As Alzheimer’s Symptoms Worsen, Hard Conversations About How To Die

By Rebecca Hersher

Six years after he was diagnosed with early onset Alzheimer's disease, Greg O'Brien is thinking differently about the future. Even as he fights to hold onto his memory, he and his wife Mary Catherine are discussing how to let go.
Six years after he was diagnosed with early onset Alzheimer’s disease, Greg O’Brien is thinking differently about the future. Even as he fights to hold onto his memory, he and his wife Mary Catherine are discussing how to let go.

In this installment of NPR’s series Inside Alzheimer’s, we hear from Greg O’Brien about his decision to forgo treatment for another life-threatening illness. A longtime journalist in Cape Cod, Mass., O’Brien was diagnosed with early onset Alzheimer’s disease in 2009.

These days, Greg O’Brien is thinking differently about the future. It’s been six years since his Alzheimer’s diagnosis, and he’s shared with NPR listeners a lot about his fight to maintain what’s left of his memory. He’s shared his struggles with losing independence, and with helping his close-knit family deal with his illness.

What O’Brien hasn’t wanted to talk about until now is the diagnosis he got two weeks before he and his family learned he had Alzheimer’s disease: O’Brien also has stage 3 prostate cancer. Now, as his Alzheimer’s symptoms worsen, the cancer is increasingly on his mind.

“I just don’t know how much longer I can keep putting up this fight,” he says.

This summer, Greg and his wife, Mary Catherine O’Brien, have started talking about how he wants to spend the final years of his life — and what Greg calls his “exit strategy.”

He hopes the cancer will kill him before the Alzheimer’s disease completely robs him of his identity.

Recently Greg sat down with his close friend and primary care physician, Dr. Barry Conant, and with Mary Catherine, to talk about that decision and about Greg’s prognosis.

Interview Highlights

Dr. Barry Conant on the ethics of not treating Greg’s prostate cancer

I think honestly, in a perverse kind of a way, it gives you solace.

Maybe it will shorten the period in your life which you find right now to be something you want to avoid, and so far you’re only talking about neglect of a potentially terminal condition.

If you decided to be more proactive, that’s where the discussion becomes more interesting. Some people would say I’m violating 001my Hippocratic oath by discussing that, but I think — I don’t feel uncomfortable having that discussion. And, while you still have the ability to reason, it wouldn’t be a bad discussion to have with your family.

Conant — who, like O’Brien, has cancer — consoles Greg that his family will be OK

Nobody is indispensable — nobody. And if you or I were to immediately vanish from the Earth, our families would do fine. They have family support. They have friends’ support. They’re in a nice community. It’s a terrible sense of loss that they’ll have, but they will do fine. And if they’re honest with themselves, they’d realize that they’re going to do fine.

Greg and Mary Catherine discuss Greg’s prognosis

Mary Catherine: Going through Alzheimer’s, it’s not the plan.

Greg: Where do we go from here?

Mary Catherine: That I don’t know. …

Greg: It’s getting so frustrating for me. I mean I care, obviously, deeply about you and the kids. I could see 3 or 4 more years of this, but I can’t keep the fight up at this level. We talked about that the other night. How did you feel about that?

Mary Catherine: Wow … (chokes up). I don’t want to talk about it.

Greg: Can you see it coming?

Mary Catherine: Yeah, I can. Fast.

Greg: Are you OK with me not treating the prostate cancer?

Mary Catherine: Only because you’re OK with it. You need that exit strategy, and the exit strategy with Alzheimer’s is horrible. Well, they’re both horrible.

Greg: You know I’ve been there with my grandfather and mother, and don’t want to take my family and friends to that place.

Mary Catherine: Right. I know. I understand.

Greg: Do you still love me, dear?

Mary Catherine: Yes, I do, dear.

Greg: I love you, too.

Complete Article HERE!

Caring for someone who is terminally ill

The following information is primarily for our friends in the UK.  However, it’s a great checklist for the rest of us too.

 

It’s important to understand the financial, practical and emotional support available to you and the person you care for. Information on the support that may be available to you or the person you care for is provided below.

sick child

Financial support

You or the person you care for may be entitled to some financial support. Some information on this is provided below.

Benefits for the person you care for

The person you care for may be entitled to:

  • Disability Living Allowance, if they are under 65 and need help with personal care and/or getting around
  • Attendance Allowance, if they are 65 or over and need help with personal care
  • Employment and Support Allowance, if they are under state pension age and have an illness or disability which affects their ability to work

There are special rules to help terminally ill people get Disability Living Allowance, Attendance Allowance or Employment and Support Allowance quickly and easily.

Carer’s Allowance

As a carer, you may be entitled to receive Carer’s Allowance. You can keep getting this for up to 12 weeks if the person you care for goes into hospital and for up to 4 weeks if they go into a care home (provided certain conditions are met). If the person you care for dies, Carer’s Allowance will usually stop after eight weeks.

Practical support

There’s lots of support available from different organisations for carers. It’s important that you have enough practical and emotional support in your caring role.

Support from social services

The social services department of your local Trust may provide a range of social care services and equipment for terminally ill people.

Assessments from your local Trust

An assessment with social services is the first step towards getting help and support for yourself and the person you care for. The person you care for is entitled to a health and social care assessment, while you, as a carer, are entitled to a carer’s assessment.

Emotional support

Although friends and family can provide emotional support at this difficult time, you may find it easier to talk to a professional counsellor or to other carers in a similar position. The person you’re caring for and other family members may also benefit from counseling.

Support groups for carers

There may be support groups for carers in your local area. This could give you the opportunity to talk to other people in the same situation as yourself.

Help with caring for someone at home

There are different options to help you care for someone at home.

Medical and nursing care

If the person you care for needs specialist medical or nursing care to enable them to continue living at home, you can arrange this through their local doctor (GP). Services that may be available include:

  • visits from a district or community nurse (for example, to change dressings, give injections or help with bathing or toileting)
  • help with getting the person into and out of bed

Services that are provided by the local Trusts may vary from region to region.

Short-term breaks

Both you and the person you care for may benefit if you can take a short-term break from caring from time to time. This is sometimes known as respite care. You can arrange short-term breaks through your local Trust.

Employing a professional carer

If you’re caring for someone who needs a lot of care, you may choose to employ a professional carer (or carers) to share the caring role with you.

Alternatives to caring for someone at home

Hospice care

Hospices are residential units that provide care specifically for people who are terminally ill, and offer support to those who care for them.

Hospices specialise in palliative care, which aims to make the end of a person’s life as comfortable as possible and to relieve their symptoms when a cure is not possible. Hospices are run by a team of doctors, nurses, social workers, counsellors and trained volunteers. Many hospices offer bereavement counseling.

Hospice staff can sometimes visit people at home and are often on call 24 hours a day. It is also possible for patients to receive daycare at the hospice without moving in, or to stay for a short period to give their carers a break.

There is no charge for hospice care, but the person you care for must be referred to a hospice through their GP, hospital doctor or district nurse.

In Northern Ireland, hospice care is provided by:

Hospital care

There may be times when a terminally ill person needs to go into hospital. If the person you care for is coming home after a hospital stay, your local Trust will work to meet any continuing health and social care needs. The person’s needs should be assessed before they return home and a package of care arranged for them.

Care homes

If the person you care for needs a level of care and support that cannot be provided in their own home, a residential care or nursing home could be the answer. You can find detailed information about care homes in the health and well-being section of nidirect.

Helping the person you care for prepare for death

It’s natural for someone who is terminally ill to want to sort out their affairs and make decisions about what kind of medical treatment they want (or don’t want) at the end of their life. The ‘rights and responsibilities’ section of nidirect contains useful information about wills, living wills and the right to refuse medical treatment and resuscitation.

When the person you care for dies

There are things you may need to consider if you care for a terminally ill person.

What to do after a death

When someone dies, there are some things you will need to do straight away, or within the first few days and weeks.

Bereavement counseling

When someone close to you dies, you may benefit from counseling from a specialist bereavement counsellor. The charity Cruse Bereavement Care can help with this.

Benefits and bereavement

If the person you care for dies, Carers Allowance will usually stop after eight weeks. If your spouse or civil partner has died, you may be able to claim one or more of the following bereavement benefits:

  • bereavement payment; a single tax-free payment for people who are under state pension age when their spouse or civil partner dies
  • widowed parents allowance for people who have dependent children
  • bereavement allowance for those aged 45 and over when their spouse or civil partner dies

Complete Article HERE!

Why use your eventual death as an excuse to try something new?

By 

Bucket lists are morbid and moronic. Let’s get rid of them

travel
Bucket lists gained mass appeal after they were featured in a Hollywood film.

Before each one of us dies, let’s wipe the “bucket list” from our collective vocabulary.

I hate the term “the bucket list.” The phrase, a list of things one wants to do in life before one dies or “kicks the bucket”, is the kind of hackneyed, cliche, stupid and insipid term only we Americans can come up with.

Even worse, “the bucket list” has become an excuse for people to couch things they actually desire to try doing as only socially acceptable if framed in the face of their death. It’s as if pleasure, curiosity and fun weren’t reasons enough for action.

If you want to try doing something others might find strange or unorthodox –write a novel, learn to tap dance, engage in a rim job, field dress a deer, climb Everest, go out in drag for a night – why do you need any justification at all? And certainly, why would you need an explanation that is only justifiable in terms of kicking the bucket?

According to the Wall Street Journal, the phrase “bucket list” comes to us from the banal mind of screenwriter Justin Zackham, who developed a list of things he wanted to do before he died. Years later, his “bucket list” became the title of his corny 2007 film starring Jack Nicholson and Morgan Freeman. It’s about two old men with terminal cancer who want to live it up before they die. That, if anyone at all, is who should be using the term “bucket list”. They want to do something with the finite time they know they have left? Fine.

But bucket list has trickled down to everday use by the perfectly healthy, the exceptionally young, and most of all, to douche bags. I realized this at Burning Man last week. Often, when I asked exceptionally boring people what had drawn them to Black Rock City, they’d say: “It was on my bucket list!”

Really? You wanted to schlep out to the desert and face freezing lows, scorching highs and soul crushing techno simply because you’re going to die someday?

If you want to try something, just own that you want to try it. At Burning Man, I was much more drawn to “trysexuals” (“I’ll try anything once”) than to bucket listers. It’s a very different dynamic to say you want to try something because you’re alive, and you’re curious, and you’re open to maybe finding something you might like than it is to justifying something because of your ultimate demise. If you want to try skydiving, skydive. If you want to try going to an orgy, go to that orgy. But be open to the experience beyond it being a mere bucket list check off, with one foot already mentally in your grave. Who knows, you might enjoy yourself.

A bucket list is a way of giving power to others as you nakedly (even if unconsciously) seek their justification for your choices. The bucket list, God help me, is forcing me to validate the one part of Ayn Rand’s objectivist philosophywhich registered with me when I read The Fountainhead years ago. People often place more importance upon the mirror of others’ judgments about them than they do upon their own desires. If you want to do something weird, don’t worry about explaining why you want to slake your desire. You needn’t rationalize your choices as “bucket list worthy” to others who deem them heretical.

There’s a funny dynamic sometimes when I go on a long trip while I’m out of work. When I backpacked through Asia and Europe in 2013, people (usually friends chained to a spouse, children and a mortgage) would sometimes awkwardly say to me: “Well, it will be the trip of a lifetime!” It was a good trip, but just one of many great journeys I’ve taken in my life so far. My adventures might interrupt someone else’s idea of what’s “normal.” But travel isn’t something I do to fulfil my “bucket list”; travel is a way of life for me. I do not rush into a trip thinking: “Good Christ, I could die tomorrow!” I don’t travel in place of the stable job or partner or kids I may or may not ever have. I do it as often as I can because it brings me joy.

Referring to your eventual death as an excuse to do something privileges the future instead of the present. We are all going to die, it is true. I am not abovemorbid thoughts and thinking about death. But to focus on the end of life as a reason to do things, rather than on the fact that you’re alive right now to do them? I cringe when I’ve hear undergraduates in college talk about their bucket list, having already decided they will work for 42 years, lead a certain kind of life, retire – and at prescribed points in that plan, check off fun things before they croak.

“Bucket list” thinking is epitomized for me in the interactive “Before I Die…” art project”, a chalkboard installation with the words “Before I die I want to______” Viewers fill in the blanks, and one turned up at Burning Man this year. If I had my way, we’d stop thinking so much about our eventual annihilation when we strive for fun in our lives … and we’d kick the bucket list to the curb.

 Complete Article HERE!

When Your Loved One’s Last Wish Was ‘No Funeral’

By

alternative_memorials

WebOver the past year, I’ve experienced several losses that, at the request of the deceased, did not include funerals. Grief rituals are central to my mourning process, but there’s no negotiating with the dead. In the absence of the most standard of ceremonies, how do you give expression to your grief while respecting someone’s final wish for “no funeral, please?” Through personal experience, and conversations with friends and readers who’ve faced the same scenario, here are seven ways to do just that.

  1. Write and place an obituary in their local paper.

My 93-year-old grandmother died in May, and had insisted she didn’t want a funeral. My grandfather had planned to write the obituary, but amid his grief, the project was understandably pushed aside. Yet the idea of my much-beloved grandmother’s life and death going unrecognized publicly was an uncomfortable one.So I contacted surviving relatives to get the details of Gram’s early life, and placed obituaries in the papers of her East Coast childhood and West Coast adulthood. Plotting her life achievements through words provided a way to process my grief. Seeing her name, picture and story in print granted me a sense that she isn’t forgotten.

  1. Take up one of their skills or hobbies.

Was she a yoga aficionado or competitive knitter? Was he a golfer? Engage in an activity that reminds you of the deceased and try to discover what they loved so much about it.

  1. Assemble an homage to the deceased in your home.

Bring out your memories of him or her — photos, postcards, ticket stubs, keepsakes — and display them with a memorial candle in your home. When the person crosses your mind, light the candle and say a few words. Rinse and repeat as needed.

  1. Post a personal tribute with photos on Facebook and/or your blog.

What would you have said at their funeral? Which story or picture would you have shared with other mourners? Craft your tribute and tell it to Facebook or your blog followers.

  1. Donate to their favorite cause.

I was crushed last September to hear that a former L.A. colleague and brilliant writer had died of cancer. She’d quietly quit her job, told no one that the disease she’d beat years ago had returned, and entered a nursing home. The news that she’d donated her body to science and didn’t want a memorial was a one-two punch. For weeks, I struggled with how to honor this woman who’d been a generous mentor early in my career. Since she was a self-proclaimed “cat lady,” I made a donation in her name to Kitten Rescue Los Angeles. The act didn’t provide the same degree of catharsis as a funeral, but it offered a personalized way to honor her legacy.

  1. Host a dinner or cocktail hour in their honor.

Gather would-be funeral attendees for a meal where signature drinks and dishes loved by the deceased are served. To encourage guests to exchange favorite memories around the table, start off by sharing yours.

  1. Plan a pilgrimage to sites charged with their memory.

After the uncle of one of my friends died suddenly, the family learned that he had not wanted a funeral. In lieu of it, they gathered in his hometown and did a walking tour that included his childhood home, the church where he was confirmed and the lake where he and his surviving sister had ice-skated. Through this expedition, the family was able to respect the uncle’s wishes while sharing the tears and memories that would accompany a formal service.

Complete Article HERE!

Do you want to die at home? Here’s why you probably won’t.

Hospice care for terminally ill patients
Hospice volunteers caress the hands of terminally ill patient Annabelle Martin, 92, as her health quickly declined at the Hospice of Saint John on September 1, 2009 in Lakewood, Colorado.

HAIDER JAVED WARRAICH

Late on a Sunday night in the hospital, my Haitian patient’s wife came in to help translate. I don’t know what I would have done without her. I needed to tell my patient that the tumor growing in his chest was pressing on his aorta. If he needed CPR overnight, the chest compressions might prove fatal.

As I explained all this, I looked back and forth from the wife to the patient like a spectator watching a tennis match. Her face contorted in horror at the news, but he remained stoic, with his arms crossed, and kept repeating one word: lakay. Finally I asked the wife, “What islakay?” She looked at me and said: “Home. He wants to go home.”

One of the few things that people across all backgrounds and cultures value in common is home. An overwhelming amount of research from around the world has shown that home is where most patients and their family members would like to take their last breath. But not everyone has that option.

Often, the underlying disease, rather than the patient’s wishes, dictates their place of death. Patients with cancer, for example, die at home more often than those with heart disease. (Cancer progresses in a more predictable way, so those patients are more likely to use hospice services at home.)

Social support is another factor. Frequently, those close to the end require 24-hour supervision, which a relative may not be able to provide. And caring for the terminally ill is extremely taxing — for caregiver and patient — so hospitals seem like the better option.

Geography can also determine where one is more likely to die. How far one lives from a hospital is directly associated with the chances of dying there. No surprise, then, that the nation with the greatest density of hospital beds — Japan — is also where patients are most likely to die in one. (On the flip side, in areas without adequate medical and hospice resources, patients may die at home when they could have been saved by professional care.)

Race, finally, plays a role. Although the proportion of home deaths since the 1980s has risen, 43% of blacks and 44% of Latinos die in hospitals, compared with 34% of whites. (In the 1970s, the percentage of blacks and whites who died in the hospital was the same: 54%.)

That’s in part because home care is expensive, and whites are more likely than other racial and ethnic groups to have access to home services through their insurance.

Culture, however, often is an even more important determinant. Many studies have found that minorities generally receive fewer medical services over the course of their lives when they are relatively stable. But at the end of life, minorities are more likely to receive aggressive care, are more likely to want resuscitation and intubation, and therefore end up spending more time in the intensive care unit than whites.

One important solution to so many people dying in hospitals would be to build more hospice homes in inner cities. But if we want more people to have the option of dying in their own homes, we need to push insurance providers to increase end-of-life options. Although most insurance pays for hospice care, many patients also require increased support at home, which is not typically covered.

But we also need a culture change, convincing patients and their families that more is not always better in healthcare, particularly when death is inevitable.

Many patients want to die at home but are pressured by relatives and even some physicians to keep trying Hail Mary procedures that end up prolonging suffering. Having the option to die at home is perhaps one means for patients to regain some semblance of control.

Given how advanced my Haitian patient’s cancer was, I knew that there was no way we could win this war, which made me desperate for every small victory. So I savored the moment as he collected his belongings to go home to hospice services, knowing that a death in one’s own bed was a privilege that many do not have.

Complete Article HERE!

The courage to die

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The day he was to die, Vernon Gearhard had breakfast with Fran, his wife of 57 years, their three children and their spouses.

He listened to some of his favorite music – classical pianist Johannes Brahms and opera singer Kathleen Battle – and around noon, he and Fran sat on their terrace. The sun peeked out from behind rain clouds and two bald eagles and several raven flew around nearby, lingering in the area as the couple watched.

The 84-year-old master mason had planned for this day. Friends and family had been visiting for the past month, many from nearby towns, others from as far away as Vermont. He had spent the last week with his family, including his seven grandchildren and three great-grandchildren.

It was time.

002The medication – powder from 100 capsules of the barbiturate Seconal – had been mixed with water, creating a slurry-type paste that Vern could drink. He went into the bedroom and grabbed the bar he needed to use to pull himself from his wheelchair into a sitting position on the bed.

“This is the last damn time I have to grab this bar,” he told his wife, Fran.

He drank the medicinal slurry, washing it down with orange juice. His eyes rolled backward and he lay back on the bed. Thirty minutes later, surrounded by his family, his heart stopped beating.

“Just our children came in while he was dying,” Fran said. “I promised him that someone would be touching him the whole time.” She stayed with his body until the hearse arrived.

Fran remembers that day – March 17, 2015 – with tears and joy.

“It was so easy for him, finally,” she said. “It has been a long time since anything had been easy. … It was really a joyful thing.”

Vern, who had Parkinson’s disease, was given less than six months to live when he decided to end his life by taking prescribed medication through Oregon’s Death With Dignity Act.

On President’s Day, Feb. 16, 2015, Fran and Vern gathered their family together and told them of his decision. Their three children and their spouses were supportive. So was the rest of the family.

That support, Fran said, made it possible. “The kids really, really, really were there for us. I couldn’t have done it without their support.”

Since Oregon’s Death With Dignity Act was enacted in 1997 more than 860 terminally ill people have chosen to use it to end their lives. To do so, a patient must get the agreement of two doctors that he or she has six months or less to live. The patient also must go through an intensive interview process to determine his or her mental state and decision-making capabilities.

It’s not easy, Fran said, noting that the Gearhards had help from Compassion and Choices, a nonprofit advocacy group that provides trained volunteers and consultants to help terminally ill patients seeking end-of-life options. The Gearhards connected by phone with a Compassion and Choices volunteer in Ashland.003

Vern was diagnosed with Parkinson’s disease about 20 years ago, when he was in his early 60s though family members say he had symptoms of the disease, including tremors, in his late 50s. He took medication and led a physically active lifestyle, which seemed to keep the disease’s symptoms at bay.

Parkinson’s disease is a progressive disorder of the nervous system that affects movement. It develops gradually, and early symptoms include tremors. In the later stages, muscle stiffness makes it difficult or impossible for patients to walk and take care of themselves.

Vern was born in Chicago, and grew up in Martinez, Calif. He joined the Navy and served in the Korean War from 1950-54. He then attended Cal Poly on the GI Bill and earned a degree in agronomy. Vern and Fran began dating while she was in college – she earned an education degree from San Francisco State University. They married her sophomore year in college. Several years later they bought acreage north of Merrill in 1965 and started farming.

Fran taught for 34 years, 28 of those as a fifth-grade teacher at Shasta Elementary in Klamath Falls. They raised three children – Theresa, Marcus and Paul.

The family farmed for 15 years, but masonry was in Vern’s blood. His grandfather, an Austrian immigrant, was a mason and Vern apprenticed under him. As farming changed, Vern spent more time on masonry and eventually worked at it fulltime, earning a reputation as master mason with an artistic and signature style.

After his Parkinson’s diagnosis, Vern continued to work as a master mason, creating artistic fireplaces, homes and other pieces for private clients as well as for local businesses. Some of his more prominent pieces include the Klamath Rotary sign downtown, the sign at the Herald and News building off Foothills Boulevard and the rock sign at Kla-Mo-Ya Casino off Highway 97 near Chiloquin.

004He helped build his house, high on a hill, an artistic nod to a mason’s mastery of his craft. Inside, a rock fireplace dominates the great room and touches of his work are throughout.

Vern loved classical music, opera, and good literature. He belonged to two book groups and owned the first version of Kindle, an electronic book reader that launched in November 2007. By the time he died, he owned his eighth Kindle.

He also was a huge San Francisco Giants fan. “He always recorded the games he couldn’t watch,” Fran recalled. “God pity you if you told him the score before he could watch it.”

When he was 80, his symptoms — tremors, muscle and balance issues — forced him to retire. The disease progressed quickly after he stopped working. First, he had to use a cane and later, a wheelchair.

As the disease progressed, Vern needed help with everyday tasks, and then could no longer use his hands well enough to turn the pages on his Kindle. In his last month, he was sleeping nearly 20 hours a day and had limited energy.

“When he had to quit work, that was huge. When he had to quit driving, that was huge,” Fran said. “When he lost the ability to read, that was it.”

In November 2014, Fran, 78, faced her own mortality when she was diagnosed with stage 4 colon cancer. She decided to go through treatment so she could be there for Vern, who was thinking about his end-of-life options. She had surgery, followed with chemotherapy in January, and currently is cancer free.

Vern approached his doctor, who said though he supported Vern’s decision, he couldn’t write the Death With Dignity prescription. His physician did prescribe hospice, which is for patients who have been diagnosed with six months or less to live.

The Gearhards were able to find two other Klamath Falls physicians who were willing to consider Vern’s decision and work with them. The law requires both a prescribing physician and a consulting physician to agree on a diagnosis and prognosis as well as whether Vern was mentally capable of making the decision to end his life.003

Klamath Hospice helped with Vern’s care and supported the family during his last months of life. Hospice does not advocate for or against the Death With Dignity Act, but provides support for patients and their families, Fran said.

When the time came, the law required that Vern take the prescription himself, holding the mug and drinking the medication without aid.

“His big worry was that he would be beyond the point where he could do it on his own,” said Dennis Ross, Vern’s son-in-law. “Your ability to follow through could be ended at any time.”

Ross was there the day of Vern’s death. An hour before he was to take the prescription, he had to take anti-nausea medication. The medication made him sleepy and he told his family: “I’m getting sleepy. We better get on with it.”

Ross, who had watched his parents die, believes the dying should have choices. His parents lived in California and didn’t have the same end-of-life options Vern did.

He watched Vern’s quality of life decline and supported his decision. “There’re just a thousand little things that take your dignity away,” he said. “It just piles up.”

But the end game is up to the patient.

“You can make all the plans, but when it comes down to drinking that stuff, that’s an incredible amount of courage,” Ross said.

Vern’s memorial was March 21 at his daughter’s home, a rock house he helped build near his own, and cars lined the road as family, clients and friends came to celebrate his life. Vern had picked the music he wanted played at his funeral – Mozart’s “Concerto in D-Minor, Second Movement” and John Lennon’s “Imagine.”

The Concerto in D-Minor was a piece Vern fell in love with in 1981 while he was collecting rock in Langell Valley. “He always listened to classical music while he worked,” Fran said. “That day he came home and said, ‘This is what I want played at my memorial.’ Before he died, he played it for his friends who came to visit, and for the hospice worker.”

Vern was an atheist and was curious about death.

“He always said he wanted to know so he wanted to be aware,” Fran said. “He was always very articulate about his perspective of life and death.”

“For us and for Vern – it was his decision – it was right,” she added. “It’s not for everyone, I understand. I just want to share the opportunity this law gave us.”

Fran recalled her husband’s last hours with joy.

It was around noon, just before the two of them went to sit on the terrace.

“Vern started to sob, and I asked, ‘What’s going on?’ He said, ‘I just feel so much love.’”

Fran smiled. “It’s a story with a beautiful ending.”

Complete Article HERE!

If These Bones Could Talk: The Stories Human Skeletons Can Tell

By ELISSA NADWORNY

There’s an open box of skulls on the floor. A table is covered with pelvis bones. Nearby: a pile of ribs, tied up with a piece of string.

I’m standing in a basement room, underneath the bleachers of the football stadium at the University of Tennessee, Knoxville. Looking at floor-to-ceiling shelves filled with cardboard boxes. More than a thousand boxes, and each one contains a human skeleton.

“Pick a box. Any box,” says Dr. Dawnie Steadman, the director of the school’s forensic anthropology program. “What’s your pleasure?”

I scan the rows of boxes. I’m thinking I should pick a female. And so I settle on a box five rows up, just above my head, labeled “Female 57.”

Steadman places it on a table and starts to unpack it. Inside, the bones are tannish brown, not the bleached white I imagined.

She knows how to read these bones, and this one tells a story right away. “So this individual needed to have an autopsy after death,” Steadman explains, “and now I know why.”

She picks up a piece of the skull and points to a place just above the left eye.

I see it: a perfectly rounded hole.

“What we see here,” she says, “is a gunshot wound.”

Allysha Winburn, a Ph.D. student from Florida, came to the Bass Collection to study age estimation, osteoarthritis and obesity.
Allysha Winburn, a Ph.D. student from Florida, came to the Bass Collection to study age estimation, osteoarthritis and obesity.

This moment is why people come from all over the world to study these bones. Female 57 is just one of the 1,200 skeletons here, part of what’s called the Bass Donated Skeletal Collection.

Anthropologists, detectives, demographers — they all come here to learn how to read these bones: How old was this person? Was it a man or a woman? How did they die?

What they learn here can help them identify a missing person, crack an old murder case … or understand how obesity relates to osteoarthritis.

Steadman heads deeper into the stacks.

“There’s no more than one person in each box,” she says, counting off the ages as we walk by: 45, 49, 42. There’s at least one person who lived past 100.

So, how did these bones get here? While they’re still alive, people can sign up to donate their remains to the UT’s body-donation program. When they die, their bodies are sent here to the university.

Contemporary skeletons show researchers the side effects of modern medicine, like a hip replacement.
Contemporary skeletons show researchers the side effects of modern medicine, like a hip replacement.

But before they become skeletons in a box, they have another stop to make: a special fenced-in field across campus. There, the corpses are laid out on the ground and students study them as they decompose. When all that’s left is the skeleton, students clean the bones and send them here.

The donors “give us all sorts of information about themselves,” says Steadman. “They tell us their age, sex … ancestry.”

Everything but their name. To visitors — like me — the bones remain anonymous.

Not Just Old Bones

Because these bones belonged to people who died in the last 35 years, many skeletons bear the marks — and products — of modern medicine.

“Here’s another prosthetic that we commonly see,” says Steadman, pointing to an box open on the floor.

I look closer, and something shiny catches my eye. It’s on the end of a leg bone.

“It’s the ball of the ball and socket joint. They remove that and they replace it with a really nice stainless steel, metal head,” Steadman says. “That’s a hip replacement.”

The collection holds more than 1,200 donated human skeletons.
The collection holds more than 1,200 donated human skeletons.

Pelvises, skulls, vertebrae! Its all so cool. But I can’t stop thinking about Female 57, that first skull with the bullet hole. We head back to her box, still open on the table.

“I can’t believe you pulled out that gunshot wound,” Steadman says, laughing.

She rolls the large piece of the skull over in her hands, looking for more clues.

“This looks to me like it could be either a contact entrance wound or exit wound. I’ll have to keep looking,” she says, sifting through the other bones.

We learn more about this 57-year-old woman. She has a bifurcated rib — meaning she was born with two of her ribs are stuck together. She was about 5 feet 7 — a little taller than I am. I’m dying to know what happened to this woman. Who shot her? Was it a suicide?

But Steadman stops me.

“I’m not gonna say much more because of this … it now may become somewhat identifying.” She trails off.

I get it. We have to protect this women’s identity, and we’re about to learn too many details.

So we pack up the bones. Steadman returns them to the shelf, tucked between a male, 35, and a female, 81.

These bones, they’re silent teachers.

Steadman agrees: “You can absolutely learn something from every single skeleton.”

And here they’ll rest, waiting for the next set of curious hands.

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