How Friendship Changes at the End of Life

“People become frightened at the end of life. Sometimes I see them moving away from friends as they get sicker.”

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Julie Beck talks with two women who met through the nontheistic religion of Ethical Culture and have spent a significant amount of time ministering to aging and dying members of their congregation. They discuss how friendship changes at the end of life, and how they work to foster connection and community for members of all ages.

The Friends:

Anne Klaeysen, 68, a recently retired clergy leader for the New York Society for Ethical Culture and a humanist chaplain at New York University. She lives in Brooklyn.
Liz Singer, 71, a geriatric-care manager and the president of the New York Society for Ethical Culture. She lives in Fort Lee, New Jersey.

This interview has been edited and condensed for clarity.


Julie Beck: How did you two meet and begin ministering to the dying together?

Anne Klaeysen: Liz became a member of the New York society maybe seven years ago. I am always at the monthly newcomer reception, so we met there. She just dove right in, and shortly became the president of the board. I have to confess, Liz, I get a little worried when people dive in so quickly. I’m thinking, Oh dear, is she going to drown? Liz did not drown; she’s a strong swimmer. Liz came at a time when we really needed strong leadership. And she wasn’t afraid to take on a couple of the old boys. So I think there was certainly a feminist bond there. [We became] partners in crime, or [rather] partners in good works.strong>Liz Singer: We have a strong aging population. I think 30 percent of our members are probably over 70. And we started to see things like dementia. As Anne and I developed our friendship, we began having conversations on the very delicate process of aging and navigating our roles with the members.

Anne: Liz is a geriatric-care manager. Her expertise in this field was invaluable, but I was a little concerned because I didn’t want to take advantage of her. Members don’t mean to take advantage, but sometimes they do.

Also, our members are humanists. We’re a nontheistic religion of ethics. So most of our members don’t believe in a supernatural deity, nor in an afterlife. And they’re fiercely independent. One of our challenges has been to get them to tell us when they’re going through something. Very often we find out about things after they’re in the hospital. It’s not that they don’t trust us; they have a real fear of losing their dignity.

Another society member, Barbara Simpson, runs something called the Death Café. That’s an opportunity for folks to come and really speak about living. We know that we are mortal, and the gift of that is we can live life more completely and in connection with each other. It’s really a joyful experience for [our members]. Barbara has said that very often people are comfortable talking about [mortality], but their children aren’t. [They’ll say], “No, Mom, you’re never going to die; you’re not going to die yet.” People may have their life in order, their papers in order, but their children are in denial.

Anne Klaeysen (left) and Liz Singer (right) sharing a meal together.

Beck: Was there a turning point where you went from having a collegial relationship to more of a friendship?

Liz: The turning point was probably our first serious case, five or six years ago. There was a woman who was estranged from her daughter. Very stubborn. We were trying to bring the daughter back into the picture and make that relationship communicative. Because it was so difficult, Anne and I had to talk about it all the time. The trick was for Anne and I to work together very closely. Anne was having lunch with [the older woman], and gaining her trust. And I was trying to bring in oversight without activating her stubbornness.

Anne: [The woman] left the society for a while because she didn’t get along with people. People didn’t quite come up to her standards. When she came back I was thinking, How can we help her to fit in? How can we help her not be so judgmental? One really good connection was with the children [in our congregation]. I suggested that she come meet with the children, and tell them about her experience. She was a Holocaust survivor; she was on the kindertransport train from Germany to England. I wanted her to be connected with the children, because she was estranged from her own daughter. And she was kind of prickly around some of the adults. The children were so appreciative, and so affectionate with her. They wrote to her when she wasn’t well. They drew her pictures. That’s another thing that a community can do when it’s intergenerational: connect at all ages of one’s life.

Beck: Being with people at the end of life is very intense work. You are regularly seeing a part of life that a lot of people don’t see, or see very rarely. How do you feel that affects your relationships generally and your friendship specifically?

Anne: Generally I have a great appreciation for what the elderly are going through. A big challenge with one of our members was the lack of understanding among hospice and health-care staff for people who are humanists, who don’t believe in God, and don’t believe in an afterlife. It was really difficult for this person when others around her were saying, “Oh, don’t be afraid. God loves you.”

I’ve been on different panels to try to train people not to assume that they are caring for God-fearing people. Just listen to these people. Even when they have dementia. They may not know where they are, they may not remember things, but you’ve got to listen.

Liz: How does it affect my personal life? Number one, it [gives me] an appreciation for life. Number two, I have a reputation when I go to dinner parties. Don’t bring up any questions about aging or I’ll get on a soapbox.

Beck: You mentioned that sometimes you are ministering to people who are your friends, which I imagine is very special, but at the same time could make the balance harder.

Anne: It does. Keeping our work separate from [our personal lives] is a challenge. Where do you draw the line for someone who’s a friend and someone that you’re pastoring to in a professional capacity? But there’s a part of me that wants my life to be integrated. You don’t want to compartmentalize, but you also don’t want to become so involved that you lose perspective. One thing Liz and I do in our friendship is try to help each other keep that balance.

Beck: Is there anything that you’ve observed about how friendship changes at the end of life?

Liz: People become frightened at the end of life. Sometimes I see them moving away from friends as they get sicker. Once people get past that fear of what’s going on, they can be friends again.

Anne: Partly, [what changes is] a sense of loss. My dad died at 101. He was hale and hearty up until the end, and very sound of mind. I remember him saying that all of his friends had died on him. But because he was hard of hearing, it was difficult for him to make new friends. I think a lot of the infirmities that are experienced in advanced age make it difficult to make new friends. Often at the New York society, I see people who become a member after a spouse has died. They’re grateful to have a group of people with whom they can socialize.

I don’t want to sound stereotypical here, but women have been raised to develop those social skills. Men have very often relied on women to do that for them. What we find is that, in the aging population, women are able to cope better. Men who have relied on a spouse or a girlfriend lack those skills. They prefer to have a woman in their lives who can do that for them. That’s the way they were raised. It’s really difficult for them.

Beck: Because of this work, are there things you’re able to talk about with each other that are harder to talk about with your other friends?

Liz: [Anne and I have] skills around dealing with very deep conversations, where a lot of people don’t want to go.

Anne: Of course we’ve also had a lot of challenges in this political atmosphere of, How do you hear somebody with whom you profoundly disagree? We’ve seen that with members who may not be on speaking terms with family or friends. A lot of the work that we do is about—no matter what age somebody is—having respect for human worth, and seeing the other person as a full person.

Liz, you and I had a little rocky time when we weren’t really understanding each other.

Liz: It had to do with some organizational issues at the society. It was very political.

Anne: I thought, I’m going to assume that this is a misunderstanding. We just really need to go back and listen more carefully. What I really appreciated about Liz was that she not only listened to me but she also checked in with other Ethical Culture clergy. I really appreciated not only the deep listening, but also her checking to see, What’s the bigger story here? I think that comes back to being a religion of ethics. Friendships take work. And a lot of people aren’t willing to do that.

Complete Article HERE!

The death doula: helping you prepare for the day you die

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What does it mean to have a good death? Leah Green meets with Aly Dickinson, an end-of-life doula. Aly helps clients to plan what they want to happen at the end of their lives, and she accompanies them as they transition from life to death. She helps Leah draw up a death plan, and takes her to a death cafe, where strangers discuss dying over tea and cake

On the art of dying

By Gary Moore

I’m reading this excellent book by the author Katy Butler entitled “The Art Of Dying Well.”

Put down those phones, no emergency call needed! I’m not going anywhere for awhile. I just want to be prepared.

George Harrison, one of my musical idols also spoke a lot about preparing for death, so when you finally die, you can do so peacefully and transition seamlessly into the next stage of your life. In fact, he wrote a song entitled “The Art of Dying,” which appeared on his first solo album “All Things Must Pass.” In that song, he wrote:

“There’ll come a time when all your hopes are fading

When things that seemed so very plain become an awful pain

Searching for the truth among the lying

And answered when you’ve learned the art of dying”

George’s wife, Olivia, said that when he passed, you didn’t need a candle to light the room. By that, I assume she meant his lighted spirit left his body. Selfishly, I wish George hadn’t left so soon, and I doubt I will encounter him if he returns (because he may not, having died peacefully). But, one never knows.

George’s wife, Olivia, said that when he passed, you didn’t need a candle to light the room. By that, I assume she meant his lighted spirit left his body. Selfishly, I wish George hadn’t left so soon, and I doubt I will encounter him if he returns (because he may not, having died peacefully). But, one never knows.

In the book, Ms. Butler outlines chapter by chapter what elders can do as they reach the end of their life cycle and how to prepare for each stage. She thoughtfully begins each chapter by stating “If you are experiencing…” and lists several conditions, going from mildly annoying to life-threatening, that people our age will experience as they reach the end. It’s done matter of factly, clinically, but with great warmth and compassion, because she then expounds in each chapter on what you should be doing at each particular stage.

One of her suggestions that I found very helpful was transitioning from a general practitioner to a doctor that specializes in elder medicine. In this kind of practice, the doctor asks “What is it that you want to do?” rather then tells you how she or he is going to save you from dying.

Let’s face it: death is a phase we all must go through. There may be a way to delay it, preventative practices you can use to slow it down, but, in the end, it’s the end.

A reader recently responded to one of my articles that discussed death with a quote from the film director and gay rights activist Derek Jarman, who is quoted to have said “I am not afraid of death, but, I am afraid of dying.”

This is because, we know death is coming, but we don’t know how or when it will come. We are unsure of the process by which we transition from life to death and what waits on “the other side.” We have books on faith and religion and spirituality to suggest, in some way, what we might expect, but we don’t know for sure and that uncertainty breeds fear.

On the other hand, another of my heroes, Mark Twain, is quoted as saying “The fear of death follows from the fear of life. A man who lives fully is prepared to die at anytime.”

A story told about St. Francis of Assisi has a man asking everybody in town what they would do if they knew they were going to die tomorrow. Various people offer various versions of tying up loose ends. When the man reaches Francis, Francis is hoeing the garden of the monastery. The man asks Francis what he would do. Francis looks up and around, smiles and replies “I would keep hoeing.”

I doubt that I possess Francis’ courage, strength of faith or ease with mortality. In fact, I might add, this column seems to verify that. Dylan Thomas urges us to “rage / rage / against the dying of the light.”

Katy Butler urges us to accept it and prepare for it as best we can.

I find myself somewhere in the middle. As my younger friend expressed it “I have so much more I have to do.” I think many people in my generation feel that way. Places to go. People to visit. Grandchildren to watch grow. Alas and alack.

But, in conclusion, this quote from Lord Beaverbrook, who was a newspaper tycoon and member of Churchill’s cabinet, struck me:

“This is my final word. It is time for me to become an apprentice once more. I have not settled in which direction. But, somewhere, sometime, soon.”

The idea of becoming an apprentice, of starting over, of beginning a new, different phase of “life” appeals to me. And, maybe, that’s exactly what happens.

Or, to quote Oscar Wilde’s dying words: “Either that wallpaper goes, or I do.”

He did.

Hold those grey heads up!

Complete Article HERE!

The Ethical Will

Life Is About More Than Your Possessions

By Deborah Quilter

Have you considered how to pass on your non-material assets?

When people find out Debby Mycroft helps people write ethical wills, she always gets a predictable response: The Lament.

“They say, ‘Oh, I wish I had a letter from my dad or grandmother or great aunt,’ whoever that person was. I have not come across a single person who has not wanted a letter from that special person,” says Mycroft, founder of Memories Worth Telling.

Unlike legal wills, ethical wills — also known as legacy letters — are not written by lawyers, but by you. They can include life lessons, values, blessings and hopes for the future, apologies to those you fear you may have hurt or gratitude to those you think you have not thanked enough. Traditionally, they were letters written by parents to children, to be read after death.

People who do not have children address them to friends or groups. One of Mycroft’s clients was placed in child protective services when she was quite young because her parents were addicts. “She had a rough upbringing. She intentionally decided not to have children herself. But she wanted to write an ethical will to other foster kids to let them know [they] can survive this,” Mycroft explains.

Why Write an Ethical Will?

Think that your life isn’t important enough to warrant an ethical will? Mycroft disagrees, saying, “You don’t have to be a war hero or a Nobel Peace Prize winner for your story to have value. When people accept awards at the Olympics, they thank the people who had an impact on their life, like Mom or Dad, who was always there to take them to training.”

But there’s an even more important reason you might want to consider a legacy letter. According to Barry K. Baines, author of Ethical Wills: Putting Your Values on Paper, such documents can bring enormous peace of mind.

Baines recalls one dying patient who was bereft because he felt there would be no trace of him when he left. “The first wave would wash away his footprints. That sense of hopelessness and loss was overwhelming,” says Baines. The man rated his suffering at 10 out of 10; after he wrote his ethical will, his suffering reduced to zero.

Don’t wait until you are on your deathbed to do this, Baines warns. As soon as you articulate your values, suddenly you start to live your life more intentionally. Especially if you share it.

“Live your life as you wish to be remembered,” Baines advises. Plus, he adds, legacy letters can help with making amends, addressing regrets and healing relationships.

Ethical Will: Telling Your Own Story

If you don’t feel capable of writing your legacy letter yourself, you can use an online template, take a workshop, read a book about it or work with a professional writer.

But don’t judge your skills harshly. Baines finds that whether people are educated or not or if their letters are simple or complex, they always have a certain elegance because of the truth they contain. “When the families get one, they just glow,” Baines says, adding, “This is a unique gift that only you can give.”

When you write your letter, don’t just say, “My core values are consideration, gratitude, kindness, simplicity,” advises Mycroft. Tell a story about how you’ve lived these values.

In her own legacy letter, Mycroft told her kids about a temp job she had as a teen. She appeared nicely dressed in a skirt, blouse and heels. When she walked in, the employers gave her a funny look and asked, “Why do you think you are here?”

She explained the agency had sent her out for secretarial work. Then her employers handed her a hard hat and steel-toed shoes. “That’s when I look at them quizzically.”

Turns out they were a plastic-bag manufacturer and she was supposed to sort through damaged goods to salvage the ones that could be sold.

“I was so angry that that agency had sent me out on that job. It was hot and humid in Virginia. I was fuming,” Mycroft says. “When I got home, my parents started grilling me. They said, ‘Did you agree on this job?’” And Mycroft confirmed that she did.

They asked what the contract said. Mycroft replied that the contract was pretty clear. Did she sign the contract, her parents wanted to know?

“Yes, but,” she says she told them. “And my parents said, ‘You signed it; you’re committed to it.’”

Mycroft stuck with the job as promised. “That was my first lesson in integrity, perseverance and diligence,” she recalls. She did what she said she would do. As a postscript, she got fantastic jobs from the agency over the rest of the summer. They knew they could count on her.

What Goes Into the Legacy Letter and What Stays Out

Ethical wills are often likened to letters from the heart, so perhaps the best advice is to literally write a love letter.

Love letters don’t recriminate. They don’t judge. They don’t scold. A love letter is there to show how much someone matters to you.

Criticisms and judgments should be left out, advises Mycroft. It’s okay to include regrets and family secrets, even if they hurt. If worded properly, these could bring the family to a place of acceptance and understanding.

She notes, “Sometimes when those things are hidden for so long it causes a lot of resentment — as in] why didn’t they tell me I was adopted? I wish I had known.”

“Definitely avoid manipulation,” Mycroft advises. “Legacy letters are beautiful expressions of love and encouragement, telling other people what is so fantastic about them. I do not think they should be hands reaching up from the grave slapping you or saying, ‘I told you so.’”

Think about how your letter might be received. Baines worked with a woman who had a very hard life. “Every part of her ethical will was blame and guilt-tripping,” he recalls. While some people can turn around a bad experience and use it is an example of what not to do, this woman could not.

“It almost seemed like she was purposely trying to hurt people,” Baines says. But eventually she realized that and gave up, sparing her family the hurt she would cause them.

Get a Second Opinion

Baines believes writers should show their legacy letter to a trusted friend before passing it on, to avoid inadvertent errors. Your reader might say, “You mentioned your two children, but you only write about one and not the other.” That could be extremely hurtful.

Baines also urges people to share the letters while they’re living. It might be painful, but there’s still potentially an opportunity to mend wounds. After you die, there’s no recourse at all.

What About Videos or Selfie Videos?

Some people make videos or selfies of their ethical wills, but keep in mind that technologies can become outmoded.

Mycroft gave both her children the letter and a video of her reading the letter so they not only have her words, but can also hear her voice.

“I’ve heard of people saving voicemails of people who have passed on,” she says. “Can you imagine saving a voicemail and all it says is ‘Susie, are you there? Can you pick up? Hello?’ If you’re willing to save that message just to hear their voice, how much more powerful would it be to hear your voice reading that letter?”

The Time Is Now

The time to write your spiritual legacy is now. Mycroft provides a case in point about her mother, who knew the family lore and lineage.

“I gave her one of these fill-in-the-blank family history books because I wanted to make sure it was preserved,” says Mycroft. “Five years later, when she had passed away and I went to clean out her office, I found the book. It was completely empty.”

Complete Article HERE!

This Seattle writer wants to change how we talk to kids about death

Facing her own terminal diagnosis, a cookbook author pivots to recipes for coping with grief.

After being diagnosed with terminal brain cancer, Seattle cookbook author Caroline Wright turned her attention to writing children’s books addressing grief and death.

by Tom Keogh

Seattle-based cookbook author Caroline Wright can teach you how to make a salad for four with grilled escarole, peaches, prosciutto, mozzarella and basil oil.

She can show you how a sandwich of grilled manchego cheese and sausage on peasant bread is made in the style of a master chef from Catalonia. For dessert, she’ll tempt you with a wicked coconut-caramel cake with malted chocolate frosting.

But when the leftovers are wrapped and put away, Wright can also impart some hard-won wisdom: how to talk to kids about death.

Wright, who studied cuisine at a renowned cooking school in Burgundy, France, always wanted to write as much as develop her skills in a well-appointed kitchen. At age 23, she became a food editor at Martha Stewart Living, and later brought her crisp, engaging voice to her cookbooks, Twenty-Dollar, Twenty-Minute Meals, Cake Magic! and Catalan Food: Culture and Flavors from the Mediterranean (co-authored with Daniel Olivella).

She hasn’t stopped writing about food. But in 2017 she was diagnosed with a glioblastoma, an aggressive, rapidly growing brain tumor, similar to the one that killed Sen. John McCain. With the possibility of death looming large, Wright turned her prose toward facing her own mortality — and starting the conversation with her kids.

Luminous and voluble in person, Wright is a self-described, inveterate doer. When not writing or cooking, she’s pursuing photography or quilting or knitting. She can’t stop making things happen, whether it’s tinkering with recipes for her next cookbook, or organizing a panel discussion at Town Hall (Saturday, Nov. 9) on children and grief. The event will explore how we talk to kids about death, a topic with no simple bearings.

Wright has written two recent books on the theme of child bereavement, inspired by her and her husband Garth’s agonizing challenge of communicating with their young sons about Wright’s still-uncertain prognosis.

The Caring Bridge Project (which came out in February) is a collection of Wright’s online journal entries from her year of chemotherapy and radiation treatment. It’s part of Wright’s written legacy to her boys, Henry, 7, and Theodore, 4. But she intended it, too, for a broader readership: families facing similar experiences with children’s anxiety and despair over loss.

This past summer she published Lasting Love, a picture book for reading aloud to bereaved kids. The heartbreaking but emotionally affirming story, with comforting illustrations by Willow Heath, is about a dying mother returning home from the hospital with a formidable friend: a mighty, furry creature who will always remain by her child’s side, as both an avatar of her powerful love, and as a faithful companion who never judges grief in any form.

Halfway through the tale, the mother passes.

“The child would know,” says Wright of her decision to include the mother’s death. “So stepping around that seemed silly. I wanted the kid to be part of spreading her ashes.”

For Wright, there was no option but honesty. She knew her kids would watch her change, physically, during treatment, and they would find her less available. Keeping them in the dark — especially the older boy, Henry — would have been unfair. “The thing kids can’t rebound from is broken trust,” she says. “There’s no resolution for that.”

When she and Garth first talked with Henry about her cancer, and how she and her doctors were doing everything they could, but she might die anyway, there were tears. But Henry devised a helpful analogy:

“Mommy’s brain is a garden, and there’s a weed in it.”

“Henry and I have had amazing conversations, poetic and hard,” Wright says. “If I die, I want both boys to have a relationship with their memories of me. If I lied to them, it would sully that relationship.”

Thirty-two months after Wright was told she’d likely have 12 to 18 months to live, she is miraculously cancer-free, but vulnerable to a swift reemergence of the glioblastoma. If you take cancer out of the picture, she actually became healthier while fighting the disease, radically changing her diet, dropping 40 pounds and growing lean and strong through yoga, energy work and exercise.

Wright says the boys now occasionally bring up her cancer at random times. When Theodore recently saw her short hair wet and matted after a shower, he grew weepy, recalling her treatment-related baldness, and associating it with being away from him.

The profundity of loss, and the despondency of a child left without the constancy of a loved one’s care, makes Lasting Love a benevolent bridge between a parent and son or daughter going through these troubles.

“The theme of Lasting Love is, literally, love lasting forever,” Wright says. “That’s what we were telling Henry. That was the only piece of hope that we could give him: Mommy’s fighting very hard. And even if mommy dies, the connection you have with her is never going to go away. And there are many loving people surrounding you.”

Wright’s Town Hall event is part of her outreach mission to regional families and to nonprofits concerned with children and bereavement. Among them is Safe Crossings, which supports grieving kids of all ages, at little or no cost. Amy Thompson, program coordinator, will join the panel, along with therapists from other organizations.

Thompson says the field of grief counseling for early childhood through adolescence is growing because of a rise in traumatic losses: gun-related murders, opioid-overdose deaths and suicides. Grieving kids are often isolated, subject to bullying, and told to “get over it” by clueless adults.

“The message from society to grieving young people is ‘move on,’ ” Thompson says. “But if you’re intensely grieving for months or even years after a death, there’s nothing wrong with you. Loss changes over time. As children grow and reach new developmental milestones, they can better process the permanency of death, and we see them regrieve.”

The attention Wright and Lasting Love are receiving in therapy circles and in the media is helping to normalize grief in children — in everyone, really. When she learned she had beaten seemingly impossible odds and, while not out of the woods, is without cancer, Wright celebrated with her family by making a favorite cake, although with a few adjustments: it was sugar-free, gluten-free and covered in carob frosting instead of her once-beloved chocolate.

“I live with great respect for this thing that may happen to me again,” Wright says of the glioblastoma cells that might still be lurking in her brain. “But I don’t live in fear of it. There is nothing to be gained by that. I might die and I might not.”

But the bond between parent and child will last beyond death, she says. “Kids are resilient. With support, they will have full lives.”

Complete Article HERE!

6 Ways to Reduce Stress at the End of Your Life

It’s not easy nearing the end of your life, but that doesn’t mean you need to be stressed.

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Death may be the ultimate stressful moment in our lives. Just thinking about the end is enough to cause your heart to beat faster. And while some levels of depression and anxiety are inevitable, those feelings need not overwhelm the death experience for you or your family. In fact, it’s possible to die well — to experience a sense of wellbeing as you approach the end. You can leave this life with a feeling of closure and a sense of contentment. That’s the difference between completing your life and merely ending it.

But stress disrupts well-being. It distracts you from prioritizing love, family, and dignity. Worry and fear interrupt precious time with family and friends. That’s no one’s idea of a good death. And while it’s easy to think you’ll skip this stressful step and go suddenly from a heart attack or stroke, the reality is the majority of us will need end-of-life care. So, put some thought and preparation into your passing now. Reducing stress will make it easier for you to say goodbye, and for your loved ones to let go. Here are six ways you can make dying the experience you want, rather than the experience you get.

Finalize Your Burial Arrangements

Preparing your burial arrangements lowers stress in several ways. For one, it puts you in control. Eliminate worry by outlining the type of service you want, the manner of internment, and the organ donation process. Burial arrangements also relieve financial stress from your family and friends. Carrying out your last wishes doesn’t have to be a financial burden for your family. So, find the best final expense insurance policy to cover costs. Or get a pre-paid funeral plan that kicks in after you’re gone. You’ll feel less stress knowing everything is taken care of.

Finally, by tending to your funeral arrangements yourself, your loved ones can focus more on spending time with you in your last day. And their grieving will be easier when they’re not weighed down with administrative tasks. Mourners often feel guilty devoting time to such business matters after a loved one dies.

Create a Living Will

If you become incapacitated before death, someone will have to make decisions for you. That’s a heavy responsibility to place on a family member or friend who may only have a rough idea of your wishes. But without a health care power of attorney (or proxy) to speak for you, you may end up being kept on life support longer than you’d prefer, or the opposite. An advanced directive or “living will” is a legal document that lists specific medical treatments you wish to receive and those you don’t. The directive takes the decision-making burden off your family’s shoulder.

To get started, have the end-of-life conversation with one or two people you would want to serve as your proxies. And also talk with your doctor so that everyone is on the same page. Living will forms vary by state. So, download your state’s advanced directive form to get started. If you don’t have the resources to create a living will, other forms of non-legal directives can work as some form of “proof” for your wishes. For example, write a letter to a family member expressing your wishes. Or record audio/video explaining what you want. While these aren’t formally recognized legal documents, they work better than nothing at all.

Make Amends

One thing that makes dying harder is knowing you’re leaving behind unsettled issues, old hurts, and past grudges. When possible, make amends with those you’ve hurt or who’ve hurt you. Now is the time for unburdening yourself and being honest with those you love. While you can leave those hurt feelings behind, your loved ones will carry them after you’re gone. And many will regret they didn’t say something when they had the chance. Knowing this will make leaving this life more stressful for you.

So, don’t put off making amends. Request a private audience with a loved one or wait for the right moment to broach the subject. Be honest and take responsibility for your part in the situation. Refer to the past event/issues that caused the rift, but don’t relive it all over again. And don’t bring up their responsibility; just explain your regrets and apologize. They will reciprocate. Think of this less as a discussion and more as a confession. So, listen more than you talk. The goal of making amends is to replace hurt and anger with forgiveness and love.

Revisit the Past

For those facing imminent death, the bulk of the conversation often focuses on medical needs, medications, or staff visits. While these are immediate needs are necessary, don’t forget the past. Revisiting old memories help us replace the current situation with one of our choosing — at least for a moment. Rather than a form of denial of death, recalling memories is an affirmation of our lives and our effect on others. For friends and family, recounting a past event is a handy way to show how a dying loved one impacted their lives. It’s often difficult for the dying person or loved one to find the right words in these moments. Words of condolence or regret can seem empty. But a pleasant or meaningful story can be a beautiful expression of our gratitude.

Recalling old memories is also a stimulating activity for Alzheimer’s patients. It fosters emotional connections and reduces anxiety. Use family albums, music, videos, or heirlooms to help prompt memories. Encourage family and friends who can’t travel or live too far away to send a short letter or audio recording. And don’t avoid humor. Include funny moments, old jokes, or humorous anecdotes. It may feel awkward at first, but laughter is nature’s way of helping us relieve stress and anxiety while connecting us.

Use Music Therapy

Studies suggest that music therapy has emotional and physical benefits for hospice and palliative care patients. Researchers found that patients who listened to music reported “less pain, anxiety … as well as an increase in feelings of well-being afterward.” Music therapy has a profound effect on people with cognitive and mental decline. The rhythmic nature of music requires little mental processing and helps stimulate memories. Choose music that your loved one enjoys, tunes from their childhood era, or a neutral New Age track. But don’t overstimulate; that can create stress. Take note of the other noises in the room. When mixed with many different sounds, even soothing music at a low volume to create a cacophony of stress.

Ask for Pain Medication When You Need It

Palliative care is about making patients feel as comfortable as possible until the end. And pain management and medication are part of this process. Unlike other vital signs, hospitals and staff can’t measure your pain. You have to help them know when you’re feeling discomfort. Still, some patients forego their pain meds because they want to stay awake to see their friends and family. Others see pain medication as “bad” substances or only for the weak or needy. But these are myths. Pain meds are integral to the palliative care process. And there’s no reason to forego pain medications that’s more important their your comfort. You may think you’re being strong for your family, but having to watch you fight intense discomfort will only increase their stress levels. Ask for pain medication when you need it.

These six tips will increase well-being and reduce stress when you’re nearing the end of your life. But once you’re faced with death, it’s important to know when it’s time to let go. Too often, we hold on too long out of a primal urge to keep going or fear of leaving our loved ones. Death is a natural process we all share. Take comfort in that immutable fact. Let your loved ones know you’re ready to go. They, too, will hold on to you, fearing that letting you go is “giving up.” This creates enormous amounts of stress. When it’s time, reassure them that — while you’re not ready to die — you have accepted it.

Complete Article HERE!

To die well, we must talk about death before the end of life

In a research study, 84 per cent of residents and families who received a pamphlet about end-of-life choices felt encouraged to think about their future care.

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I would like to tell you an all-too-familiar story. It begins with a long-term care home resident, Laura, who has multiple chronic conditions and gets an infection that doesn’t get any better.

Her health has been declining for months, but no one has talked to her about her preferences for end-of-life care. In the absence of that knowledge, she is sent to the hospital where she undergoes stressful tests.

The story ends with Laura dying in the hospital, alone and frightened. Her family is traumatized, and so are the staff who have cared for her over the past year.

It’s a simple fact that 100 per cent of us will die. Conversations about our future health care and what’s important to us — called advance care planning — have shown distinct benefits.

In fact, research shows that as many as one third of seriously ill, hospitalized older people are receiving invasive treatments they don’t want at end-of-life, because no one has talked to them about their wishes for future care. This is true even in long-term homes, where the average lifespan is less than two years.

Pamphlets help stimulate conversation

How do we change those statistics and give our older people the care they want — and deserve? My team’s research has focused on answering that question over the past six years.

We recently developed a series of pamphlets and distributed them in long-term care homes to try to get the conversation started.

The pamphlets were disease-specific (for example, focusing on dementia), and included information about life-limiting illnesses, what to expect and tips for talking about wishes for the future.

In our study, 84 per cent of residents and families who received a pamphlet felt encouraged to think about their future care and 70 per cent felt clearer about what to talk about.

Planning death is a great relief

Moving from thinking to discussion, however, was a different matter. Family members worried that bringing up the subject would destroy hope. Residents thought they should protect their families from thinking about their death.

And many long-term care home staff indicated that they did not feel trained to participate in these conversations — in fact, only 21 per cent handed out the pamphlets, preferring instead for families or residents to take them from a display board.

Encouragingly, the 56 per cent of residents and families who did have conversations after receiving a pamphlet expressed great relief. A typical response from families was: “It makes it easier for me right now because now I don’t have to guess.”

Death is taboo, globally

The problem goes beyond long-term care homes. A striking 93 per cent of Canadian participants in a recent poll think it’s important to communicate their wishes for future care should they become seriously ill, but only 36 per cent have actually done so.

That may seem shocking. But according to the World Health Organization, Canada is actually ahead of most European countries.

Clearly, talking about death and the end of life is still taboo around the world.

Informational resources such as our pamphlets can be a great first step in helping all parties gain clarity on what to be thinking and talking about. But because residents and families tend to protect one another, staff need to take more active roles in supporting such conversations.

Care home staff need training

That means we need to clarify roles and provide the necessary training to support long-term care home staff, especially those who develop strong relationships with residents.

We have an aging population, and thanks to technological advances, more of us are living longer with frailty and chronic conditions. We need to find ways to communicate what’s important to us, so that we receive the care that’s right for us.

I would like to be able to tell you a different story. It begins with a care home resident, Sam, who gets an infection and is not getting better, even with antibiotics.

Sam has been living with multiple chronic conditions for some time and his family knew frequent infections could be a sign that the end of life was near. The family also knew that he wanted to die in the long-term care home and not in a hospital — because they had talked about this when he was healthier and could communicate his desires.

Sam dies, but with dignity and in peace and, most importantly, in keeping with his own wishes.

Complete Article HERE!