pandemic and travel restrictions were put in place, signs warned visitors to wear appropriate clothing and refrain from using bad language.

Rubber sandals, cigarette packages, toothpaste tubes and pots and pans were scattered around the site, along with baskets filled with coins and crumpled money — all left by mourners for dead relatives to use in the afterlife.

“Locals won’t take anything because it belongs to the dead. That’s our belief,” Sukarmin said.

“I don’t know what the consequences would be if you took something but I believe in karma,” he added.

– Millennia-old custom –

If the cages become full then older corpses are moved to an open ossuary, to make way for new ones.

Then when there is no flesh left, the skulls of the long dead are placed upon a stone altar, until they too crumble back into nature.

Nearby, there is a second cemetery for the unmarried and children, while a third location is for those who died unnatural deaths like murder or passed away from acute illness.

The Bali Aga — or mountain people — who live in these isolated villages, claim to be descendents of the original Balinese and the main temple in Trunyan village dates back to the 10th century according to historical records.

The origin of the custom of open-air burials is subject to debate.

One legend has it that the area’s early inhabitants fought over the prized Banyan tree, so to keep the peace, leaders decided to place the dead there, believing the smell from the corpses would make the spot less attractive.

Another story suggests that the ritual was adopted to avoid angering the rumbling volcano nearby by cremating people.

“There are several versions of the legend so I can’t decide which one is correct,” Arjuna said.

But these open-air burials are now so rooted in the culture that few expect much to change in Trunyan, even as the pandemic ravages the world.

“It’s relatively easier to prevent infections in isolated and faraway places,” said Bali’s virus taskforce chief Dewa Made Indra.

“There aren’t any reported cases in Trunyan. But if that happens then we’ll handle it with special procedures and I think the villagers will understand.”

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