What do dying people really talk about at the end of life?

by Stacey Burling

It is common wisdom that nobody ever wished he’d spent more time at the office when he’s at death’s door.

That certainly makes sense, but Michael Ent, a social psychologist at Towson University, did what researchers do when confronted with unproven beliefs. He wondered if it was true. Then he tried to find out.

He and Mary Gergis, a nurse who also teaches at Towson, asked hospice nurses what dying people really talk about at the end of their lives. The 124 nurses from the Hospice and Palliative Nurses Association who responded to an online survey said patients are often more consumed with worries about how their families will fare after their deaths than they are with their own fates. They are about as likely to savor lives well led as to grapple with regrets. Many are worried about legacy and finances, a sign, Ent thinks, that some of them do indeed wish they’d worked more, or at least done a better job of managing their money.

Ent said the information, which has been accepted for publication in the journal Death Studies, could be helpful to caregivers. Some may be reluctant to push patients to engage in “life review” — end-of-life discussions of life history that have been shown to help alleviate anxiety and depression. “Sometimes patients might feel that it’s intrusive for a stranger to start asking them about their personal lives,” Ent said. However, if patients bring up some of the topics the nurses mentioned, that could be an opening for a deeper conversation.

Ent, whose wife is a nurse who has worked with hospice patients, said he was interested in what we could learn from the dying. Most of the academic studies he was able to find were more focused on practical aspects of support for the dying than on trying to harvest their wisdom. He couldn’t find anything about which subjects were on their minds. He read The Five Invitations: Discovering What Death Can Teach Us About Living Fully, written by a Buddhist hospice founder, but Ent wanted to do something more concrete and systematic. He read The Top Five Regrets of the Dying, also written by a hospice worker, and particularly questioned the top regret: “I wish I’d had the courage to live a life true to myself, not the life others expected of me.”

Again, Ent was skeptical. “I couldn’t imagine that being a top deathbed reflection,” he said.

For the survey, Ent and Gergis asked the nurses to list up to five “reflections” they heard most frequently from hospice patients. He concedes it would have been better to talk to patients themselves, but said privacy rules make them harder to reach. The nurses’ answers covered a wide range, from regrets to pride to faith in an afterlife. “I don’t want to be a burden” was a common sentiment, and many patients worried about how survivors would cope after they died. Some wished they had taken better care of themselves. Some said they were ready to go, while others wished for more time. They were thinking about whether their lives had mattered.

Ent categorized the comments and found that concern about loved ones was the most common response. Half of the nurses mentioned it. Regrets — these included people who thought they’d worked too much — came up 42 percent of the time, compared with 36 percent for gratitude. Concerns about legacy were cited by 29 percent of the nurses. Some of those people wished they had achieved more. About the same number of nurses said patients often said they were not ready to die (29 percent) as said they were ready (28 percent).

Ent said that the survey results show that hospice workers may want to spend more time allaying patients’ fears about how their deaths will affect family members.

He also thinks that research on what dying patients regret could help healthy people plan for the inevitable. Maybe fewer of us would be “blindsided” by our deaths if we talked more openly about mortality. Better financial planning could prevent many of the worries about unpaid bills.

Complete Article HERE!

The Nuance of Death With Dignity

Six states allow medical aid in dying, but opinions and experiences run the gamut

By Michelle Carter

Death with dignity is a movement gaining steam.  A June 2017 Gallup poll found that 73 percent of Americans supported medical aid in dying at a patient’s request, as long as it is painless.

Oregon is just one of six states plus the District of Columbia with laws in place that allow medical aid in dying. Doctor-assisted suicide will also become legal in Hawaii in January 2019. In 2018, 23 states entertained death with dignity legislation, and Maine is voting on a ballot initiative in 2019.

While the names of the bills vary — Death with Dignity, Medical Aid in Dying, Medically Assisted Dying — the bills are remarkably similar.

Death With Dignity: The Details

For death with dignity, participation by doctors or nurses is strictly voluntary. No doctor can be compelled to prescribe life-ending medicines, there are no government programs which will provide assistance and there is no database of participating doctors.

To qualify for a prescription for life-ending medications, patients must prove they are a legal resident of the state in which it is legal, be 18 or older, be mentally competent and diagnosed with a terminal illness that will likely lead to death within six months. Patients must also be able to self administer the medication. At least two physicians must determine all criteria are met, and several states with pending legislation require witnesses who are unrelated to the patient who have no financial interest in the patient’s estate.

Physicians must also inform patients of alternatives, such as hospice, palliative care and pain management techniques. Physicians may make a referral for psychological or psychiatric evaluation. The laws and bills also require the patient to make at least two oral requests with a waiting period of at least 15 days (20 in Hawaii) between requests, followed by a written request.

Controversy Still Present

Dr. Jamie Wells, a medical ethicist and a director of medicine for the American Council on Science and Health, said the debate over medically-assisted dying laws is difficult in part because we live in a binary culture which tries to reduce everything to black and white. But the individual situations where a law like this would come into play, she noted, are often gray.

“I wish we had more of an honest portrayal of how things happen in these circumstances. Nuances matter, and with these conversations about right to die and end of life, discussion is lost and progress is not made,” Wells said. “There are many shades of gray. Some people refuse further therapy. Sometimes trying the last-ditch chemo can be the cause of death.”

Australian scientist David Goodall made headlines in May when he traveled to Switzerland to end his life at age 104. He had at least one failed attempt to end his life at his home before traveling to Switzerland.

“When people have a failed attempt they can acquire new disease and illness which increases their suffering,” Wells said. “People who attempt to overdose on Tylenol, for example, can have profound liver disease as a result.”

Navigating Family Influence

End-of-life care is an area of medicine where a patient’s family often has an influence on care. But since death with dignity legislation requires non-family witnesses, patients aren’t pressured into ending their lives prematurely.

The opposite scenario happens as well — one where family members resist the patient’s desire to die.

“I’ve literally had a spouse say to me, ‘He can’t die until this date because that’s when the next check comes in,’” hospice nurse Alison Keeler of Washington state said. “Family isn’t always on board with a death with dignity decision. I became a hospice nurse because so often we were doing interventions on people that I felt were really hastening their deaths. They weren’t comforted. They suffered.”

Kristin Metzger of Maryland, another hospice nurse, has taken care of patients who had family members waiting on an inheritance and patients who receive the gamut of care because a family is depending on a Social Security check.

“I’ve seen people intubated, tube-fed, because there is financial gain,” Metzger said. “They’re the reason hospitals have ethics committees.”

Metzger stressed that terminal patients, regardless of whether they are in a state where medical aid in dying is legal or not, should not have to worry about suffering or pain.

“Is physician-assisted dying the answer or the Band-Aid? I actually wonder if we put our work and energy into addressing the root cause — if hospice isn’t actually the answer.” Metzger said. “Many people live longer on hospice because we’re managing their quality of life… If people truly understood what hospice and palliative care can provide for the terminally ill, no one would ever consider medical aid in dying.”

While Metzger, Keeler and Wells hold different opinions on death with dignity legislation, all three agreed it is important for families to discuss their opinions and wishes openly long before a crisis occurs.

“In a perfect world: Everyone has the right discussion at the right time when they can make the right decisions, but unfortunately people are messy and complicated.” Wells said.

Complete Article HERE!

Talking about advance directives is a perfect holiday conversation

By Kenneth R. White

Until Louisa’s accident, you could almost always find her working in her garden, pulling weeds, deadheading old blossoms, coaxing tomato vines up their stakes. Well into her 80s, she still made a full midday meal every Sunday for her family and an ever-shifting gaggle of neighbors, grandchildren, and friends — basically anyone who showed up hungry.

As vigorous as Louisa was, when she stumbled and fell earlier this fall, it changed everything. Landing awkwardly on the hard ground, her skull hit a paving stone, causing bleeding inside her brain that led to immediate unconsciousness. After Louisa was rushed to the local hospital, she underwent emergency surgery, but it yielded no improvement. Still unresponsive, she was transferred to a quaternary academic medical center for further evaluation and treatment. But there was nothing more to be done.

As her garden hibernated beneath piles of dead leaves and bits of snow, no one could believe this had happened — or imagine life without Louisa. The 180-degree pivot from healthy and upright to comatose left them breathless.

Family members encircled the hospital bed where she lay: broken bones set, minimal brain activity, a machine breathing for her. I asked them whether Louisa had an advance directive or a living will. Their silent stares were my answer.

It’s not an unusual situation, and they weren’t alone in saying no. In Virginia, where I live and work, nearly 5 million adults don’t have advance directives, including many of the patients I care for at the University of Virginia Medical Center. Nationally, a whopping two-thirds of Americans lack them. But this holiday season, it’s my hope to start to change those odds.

Advance directives are formal declarations of your last wishes, should the unthinkable — a fall, stroke, car accident, aneurysm, heart attack, or other incapacitating event — befall you. They explicitly lay out the extent to which you want lifesaving measures (breathing and feeding tubes, resuscitation if your heart stops, and the like) when other remedies won’t improve your odds of survival; or when, as with Louisa, there isn’t anything more than can be done and you will likely face your remaining days in an unconscious, possibly vegetative state.

In my practice as a palliative care nurse practitioner, in my classes teaching nursing and medical students, and even when I share meals with friends, I often work advance directives into the conversation. Some people twist in their seats, fumbling through their answers, while others are curious and upfront about what they do and don’t know. Still, I press.

I keep a stack of “Five Wishes” worksheets — a simple pen and paper guide to creating an official advance directive — in my office, car, briefcase, even in the guest rooms of my home (Harvard Health Publications, AARP, and others also offer them). And if I don’t have the paper copies on hand, a quick email later and my friend, colleague, student, patient, or family member has what’s needed to get started.

Advance directives get a lot of bad press for being macabre. But I urge you to think of them as love letters to the people you adore. In these documents, you define your last wishes, set parameters for care, and help those who will be caring for you make decisions based on what you want and, just as important, what you don’t want, when curative treatments are off the table.

These love letters safeguard those thrust into the difficult position of making medical decisions for you — some about life and death — so they don’t have to be guided only by well-meaning strangers like me, as Louisa’s family and countless others have had to do.

Advance directives are easy. They don’t take long to complete. Anyone can create them.

As families gather for the holidays, fretting about food, finances, gift giving, politics, and more, I urge them to ask everyone around the holiday table — middle-aged, old, young at heart, and everywhere in between — the following questions. (They’re the same ones I ask my patients who find themselves at various stages in the trajectory of life-limiting illnesses, bringing into razor-sharp focus what matters in the time they have left.)

  • What would you want done for you if the unthinkable happened — like a catastrophic fall or a major stroke — and treatment options are limited?
  • Would you want every medical intervention, or only some?
  • Do you want to die in a hospital or, if it’s possible, at home?
  • Are there things undone you wish to tend to, people you want to see, and things you want to say?
  • Are there things you fear, wonder, or wish for?
  • Essentially, what really matters to you?
  •  
    When death is imminent, perhaps a matter of days or weeks, patients I’ve had the privilege of caring for often want to leave the hospital and spend their final days in a favorite chair, with a favorite pet, satisfied by favorite meals in the comfort of their own home. Others wish to express their love and gratitude for those around them, imparting last thoughts with purpose, dignity, and humanity. Some want to connect with a loved one with whom they’ve sparred.

    To do any of this, they need to declare their intent.

    No one needs to wait until death is near to understand or crystallize their last wishes. There’s no time like the present — and no time like the holidays, when family and friends gather — to ask those you love, as well as yourself, about what they want the end of their life to look like, no matter whether that day seems far away or if it might be closer.

    The only way to find out is to ask.

Providing comfort and a connection as the end draws near

In 2008, Sister Rose Mary Dougherty created a Companioning the Dying training program. She started with a few basic principles. One was to help caretakers learn to become better listeners. “It’s sitting with a loving alertness,” she says.

By Debra Bruno

In the United States, there’s probably no better way to spoil cocktail party chatter than by introducing the subject of death, dying or the end of life.

Yet, in the same way that the birth process went from a doctor-run event to a movement in which women took charge of their own pregnancies and deliveries, there is growing interest in thinking about the dying process. In part, that’s because the large population bulge of boomers is reaching a point where the end seems not that far away. But also, many people have had the experience of sitting at the bedside of a dying person without the slightest clue what to do.

The growing interest in the topic is seen in death cafesdeath doulas, the “death positive” movement, hospice work and even the End-of-Life University . There are special decks of cards that allow families to work through end-of-life decisions.

And increasingly, classes, seminars, and programs are available that try to help people understand how to comfort those in the last stages of life.

Sister Rose Mary Dougherty, 79, a member of the religious order School Sisters of Notre Dame, calls this companioning the dying and she decided to make it a focus when, years ago, she found herself sitting at the bedside of a dying priest who was a friend. Next to her sat another friend, also a priest.

She watched as the two priests sometimes prayed and sometimes were quiet, together, doing nothing at all. At one point, the priest sitting next to her turned and said: “I don’t know what a priest should do anymore. I don’t know what I’m to do here, but I can be here. Maybe that’s my final vocation.”

That’s when it hit her: Even people trained in comforting feel a sense of helplessness when a friend or family member is dying. But she also resolved to do something about it.

So in 2008, Dougherty created a nine-month Companioning the Dyingtraining program, based in Baltimore. Today, the program provides instruction for hospice workers, caregivers, volunteers and family members on how be with someone in their final months or days.

Companioning the Dying concentrates on something that nearly everyone will have to face at some point in their lives. In the past, it was common for elderly family members to live with their adult children as they aged. Their last days were spent at home, surrounded by loved ones.

Society is different now, at least in many places in the ­industrialized West, where a youth-focused society has pushed end-of-life concerns mostly out of sight. As a result, people can feel unprepared — even panicked — when they have to deal with end-of-life issues.

“We’ve lost the place of dying,” says Jan Booth, a hospice nurse who also helps out with the Companioning the Dying program. “How do we bring aging and illness and dying into some kind of context that doesn’t change the grief that’s inherent, but changes our capacity to be with it?”

Dougherty started with a few basic principles. One was to help caretakers learn to become better listeners. “It’s sitting with a loving alertness,” she says.

Dougherty, now emeritus program director of Companioning the Dying, lives in her order’s residence in Baltimore. Her voice is weakened by Parkinson’s disease, yet her piercing blue eyes demonstrate the same alert presence that she teaches.

Companioning the Dying has something of the feel of group therapy — with readings, exercises and discussions — in which participants can talk freely and without judgment about anything they might have experienced with the dying, Peter Fitz, 75, says. He wanted to get involved in hospice volunteer work and did the program three years ago.

“Every death, and every person, is different,” says Fitz, a retired English professor. “The crucial part is to find out, with the individual not only on any given day or a particular hour or minute,” where they are. The task, then, is “emptying out your suggestions for people and learning to listen in a different way.”

Those “suggestions” can often end up being the worst thing people can do, says Sallie Tisdale, author of “Advice for Future Corpses (and Those Who Love Them).” People often say things such as “Are you sure the doctor knows what he’s doing?” and “God always has a plan,” she says. “Please don’t say those things.”

She suggests something similar to the Companioning program. “People ask me how to prepare. I say, stand at the doorway and take a self-inventory. Try to drop your own agenda. If the person says, I want to eat ice cream and watch a Yankees game,” just accept that, and do that for them she says.

Lourdes Salazar, a caretaker by profession who also volunteers for her church, St. Camillus in Silver Spring, says that one exercise her Companioning the Dying group did was to choose a day and behave as if it is your last day on Earth. She went out to lunch with her son and told him what she was doing. “I never realized how wonderful it would be to have a lunch with you on my last day,” she told him.

One of the main advantages of Companioning the Dying say participants, is the way it helps them all appreciate their own lives. “When you change your concept about the meaning of death, your life changes,” Salazar says.

Even a nurse who has spent most of her career working with terminally ill children and their families has found that the experience of the course helped her when she was faced with five nearly consecutive deaths in her own family. Janet Will says she thought she was experienced in handling difficult situations. But having the Companioning program allowed her to focus on her own grief and avoid the role of the professional.

“The people who love you the most don’t want to see you grieving any more,” Will says. “Where do you go with that?”

Xaverian Brother Michael McCarthy says that his group ended up being a “tremendously rich melting pot” of people from all walks of life. The group covered details such as what is involved in the dying process, but it also offered time to reflect on being compassionate with oneself even as you help someone else.

It’s not about taking a person’s blood pressure, he says. “You’re going to be present, and if you’re not present with yourself, then your presence isn’t going to be as meaningful” to the dying person.

Peter Fitz remembers visiting a man at a hospice in Baltimore. Fitz didn’t know him. The man was in a “highly agitated” state and couldn’t speak. Fritz asked him if he could nod his head. “Can I take your hand?” he asked. The man nodded yes. The two held hands until the man finally fell asleep.

“In a funny way, he gave me comfort, too,” Fitz says. “It’s an experience that in some important way we shared.”

Complete Article HERE!

7 Inspiring Books to Read When You’re Grieving

By Kelley O’Brien

Books on Loss and Grief

Grief is one of the most human of all emotions. At some point in our lives, it is something we all go through, probably multiple times, and it is never easy. This list of books to read when you are grieving won’t cure you of your grief, but it can help you make sense of it. Some of the books on this list will help help you through the beginning stages of grief, while others will help you make sense of some of the things you are feeling. There is a daily mediation on the list and many different perspectives on grief that are sure to be help you cope through such a difficult journey.

1. Grieving: A Beginner’s Guide

Jerusha Hull McCormack’s Grieving: A Beginner’s Guide is exactly what it sounds like – a good book to read when you are experiencing grief and loss for the first time.

2. It’s OK That You’re Not OK: Meeting Grief and Loss in a Culture That Doesn’t Understand

We live in a society that isn’t comfortable with grief and grieving and Megan Devine’s It’s OK That You’re Not OK is the antidote you need when you’re grieving and the world doesn’t understand. According to Devine, “Grief is simply love in its most wild and painful form. It is a natural and sane response to loss.”

3. Modern Loss: Candid Conversation About Grief. Beginners Welcome.

Rebecca Soffer and Gabrielle Birkner, the founders of the Modern Loss website, bring us this honest take book on grief, letting us know that it’s okay for grief to be messy, complicated, sad, and complicated.

4. Healing After Loss: Daily Meditations For Working Through Grief

Now considered a classic, Martha Whitmore Hickman’s Healing After Loss is a daily meditation that you work through a little bit at a time. It’s an on going recovery book and something to keep with you as you journey through the grieving process.

5. Bearing the Unbearable: Love, Loss, and the Heartbreaking Path of Grief

Joanne Cacciatore’s Bearing the Unbearable is a 52 chapter that “opens a space to process, integrate, and deeply honor our grief.” A bereavement educator, Cacciatore creates a book that is perfect for those grieving, therapists, and anyone else.

6. Tiny Beautiful Things: Advice on Love and Life from Dear Sugar

Known for her memoir Wild, Cheryl Strayed, who experienced the loss of her mother and her marriage, brings forth a lot of advice on grief in Tiny Beautiful Things.

7. Anxiety: The Missing Stage of Grief: A Revolutionary Approach to Understanding and Healing the Impact of Loss

Only a few months old, this new book takes a different approach and delves into an often overlooked aspect of grief: anxiety. Packed with advice on how to cope and strategies to get you through grief.

Complete Article HERE!

Not a season to be jolly:

how to deal with dying during the holidays

By

Dying doesn’t disappear at Christmas. For those who know death will come soon but don’t know exactly when, the festive season, when the air is thick with “joy”, can be particularly unsettling.

As a psychotherapist working in palliative care, I often see distressed patients in the lead up to Christmas. Patients can find decorations and carols being played in shopping centres particularly triggering, reminding them this may be their last Christmas.

The dying person may often face an inner struggle. They may want to be involved in activities but may not have the physical and emotional capacity to deal with the heightened stress and stimulation. Some may prefer to sit quietly and watch proceedings without necessarily being amongst the action, but still feeling like they are a part of things.

Regardless of the the type of life-threatening illness, and whether an infant, child, adolescent, young, middle or older aged person is dying, both the patient and their family members may experience deep distress. You may feel the impending death, and your family the anticipated loss. These gloomy or morbid feelings might clash with the celebrations of Christmas.

Whether it’s you or a loved one facing dying at this time of year, there are some practical tips available that draw from a wealth of research and experience.

If you are the one dying

Where possible, plan ahead how you want to spend your Christmas festive period so you don’t place additional pressure on yourself. Think about the most comfortable arrangements for you. Where and with whom do you want to spend Christmas Day? Which is the best time of day for you to manage different activities? Let people close to you know your thoughts.

The process of dying is unique to each individual. It may be quick or slow, spread over weeks or days. Palliative care specialist at Stanford University, Dr James Hallenbeck wrote:

For those who do die gradually, there’s often a final, rapid slide that happens in roughly the last few days of life — a phase known as ‘active dying’. A person may begin to lose their senses and desires. First hunger and then thirst are lost. Speech is lost next, followed by vision. The last senses to go are usually hearing and touch.

We have an ideal perception around death, that a dying person wants to be surrounded by family in their final hours. But some people in the active phase of dying may actually prefer to be alone. And while this may be difficult for family members to hear, you can give yourself permission to ask for whatever you would like.

Studies indicate some dying people may feel they’re a burden to their family. Other people have difficulty saying “no” because they don’t want to disappoint or hurt others, or they may fear conflict. Know your limitations and don’t push beyond these to simply please others.

Many dying people feel they may be a burden to their families.

Have kind consideration for yourself. Remember you are a person before you’re a patient. And remember it’s OK to say “no” and forgo invitations.

If you’re caring for a loved one who is dying

Essential care demands such as helping the person you are caring for to feed, go to the toilet, and clean themselves, will not disappear at Christmas. If your loved one is dying at home, they may require unrelenting attention.

Be realistic with your expectations. This can be a different and simpler Christmas than others. Allow for spontaneity. Try not to be a martyr and delegate and ask others to help. Doing so enables others to feel they’re included and contributing in special ways.

Listen to the person who is dying. Let them speak if and when they can. Gauge their mood and be guided by them. There is value in being present with the dying person without talking.

Heightened noise and activity, which often go hand in hand with the holiday season, can create distress for a terminally ill person. Ask family and friends to roster their visits over the different days of Christmas so as not to tire, overwhelm or stress the dying person.

People can think children don’t understand death and wouldn’t be able to cope with the concept, so often they may protect them by hiding it. But children are attuned to the family emotional dynamics. They know something is happening and they need their feelings validated. It can be helpful to get children involved in taking care of someone who is dying.

Research shows children do manage themselves well in the face of dying, when adults support them to deal with their responses.

Expect things can change quite suddenly. Have a backup plan ready. Keep emergency contact details readily on hand always.

When dying is happening at Christmas, it’s best to allow all feelings to be expressed rather than simply putting on a brave or smiling face. Feelings are a natural response to suffering and what may be a stressful situation.

It’s mostly important to remember not to hide your needs and feelings but to speak and communicate with your loved ones. Especially when dying may be imminent.

Complete Article HERE!

End Of Life Planning:

It Won’t Kill You

By Sara Zeff Geber

If you are over 50 and reading this, you have probably done some end-of-life planning. No? Time to get to work. You made a will 15 years ago? Not good enough. If you haven’t done anything or haven’t reviewed your planning in over five years, read on.

The key components of end-of-life planning are:

  • A will
  • A power-of-attorney for finances
  • A power-of-attorney for health care
  • An advance directive for health care
  • A trust for your assets

I am not an attorney, so I am not going to go into any depth about these legal documents. My intention is to rouse your interest in doing end-of-life planning by telling you about some novel and inventive ways to enhance it. So, even if you have done the basic planning with your estate attorney and have the documents on record, there are some new and interesting twists today that you may want to know about.

Traditionally, when the topic of end-of life planning comes up, the first item that comes to mind for most people is a will. If you are just beginning this journey a will is a good place to start and you may not need an estate planning attorney to take this first step. There are a number of online tools today for building a will, and some of them are so robust you may only need a couple of witnesses rather than an attorney.

FreeWill.com is one of the newest players in this space. Founded at Stanford University and launched in 2017, FreeWill (in the company’s description) “provides high-quality, intuitive online estate planning tools at no cost to the consumer.”  The founders, Patrick Schmitt and Jenny Xia, are young entrepreneurs with experience in finance and technology.

Several years ago, Patrick, who has a background in nonprofit fundraising and technology for social impact, was about to travel to areas that were not particularly safe for Americans. He decided the prudent thing would be to make a will. In doing so, he discovered that the process was more complicated and difficult than it needed to be, especially if one wanted to include any kind of planned giving to a non-profit. That event became the impetus for starting his company, FreeWill.com.

FreeWill strongly supports the inclusion of planned giving and it is built in to their will-creation software. Through their own research, they have discovered that single people are more than twice as generous as any other group when writing a will and single people who choose to leave a bequest are the most generous (2.5 times more than married people). FreeWill reaches out to singles through their marketing and because I often write about solo agers they reached out to me to help them spread the word.

I tried the online will creation form and discovered it to be very simple and straightforward. It took me less than the 20 minutes they suggest. Once I had completed the online form, I had the option to print it. Printing is necessary because for a will to be legally binding it must be signed by the principal and also by two witnesses. Then it can be kept stored in a safe place, including cloud storage. For larger, more complex estates, FreeWill suggests pairing the effort with a visit to an attorney and they provide the forms for doing just that. FreeWill will be rolling out additional end-of-life forms. A health care directive and a durable power-of-attorney are in the works.

An often-overlooked piece of end-of-life planning is the disposition of your remains after you have passed. I think many people have an even harder time facing this question when they are still healthy and strong, but making these plans ahead of time is one of the kindest gestures you can make for the loved ones you leave behind.

When I was still in my teens, my divorced father, age 55, purchased a burial plot and picked out a casket. He wanted to take me to see the burial park and the plot. I resisted, but he eventually wore me down and we went to visit the cemetery. About 15 years later, he created very specific plans for where he wanted his memorial service and who should be invited. Again, I resisted his efforts to share these plans with me, but he insisted. In addition to telling me, in great detail, what he had in mind for the burial service and the memorial, he also showed me where he kept all his important papers and took me to the bank to show me how to open the safe-deposit box where he kept some gold coins and other valuables.

It upset me to think about him dying; he wasn’t sick at the time and I couldn’t figure out why he was making all these seemingly-premature plans. Of course, years later he did die and it was fairly sudden. Amidst the shock of his passing I realized I did not have to make any decisions; all I had to do was put his plans in motion. It was the greatest gift he could have given me.

My father chose to be buried.  Now, thirty years later, my husband and I have chosen cremation and having our ashes scattered at sea near our Northern California home. The Neptune Society and the Trident Society (both subsidiaries of Service Corporation International) have pre-need programs for cremation. There are other cremation programs, but these two have been around the longest and that seemed important for a decision like this. They both have 5-year financing plans and other payment options.

There is also a green burial option today that may be appealing to you if you are concerned about traditional burial’s impact on the environment and use of open space.

As with so many later-life concerns, baby boomers are changing the landscape at the end of life. I think we can expect to see many more new concepts arise in the next two decades as this large population cohort enters the final decades of life.

Complete Article HERE!