What Happens As We Are Dying?

The First And Last Things To Go

Knowing what happens when we’re dying can tell us how to console colleagues and loved ones as they lose their battle with COVID-19.

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As our mother lay dying, my sister and I sat on either side of her, holding her hand and whispering words of comfort until the hospital machine showed a flat line. Having heard that physicians often witness positive reactions in patients when loved ones speak to them in their final moments, we intuitively thought that perhaps she could hear us. No one knows for sure what happens as we die, but recent information from neuroscientists shows that our intuitions could be right. Knowing what happens when we’re dying can tell us how to console colleagues and loved ones as they lose their battle with COVID-19.

The Last Thing To Go

In the last hours before an expected natural death, many people enter a period of unresponsiveness, during which they no longer respond to their external environment. Anecdotal reports from near-death experiences commonly include stories of the dying person hearing unusual noises or hearing themselves pronounced dead.

In a June 2020 groundbreaking study published in Scientific Reports, neuroscientists provided the first empirical evidence that some people can still hear while in an unresponsive state hours before dying. Using EEG indices, neuroscientists at the University of British Columbia measured the electrical activity in the brain from hospice patients at St. John’s Hospital when they were conscious and when they became unresponsive. A control group of young, healthy participants was also used. The researchers monitored brain responses to tones and found that the auditory systems of the dying patients responded similarly to the young, healthy control groups just hours from the end of life. They concluded that the dying brain responds to sound tones even during an unconscious state and that hearing is the last sense to go in the dying process.

The First Thing to Go

Many people who have had near-death experiences describe a sense of “awe” or “bliss” and a reluctance to come back into their bodies after being revived. I interviewed brain scientist Dr. Jill Bolte Taylor, who described having a strikingly similar awe experience during her stroke which she detailed in her book My Stroke Of Insight.

Jill Bolte Taylor: I was bouncing in and out of the consciousness of my right brain. The left brain had the hemorrhage, growing at an enormous rate over those four hours. By the time I got to the hospital, the hemorrhage was about the size of my fist in my left hemisphere. Over the course of the morning, I drifted into blissful euphoria, the consciousness of my right brain. And then I would come back online and attend to the details to get myself help. It was a movement in and out of being aware of external reality. I was completely conscious through the entire experience, but only at some point could I attend to detail in the external world, recognize that it existed, or even care.

Bryan Robinson: So the fear factor wasn’t there?

Taylor: I was very blessed. I had zero fear. I was there in blissful euphoria in the right brain. Or I was in the left brain, preoccupied with trying to figure out what I needed to do to orchestrate a rescue.

Robinson: How did the stroke change your outlook on life? Or did it?

Taylor: One hundred percent. It shifted me away from believing that I was the center of my world and that “me and mine” is what matters. That whole circuit—the consciousness of me as an individual—went offline. In the absence of the focus of my life being me, I shifted into a consciousness and awareness that I’m a part of a greater humanity. I’m more open, expansive, and flexible to possibilities—as opposed to “here’s what I want and these are the steps I’m going to take to get what I want.” I function inside of a hierarchy of people above me and below me and I’m climbing a ladder. So I shifted away from the linear way of looking at the world and my relationship to it. I live more open to the possibilities of what can be and what is the best match for me.

Robinson: Is it true that your training and professional and personal experience have led you to believe that the right brain or authentic self is the brain hemisphere that endures even at death?

Taylor: The authentic self is the part of us that I firmly believe shows up in the last five minutes of our lives. When we’re on our deathbed, the left brain begins to dissipate. We shift out of all the accumulation and the external world because it’s no longer valuable. What is valuable is who we are as human beings and what we did with our lives to help others. We all face it, and I think that is judgment day. But I don’t think it’s the judgment of something beyond us; it’s the judgment of ourselves. Those of us who are tangled up in the external judgment are not slowing down enough to reflect on the essence of who we are as human beings and what we could be in connection with one another.

Steps You Can Take

It’s important to be supportive, compassionate and understanding in cases where a coworker loses their battle with COVID-19. Don’t hesitate to reach out to other bereaved colleagues, share your concerns and be willing to listen. If you’re an employer, make sure HR personnel are well educated about the process of death and dying. If you are an employee in an organization where COVID-19 deaths haven’t been acknowledged or discussed, speak to someone in authority who can take steps to provide training for all employees. Appropriate information makes sure employees receive emotional support during the loss. Otherwise social isolation can cut employees off from help when they most need it.

Now that hearing is widely thought to be the last sense to go during the dying process and that a blissful experience might replace fear, this information might be helpful to bring comfort to family and friends in their final moments. Perhaps being present with comforting words in the last hours in person or virtually can console the dying as well as loved ones. According to Dr. Elizabeth Blundon, lead researcher in the Scientific Reports experiment, “This is consistent with the trope that hearing is one of the last senses to lose function when a person is dying and lends some credence to the advice that loved ones should keep talking to a dying relative as long as possible.”

Complete Article HERE!

Death is part of life, and there is a lot we can learn from it

There are moments when disease and political protest suddenly make dead bodies far more visible, here are five lessons they can teach us.

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I grew up around dead bodies. In fact, some of my earliest childhood memories are of dead bodies in caskets, and I mean dozens of corpses — not the occasional family friend or relative. The reason I saw so many dead people was because my father was a funeral director for thirty-five years in Midwest America.

Fast-forward now through some strange twists of fate, and I am currently the Director of the Centre for Death and Society at the University of Bath, the world’s only interdisciplinary research centre focused on death, dying, and the dead body. Human mortality looms so large in my upbringing and academic career that my younger sister, Julie, is on the record calling me the Overlord of Death.

As a result of these labours, I published a book called Technologies of the Human Corpse in which I cover the history and meaning we living humans assign to dead bodies by using different kinds of technologies: embalming, photography, rail transport, science museums, detention camps, radical life extension, the list goes on.

I have spent many years trying to understand what the bodies of the dead can teach us about the living, and here are some of the lessons I have learnt.

Dead bodies prove a once-living person died

When you see a dead body, you see causation. Some set of events or actions caused that dead body to be in front of you. Dead bodies do not just happen and require either an internal or external force (sometimes both!) to appear. Place a dead body in any situation and that situation automatically becomes far more serious.

One of the great 17th Century human inventions was the autopsy (literally ‘seeing for oneself ’), which stressed peering into the dead body to understand causes of death. The autopsy’s historical success is also one of the reasons we 21st Century humans find it so distressing when a cause of death cannot be determined.

How is an indeterminate cause of death possible, many people ask, with all our advanced bio-medical technology? And it is on this very ship 1,000 different CSI television programmes sailed…

But set aside the impossible forensics portrayed on popular television programmes for one minute, since we are living in a historical moment dominated by very real dead bodies with clearly defined causation.

Dead bodies from COVID-19. Dead bodies from police violence. Dead bodies from lack of access to necessary medical care. Dead bodies from interconnected social inequality that accelerates death, which leads me to lesson number two.

Dead bodies teach us about politics

Human corpses invisibly surround we the living on a daily basis, so much so that under normal conditions approximately 1,700 people die each day across the UK.

But there are moments when disease and political protest suddenly make these dead bodies far more visible. The current visibility of dead bodies due to COVID-19 and the global protests around George Floyd’s death in Minneapolis are examples when human corpses become a catalyst for action.

Whether it is the over 550,000 COVID-19 deaths from across the globe or the singular dead body of one black man in Minneapolis – these human corpses create new political meanings when answering some fundamental questions: why is this person dead and what political dynamics led to the death?

In many ways we have seen aspects of the current COVID-19 dead body politics before. In chapter 3 of my book I focus on HIV/AIDS corpses and the postmortem political changes produced by that pandemic.

So, for example, a key question during the height of the AIDS epidemic was whether or not it was safe to touch the body of a person killed by the HIV virus. It was safe, but it took many years for that answer to arrive.

Historical examples of dead body politics and race also abound. George Floyd’s death is part of a much broader US context captured in the book Without Sanctuary: Lynching Photography in America (2000) that documents how white Americans collected photographs of lynched black people and turned those images into collectible postcards. I highly recommend this book to any white person wondering why so many black communities feel such rage and anger about their dead.

We don’t always see the dead bodies until suddenly we do and then it is difficult to look away… until we do

I describe lesson three as part of a National Death Infrastructure into which dead bodies are absorbed by any nation’s very local but also quite global system for managing human corpses.

Any National Death Infrastructure includes systems such as local cemeteries and city morgues alongside international air transfer companies handling postmortem repatriations. It is when those systems overload that we begin to see the dead bodies and cannot stop seeing them since there are simply too many corpses to store. The dead bodies must be moved somewhere.

The recent COVID-19 experiences in many cities, New York and London in particular, demonstrate how pandemics can produce mass fatality events that quickly overload the everyday death infrastructure and create the need for rapid adaptation. In these moments of emergent adaptation, we begin to see how quickly the dead really do impact the world of the living.

But many of us do eventually look away and forget about the dead bodies. In the not-to-distant-future, I have a feeling that the dead bodies created by COVID-19 will be forgotten about, especially by the people who did not lose someone close to them.

Here is a quick test – how many people have died from AIDS? The answer is 38 million and counting. That is an enormous number of largely invisible dead bodies.

Dead bodies teach us not to hide the dead bodies

Virological determinism is the concept I use to describe the current US and UK response to the COVID-19 pandemic, that is, we humans blame the virus for creating all the COVID-19 dead bodies as opposed to recognising human failures (and here I mean government leaders as much as anything) at mitigating the contagion.

This is similar to the way we use technological determinism to explain human problems by saying, “…the computer did it!” as opposed to accepting responsibility for our own actions.

COVID-19 created a whole new linguistic dynamic for 2020’s human catastrophes – blame the virus. Name a problem and the coronavirus caused it. And while this is correct in some instances, the virological determinist rationalisation only goes so far with dead bodies.

The sudden surge in COVID-19 dead bodies that overloaded National Death Infrastructures everywhere meant hiding the bodies was not possible. Most countries face a real dilemma right now with care homes since the number of dead cannot be easily glossed over.

Governments may try (and some will surely succeed) but here is a key rule: one dead body makes any given situation a tragedy. Twenty-thousand dead bodies make the same situation a mass fatality catastrophe.

Any government that attempts to hide these dead bodies, and here ‘hiding’ can also mean ‘not acknowledging,’ faces an immediate problem – all attempts at obfuscating the dead will only make their loved ones and advocates work even harder to name the deceased.

There is a parallel here, too, with the George Floyd case. The video recording of his death resonated so deeply because it showed his death in clear-cut terms that meant nothing was going to hide his dead body from public view.

Finally….

Dead bodies teach us about grief and bereavement

I opened these five-lessons with my younger sister Julie calling me the Overlord of Death. Julie died on 29 July 2018 from brain cancer and I wrote at length about her death in the preface to my book. She died in Italy (where she lived), and took her final turn while I boarded a Milan-bound plane at Bristol Airport.

When I arrived at the hospice where she died I immediately asked to see my sister and was taken to her body. I spent a long time talking with Julie about how much everyone loved her and how much everyone would miss her.

I also suddenly found myself next to a dead body, similar in so many ways to my youth, but this time it was my sister. And sitting next to her dead body taught me what loss truly felt like, since I couldn’t just call my sister on the phone and tell her what was happening.

She was dead but that experience with her in the hospice meant that Julie would forevermore remain an active presence in my everyday life. And she is.

Complete Article HERE!

Planning For The End Of A Life

Talking about death makes many of us uncomfortable, so we don’t plan for it. NPR’s Life Kit offers tips for starting an advanced directive to prepare for a good death.

By Kavitha Cardoza 

MICHEL MARTIN, HOST:

Thinking about death makes most people uncomfortable, which means many of us end up not planning. But Betsy Simmons Hannibal, a legal editor, says it’s like wearing a seatbelt.

BETSY SIMMONS HANNIBAL: We all wear our seatbelts even though we don’t expect to get in an accident on the way to the store. It’s just, like, something that we know is possible.

MARTIN: So buckle up. NPR’s Life Kit looked into preparing for the end, and reporter Kavitha Cardoza is going to walk us through a simple document called an advance directive.

KAVITHA CARDOZA, BYLINE: You don’t need to have a medical background or a lawyer to fill out an advance directive. You don’t even need a lot of time. And I promise it’s not too morbid. You can easily find an advance directive form online. There are different versions, but basically, it has two sections. The first is the most important – the medical power of attorney. Choose a person who can legally make health care decisions for you if you can’t.

PALLAVI KUMAR: 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 for you and to be a voice for you.

CARDOZA: That’s Dr. Pallavi Kumar, a medical oncologist and palliative care physician at the University of Pennsylvania. She says your medical proxy should be someone you trust who can handle stress because your loved ones will disagree on what to do, and it can be emotional. So you want to name someone who will carry out your wishes. Kumar says research shows when a caregiver sees a loved one die in the hospital under circumstances they believe that person never would have wanted, they’re in emotional pain for a long time.

KUMAR: And at six months and a year after death, these bereaved caregivers are still suffering from pretty severe depression and anxiety. There’s even some data to show that the survival for those caregivers is shortened.

CARDOZA: So think of an advance directive as a gift you’re giving your loved ones. The second section of the advanced directive document is called a living will. This part walks you through the general approach of how you want to die and what kind of care you want. Do you want to be resuscitated? Are you OK being hooked up to a ventilator? How do you feel about a feeding tube? Dr. Jessica Zitter is an ICU and palliative care physician in California. She says there’s no right or wrong decision. It’s personal.

JESSICA ZITTER: Someone once told me her father was – she says, he’s an old, crusty Italian man, and he said if someone else has to wipe my behind, I do not want to live. But there’s many, many others of us – if I was quadriplegic and still have an intellectual and emotional relationship with people, I don’t think I’d want to die.

CARDOZA: Even among patients who are very, very sick with cancer, less than half have had conversations about how they want to die. So it’s critical to share your wishes with your medical proxy and your loved ones as well as your doctor. Share a copy of the form with them.

Dr. Pallavi Kumar says the end of life is about more than just the medical aspect. When she knows a person’s priorities, that helps inform her treatment plan. For some patients, it might mean spending time at home with family. For others, it means trying every treatment possible for as long as possible.

KUMAR: 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.

CARDOZA: While no one can predict when they’ll die, an advance directive can help you plan for how. It’s not a guarantee but a safety net for having what Doctor Zitter thinks of as a good death.

ZITTER: In order to figure out what a good death is, you have to figure out what a good life is and what living well means to you. That’s the only way to know how to die well because actually, they’re kind of reflections of each other.

Complete Article HERE!

BIPOC in Death Care

The voices of Black, Indigenous, and People of Color (BIPOC) need to be amplified so we are going to use our newsletter and social media platforms to aid in their sharing. Here are a few resources for us to explore racism, privilege, and bias in death care:

Sayin It Louder: A Conversation About “A Good Death” in a Racist Society.

A conversation among death care professionals Alua Arthur of Going with Grace, Lashanna Williams of A Sacred Passing, Joél Simone Anthony of The Grave Woman, Alicia Forneret, Oceana Sawyer, and Naomi Edmondson.

 

Watch the recording of their discussion by clicking here.

Goodbye, Grandpa

– An expert guide to talking to kids about death during Covid

By Robyn Silverman

My daughter’s questions started after a family friend got sick with Covid-19.

“If people are sick, they can just give them medicine so they get better, right?” my daughter asked with the hopeful perspective of an 11-year-old. “They can just go to the hospital so the doctors and nurses can help them?”

The questions stemmed from a positive update my husband gave about his martial arts buddy, John R. Cruz, a first responder being treated at Holy Name Medical Center in Teaneck, New Jersey.

He’s one of the lucky ones.

Not everyone is as fortunate. We’ve already surpassed 124,000 Covid-related deaths in the United States and nearly half a million dead worldwide.

For adults, these numbers are shocking. For children, they are unfathomable. Some can’t even conceptualize the notion of a single death.

It’s natural for parents to want to protect children from the feelings of worry and distress we are experiencing during this pandemic, but decades of research underscores that being honest with children is the best way to mitigate feelings of anxiety and confusion during uncertain times.

Even young kids are aware of the changes in the emotional states of adults and will notice the absence of regular caregivers, including grandparents.

So how do we talk to kids about death and dying during the coronavirus crisis? These are tough talks, no doubt about it. Here are six guiding principles, with sample prompts and scripts, to keep in mind.

Assess what’s age-appropriate

While parents should always be honest about death, the information you divulge may differ in amount and depth depending on the developmental age of your child.

How do you know where your child falls? It’s a best practice to follow your children’s lead and answer their questions without volunteering additional details that may overwhelm them. If you don’t know the answer, it’s OK to admit it.

Children between the ages of 4 and 7 years old believe that death is temporary and reversible, punctuated by the fact that their favorite cartoon characters can meet their doom and then come back the next day for another episode.

Even after you explain that “all living things die” and “death is the end of life,” it’s normal for young children to ask, “When can that person can come back?” Be prepared to remind them, kindly and calmly, that “once a body stops working it can’t be fixed” and “once someone dies, that person can’t return.”

Older children grow out of this “magical thinking” as they enter tweenhood, questioning the meaning of death during adolescence, while often seeing themselves as invulnerable to it. They may want to talk with you about why someone has died and need guidance about which resources they can trust for valid information about coronavirus and Covid-related deaths.

Ask your children, whatever their age: “What have you heard about the coronavirus and how someone might get it? What do you know about what happens when someone gets sick from it?” Clarify the difference between the virus and the disease and explain who is at the highest risk for becoming severely ill from Covid-19.

Prepare yourself

A conversation about death, especially when you are reporting on a family member or close friend, is especially difficult. You don’t want to just blurt out the news without carefully considering your words. Give yourself some time to gather your thoughts and take a couple of deep breaths.

Ask yourself: Do I want another supportive adult with me while I deliver this news? Where in my home would be best to discuss this with my child? Should my child have a special toy or comforting blanket with him or her when we have this conversation?

Even though it’s best to discuss what happened with your child before someone else tells them, taking a few minutes to calm yourself down and be present is important for you and for them.

Explain what happened

If someone in your children’s world does pass away from Covid-19, be sure to tell them honestly, kindly, clearly and simply. Experts agree that parents should avoid euphemisms such as “went to sleep,” “we lost her” or “went to a better place” to avoid confusion.

Instead, you might say; “Sweetheart, remember Grandpa got very sick and has been in the hospital for the last few weeks? His lungs stopped working and couldn’t help Grandpa breathe anymore. The nurses and doctors worked so hard to try to make Grandpa’s body healthy again but they couldn’t make Grandpa better. We are so sad and sorry. Grandpa died today.”

Then pause and listen. You may need to repeat your words a second time as distress can make it difficult to digest information.

Give room for the ups and downs of grief

In a time of suffering, it can be difficult to know what to say. Honesty about your own emotions gives children permission to be open about their own confusion, sadness, anger and fear.

You might admit: “This is all so hard to take in, isn’t it? I am feeling sad, and I’m crying because I miss Grandpa.”

Don’t be surprised if some of your child’s feelings come out all at once, while others may peek out days and weeks after the death of a loved one. Be ready for the unexpected and know that, when children grieve, they may be crying one minute and playing the next. This is normal.

“Grief is not a linear process,” said Joe Primo, CEO of Good Grief, in an interview on my podcast, “How to Talk to Kids about Anything.”

Good Grief is a New Jersey-based nonprofit organization that provides healthy-coping skills to children grieving the loss of a family member.

“Grief is like a roller coaster. It’s up, down, all around. For kids and adults alike, every single day is different. And as the grieving person, you have no idea how your day is going to unfold.”

Answer questions

Many children will ask for more information and want to know why their loved ones didn’t survive. Reiterate that your loved one had Covid-19 and the medical team worked very hard but the disease made it so the body could no longer work. You might tell your child about complications such as asthma that made it difficult to breathe even before the coronavirus.

It is also normal for your child to ask if you or others in their life will get sick or die of Covid-19 so be clear about the precautions your family is taking in order to stave off the illness.

“We are doing everything we can to stay healthy. We are washing our hands with soap and water, keeping our home very clean and staying away from others to keep from getting the virus,” you might say.

“We are also wearing masks and gloves when we are at the store to get groceries. And don’t forget, we are continuing to eat nutritious food, exercise and get good rest to keep ourselves strong.”

Provide ways to commemorate and honor

Given that social distancing is making it increasingly difficult, if not impossible, to grieve alongside loved ones as we typically do when someone dies, it’s imperative that we find a way to allow children to say goodbye and remember. Studies have repeatedly found that when children are part of funerals and celebration of life events, they fare better.

“Funerals are about mourning,” Primo noted, “and mourning is a core component of a child adapting to their new norm, expressing their grief, and getting support from their community.” Without these traditional markers, find other ways to honor your loved one.

For example, have a small home-based ceremony and commemorate the person’s life by planting a tree, doing an art project, reading a poem, eulogizing and saying goodbye. You can also collect letters, video tributes and memories from others and share them with your children. Many have used Zoom to remember those who died. Ask your children, “How would you like to honor and remember _______?”

This conversation may be one of the toughest you will have with your kids, and one that, given the numbers, will be part of many families’ reality as we cope with incredible loss from the coronavirus. It’s stressful for everyone involved — for your children and for you, too.

Continue to reach out for the support you need so you and your children can be cared for during this difficult time. Even while we must be socially distant, no one should have to grieve alone.

Complete Article HERE!

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!

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

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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!