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Doctor Considers The Pitfalls Of Extending Life And Prolonging Death

By Fresh Air

[H]umans have had to face death and mortality since since the beginning of time, but our experience of the dying process has changed dramatically in recent history.

Haider Warraich, a fellow in cardiology at Duke University Medical Center, tells Fresh Air‘s Terry Gross that death used to be sudden, unexpected and relatively swift — the result of a violent cause, or perhaps an infection. But, he says, modern medicines and medical technologies have lead to a “dramatic extension” of life — and a more prolonged dying processes.

“We’ve now … introduced a phase of our life, which can be considered as ‘dying,’ in which patients have terminal diseases in which they are in and out of the hospital, they are dependent in nursing homes,” Warraich says. “That is something that is a very, very recent development in our history as a species.”

Prolonging life might sound like a good thing, but Warraich notes that medical technologies often force patients, their loved ones and their doctors to make difficult, painful decisions. In his new book, Modern Death, he writes about a patient with end-stage dementia who screamed “kill me” as a feeding tube was inserted into his nose.

“This is probably one of the encounters that I had in residency that I have been unable to shake from my memory,” Warraich says. “I think if you ask any physician, any nurse, any paramedic, they’ll have many such stories to tell you.”

Interview Highlights

On the importance of having a healthcare proxy, living will and advanced directive

One of the biggest problems that we face in not only modern society, but in societies of olden times as well, is that people have always been very afraid to talk about death. In many cultures it is considered bad luck to talk about death and it is thought to be a bad omen. I think to some extent that extends to this very day. But … I think having a living will, having an advanced directive, or perhaps most importantly, having a designated healthcare proxy, someone who can help transmit your decisions to the team when you’re not able to do so, is perhaps the most important thing that we can do for ourselves as patients and as human beings.

On giving CPR and knowing when to stop giving CPR

One of the things about CPR, Terry, is that almost everyone in medicine knows how to start CPR, when to start CPR, really what to do in CPR under even complex situations, but the one thing that almost no one really teaches us, and there are no guidelines for, is when to stop CPR. I think in some ways that is one of the biggest challenges that we in medicine face all the time. …

I was actually working in the hospital last night and it was about 3 in the morning and I was called by one of my other colleagues who was another cardiology fellow, he asked me, “Haider, I need your help. I have a patient that we are doing CPR on,” and he wanted some help from me. So I walked over to the intensive care unit, and the patient was in her 60s. … There was an entire team in the room doing chest compressions on this woman, and they had been doing it for an hour and a half at that point, much, much, much longer than most CPRs last. …

At the same time while this CPR was ongoing, the patient’s family member, her daughter, was outside the room, and she was crying. … Even though we could give her all the information … that wasn’t perhaps what she was looking for, because what we were asking her to think about or to do was one of the hardest things anyone has to ever bear, which was, “Do you want us to stop CPR?” And that’s the type of thing that I don’t think any of us can ever prepare for, especially when it’s our parent that’s involved.

On why he wrote a book about dying

I really wanted to find answers to some very, very basic questions, like what are the implications of the sort of life extension that we have achieved? What is the role of religion, not only a patient’s religion but a physician’s religion when it comes to dealing with the end of life? How is social media affecting how people experience the end of life? …

So many times I’ve found myself in the room where there are people who were so much more experienced in life than I was, yet knew so little about death and dying. And so I wanted to write a book so that people could go into those really, really difficult places and feel like they’re armed with information, that this isn’t a completely foreign territory for them and that in some way could help them navigate and deal with the sort of difficult situations that lay ahead for them.

Dr. Haider Warraich has written medical and opinion pieces for The New York Times, The Wall Street Journal and The Atlantic.

On the possible repeal of the Affordable Care Act

It is very unfortunate that health is so politicized in this country, because it doesn’t have to be. Health and wellness aren’t red or blue, and they shouldn’t be, but unfortunately that is where we are. I hope that when policies are being enacted in DC, patient’s voices, those who have benefited from the ACA, those who have gained insurance, those voices are not lost in the midst of all of this political activity.

On immigrating to the U.S. from Pakistan

I came to the United States in 2010 and [until now] have only lived in an America in which Barack Obama was the president. I think in some ways Trump’s victory has really shaken me, because of how invested I was in the idea that America is a special place, it’s a truly multicultural society. And I’m still trying to understand, I think like so many others, just exactly what happened. Especially as a writer and as a physician I’ve tried to separate myself from my identity as a Muslim. I’d rather be known as a physician/scientist/writer who happens to be Pakistani, rather than a young Pakistani Muslim immigrant who happens to be a doctor and a writer, but I don’t know. Given how things are changing, I’m not even sure if I’ll be able to set that narrative for myself. That’s a scary thought — to live an identity that is so politicized even when you wish for it to not be.

Complete Article HERE!

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This Study Reveals The 5 Biggest Regrets People Have Before They Die

With just a few weeks to live, these are the biggest regrets most people have

By

[D]o you have any regrets?

Most people do.

But it appears our regrets gain a lot of weight as we approach the end of our lives.

For many years, Bronnie Ware – an Australian nurse and counselor – worked in palliative care; taking care of terminally ill people, most of whom had less than 12 weeks to live.

Her patients were typically old people with very serious illnesses, waiting to die.

And a lot of her work involved providing counseling and relief from the physical and mental stresses that come naturally when a human being comes face to face with their mortality.

Death is not a comfortable subject for most people. We prefer to not think or talk about it.

But the sad truth is, all of us will die someday.

Knowing you are going to die in a few weeks is a very bitter pill to swallow. And Bronnie noticed as her patients experienced a range of emotions that usually started with denial, and then fear, anger, remorse, more denial, and eventually, acceptance.

As part of therapy, Bronnie would ask about any regrets they had about their lives, and anything they would do differently if life gave them a second chance.

Of all the responses she got from her patients, she noticed there were 5 regrets that stood out. These were the most common regrets her patients wished they hadn’t made as they coursed through life.

But the regrets of the dying can be sound and invaluable advice for the living.

And that’s why it’s a really good thing you’re reading this article.

One of the key revelations from Bronnie’s study is that we often take our lives for granted because we are healthy.

Health affords us boundless freedom very few realise, until we no longer have it.

But while her dying patients were helpless in the face of their regrets, you and I still have time to do something about our regrets, before it’s too late.

Let’s now look at each of the 5 most common regrets Bronnie observed:

1)    I wish I pursued my dreams and aspirations, and not the life others expected of me

According to Bronnie, this was by far the most common regret of all.

When people realise their life is coming to an end, it becomes easier to look back and see all those dreams they had but didn’t have the courage to pursue.

In many cases, their failure to pursue those dreams were often due to fitting into the expectations of others – usually family, friends and society.

One of her dying patients, Grace, made Bronnie promise that she would pursue all her dreams and live her life to its fullest potential without ever considering what others would say.

According to Bronnie, Grace was in a long but unhappy marriage. And after her husband was put in a nursing home, she was diagnosed with a terminal illness. And Grace’s biggest regret was that she never was able to pursue all the dreams she put on hold.

I think the biggest lesson from this regret is, if you know what really makes you happy, do it!

It appears that our unfulfilled dreams and aspirations have a way of silently stalking us, and eventually haunt our memories in our dying days.

And if you’re afraid of what people will say about your choices, remember that their voices will not matter to you in your dying days.

2)   I wish I didn’t work so hard

This one makes me feel guilty.

According to Bronnie, this regret came from every male patient she nursed. And a few female patients too.

As breadwinners, their lives were taken over by work, making a living, and pursuing a career. While this role was important, these patients regretted that they allowed work to take over their lives causing them to spend less time with their loved ones.

Their regrets were usually about missing out on the lives of their children and the companionship of their spouse.

When asked what they would do differently if given a second chance, the response was quite surprising.

Most of them believed that by simplifying our lifestyle and making better choices, we may not need all that money we’re chasing. That way, we can create more space in our lives for happiness and spend more time with the people who mean the most to us.

3)   I wish I had the courage to express my feelings and speak my mind

This one just made me so much bolder. 🙂

According to Bronnie, many of her dying patients believed they suppressed their true feelings and didn’t speak their mind when they should have, because they wanted to keep peace with others.

Most of them chose not to confront difficult situations and people, even when it offended them. By suppressing their anger, they built up a lot of bitterness and resentment which ultimately affected their health.

Worse still, harbouring bitterness can cripple you emotionally and stand in the way of fulfilling your true potential.

To avoid this type of regret later in life, it’s important to understand that honesty and confrontation are a necessary part of healthy relationships.

There is a common misconception that confrontation is bad for relationships and can only create division.

Not all the time.

In reality, when confrontation is kind, honest and constructive, it helps to deepen mutual respect and understanding and can take the relationship to a healthier level.

By speaking our minds, we express our true feelings and reduce the risks of building up unhealthy stores of bitterness that ultimately hurt us.

4)   I wish I had stayed in touch with my friends

This one is a regret many of us struggle with.

Bronnie found that her patients missed their old friends and regretted they didn’t give those friendships the investment of time and effort they deserved.

Everyone misses their friends when they’re dying.

It appears that when health and youth have faded, and death is looming, people realise that some friendships hold more value than all their wealth and achievements.

According to Bronnie, it all comes down to love and relationships in the end. Nothing else mattered to her patients in the last few weeks of their lives but love and relationships.

We live in a busy world these days. And the pressures and demands of work, city life and trying to raise a family can take its toll on some golden relationships.

Knowing this now, what would you do differently?

5)   I wish I had let myself be happier

This is a very humbling one, really.

Many of her patients didn’t realise until the end of their lives that happiness is a choice.

They wished they had known that happiness isn’t something to be chased and acquired through wealth, social acceptance and the trappings of life.

In their deathbeds, these patients realized they could have chosen to be happy, regardless of their circumstances in life – rich or poor.

To me, this regret is the most touching.

Throughout our active lives, we often focus too much on acquiring the things we would like to have – wealth, status, power and achievement. We often (wrongly) believe that these things hold the keys to our happiness.

When asked what they could have done differently, here’s the key message those dying folks shared: Learn to relax and appreciate the good things in your life. That’s the only way to find real happiness.

Happiness is a choice.

Is it possible to live a life without regrets?

This is the big question I’ve been asking myself.

As no human being is perfect, and I doubt there’s anything like a “perfect life”, I expect all of us would have some regret(s) in our dying days.

But I think the key is to have as few regrets as possible.

And the best way to die with very few regrets is to live life as if we would die today.

After all, almost nobody knows exactly when they’ll die.

By living our lives as if the end is nigh, we would realise that we really don’t have all the time in the world. As a result, we would procrastinate less, and pursue our truest desires, dreams and aspirations.

Also, to live a life of few regrets, we have to focus on and accommodate ONLY those things and people that make us happy. Because if we try to conform to the expectations of others and hide our true feelings, the regrets could haunt us later in life.

If you’re reading this article and you’re alive and healthy, you still have a choice.

Remember, you only live once!

Don’t forget to share this article with people you care about. You may just save someone a ton of regrets.

I wish you an amazing life.

Complete Article HERE!

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‘Kamp out’ aids kids in dealing with death

Iowa City Hospice has worked hard to create a day dedicated to aid children in dealing with death.

By Kayli Reese

Children play with bubbles in the Coralridge Mall Parking Lot on Sunday as part of PLAYvolution. This particular event is a two-week-long Johnson County movement featuring a series of activities which encourage children and adults to get outside and play.

[K]amp Kaleidoscope kids spent a fun day Jan. 28 making friends and crafts despite the ever-pressing discussion hanging through the air — the subject of death.

Kimberly Peterson of Iowa City Hospice said the one-day camp focuses on helping children understand grief and provides support in the wake of a death of a loved one. Kamp Kaleidoscope was put on by the Iowa City Hospice bereavement counselors and volunteers.

This is the second such Kamp Kaleidoscope event, Peterson said. Iowa City Hospice began this event for children in June 2016, she said.

“At Iowa City Hospice, we’re always evaluating our services,” she said. “We wanted to expand support for children and youth.”

Emily Mozena, a Hospice volunteer and a University of Iowa lecturer in the graduate Child Life Program, said Kamp Kaleidoscope in June was very successful, and more children participated in the January event. She said Iowa City Hospice hopes to have Kamp Kaleidoscope events twice a year.

The camp supports children who have lost someone close to them, she said, be it a grandparent, parent, or sibling.

Peterson said kids can come to the camp more than one time, and any of the children can receive any follow-up support needed.

“[The camp is] a really safe space for kids to talk about death,” Mozena said, noting how difficult it can be for children to speak about such heavy topics in schools. “It’s amazing to listen and see what the kids are willing to share.”

After starting the day by decorating bags and participating in silly icebreakers, Mozena said, the kids began delving into the heavier emotions the camp focuses on. The theme of this event was seasons, she said, and the kids spent time thinking of memories with their deceased loved ones that can be associated with each season. Some of these memories, she said, include building snowmen, playing with water balloons, and jumping in leaves.

A music therapist also participated, Mozena said, creating a song based on the kids’ memories. During the closing ceremony for parents, she said, the kids agreed to perform the song.

A nurse from the Hospice also came to the camp, she said, to answer any questions the kids had about the circumstances surrounding their loved one’s death. She said talking compassionately but plainly with the kids helps to minimize questions and creates less confusion.

“Open communication with the kids and using simpler terms is key,” Mozena said. “Using the ‘D-words’ — death and dying — is very important.”

Kelsey Tebbe, a volunteer for Kamp Kaleidoscope and UI graduate student in Child Life, said she found it amazing how the kids opened up to each other and the volunteers in only a day. In the beginning, she said, the kids were shy, but they quickly were able to talk openly and comfort one another.

Tebbe noted that she found the ability of kids, some who were only 6 years old, to understand their feelings surrounding death, using big words to describe their emotions.

During the day’s events, she said she learned important methods and resources to practice later in her field, citing the experience as extremely eye-opening. By taking time to build each child’s trust, Tebbe said, the kids were able to leave Kamp Kaleidoscope with a better outlook and better understanding of coping.

“With a 6-year-old, you don’t always know what they’re going through by looking at them,” she said. “That’s why it’s so important to talk.”

Complete Article HERE!

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6 Things to Do for a Family After the Loss of a Baby

Most of all, be proactively there and present for your friend.

by

Watching a friend or loved one go through the heartache of losing a child can be a horribly painful thing to do. If you yourself have experienced such a thing, then the pain is acutely familiar to you; but if you haven’t, you may not have the first clue about what to do or say. Below are six things to you can do to show that you’re there and that you care.

1. Be proactive.

If a friend or a loved one has just lost a child, you may be inclined to reach out and say to them something like, “Please let me know if there’s anything at all I can do to help,” or perhaps, “Don’t hesitate to reach out if you need anything from me.” But how often do people in need readily and comfortably reach out? If you’re sincere in your offer to help, be proactive and offer it outright instead of waiting to be asked. Rather than sitting around and expecting the family to come to you in their time of grief, put a life preserver right within their reach, and place your hand directly in theirs.

2. Feed them.

One of the last things a grieving family wants to think about after the loss of a child is meal-planning, cooking, and cleaning up — especially if they have children in the house who don’t understand the level of grief they’re experiencing. If you have the capacity to make a home-cooked meal, to bring takeout, or even to just provide them with a gift card to their favorite restaurant, then do it at the first opportunity you have. They’ll be so grateful for the thought, for the meal and for the provision you gave them.

3. Hope for the best, but assume the worst.

Maybe you yourself have experienced the loss of a baby, or maybe you haven’t — but an important thing to remember is that grief is not linear, and the course it takes through each grieving parent is deeply personal and unpredictable all the same. Time will pass, and you will find yourself as an outlet of support hopeful that the wound is healing — but do not assume that it has just yet. Triggers abound, and the loss of a baby will be with its mother for the rest of her life; so try your utmost to allow her an abundance of safe space to grieve, no matter how much time has passed or the extent to which you figure she should have moved on by now.

4. Commiserate and empathize.

The last thing a person wants to hear after the loss of their child is that it was for the best, that it was meant to be, or that it all happened this way for a reason. Put yourself in a grieving family’s shoes and remember that platitudes and placations have no place. Instead, do everything you can to empathize, to console and to be a haven where sadness, anger and hopelessness can abound freely and without reservation. Be an outlet for that grieving mother to process everything she’s feeling — whether she chooses to lament outwardly, to curse the ground she walks on, or to retreat deep within herself for an extended period of time. Allow her grief take its course.

5. Show grace.

Don’t be offended if she doesn’t readily interact with you, return your calls or much acknowledge you at all. This isn’t personal, nor is it the time to analyze the health or status of your relationship. People grieve in different ways, and it’s important to show all the grace you can while you watch from the outside as a family processes the loss of their child.

6. Send a text.

If you’re up to your eyeballs at home, if you’re living a thousand miles away, or if you just don’t otherwise have it in you to be on the front lines, do what you can to remind your friend that you’re there, that you love her and that you’re thinking of her. Whether or not she replies right away doesn’t matter; she’ll be endlessly grateful to know that she’s on your mind, because the silence from the people she thought would be there for her can be otherwise deafening.

Complete Article HERE!

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How to die well

Lack of faith is no impediment to a decent death – or to helping another through theirs

Stand by me: Shailene Woodley and Ansel Elgort as cancer patients who fall in love, in The Fault In Our Stars.

By Johannes Klabbers

In the secular age you don’t need special authorisation to console a dying person. Just learning what it means to be there for someone is enough.

“Death literacy” is officially a thing. People go to death cafés; books about death are in demand… and around 55 million people worldwide do it every year. But how do you actually do dying well? And who can dying people turn to for support?

Although I know exceptional doctors and nurses who can and do talk with patients about their looming demise, it is something that many don’t feel qualified to do.

Traditionally, expertise in dying was thought to be the remit of religion. The Catholic church recently revived their medieval handbook for dying people, Ars Moriendi, now illustrated with drawings of happy families rather than demons, like the original, and handily available in the form of a website: artofdyingwell.org.

But what are the options for atheists or agnostics today? When it comes to thinking about what it means to be mortal, many people find themselves in a kind of secular vacuum. But living a life without religion doesn’t mean that you have to be alone at the end.

As a secular pastoral carer, I learned that consoling a seriously ill and dying person is something that almost anyone can do, whatever their faith – or lack thereof. You don’t need a special qualification, or a badge, or permission from an authority figure, supernatural or otherwise, just your humanity and determination – and for the suffering person to want someone to be there with them.

The first crucial step is turning up. Too often, our anxiety about saying or doing the “wrong thing” leads us to decide not to visit someone. Offering to be there for someone, even if they decline – and they might – is never wrong. Being there for someone means giving your attention to the person not to their illness, and concentrating on listening, not on worrying about what to say.

You will need to accept that the dying person may not want to discuss their sadness and fears – at least at first. They may want to talk about the football or the latest episode of Bake Off. Or they may just need someone to sit with them in silence.

Remember that it is not unreasonable to feel awkward. You might feel uneasy in the setting, or be distressed by their appearance. But your job is to accept your discomfort and think beyond it. You can show sadness, but do not burden them with your grief. You may need to be supported and comforted yourself afterwards.

While there might not be any formal qualifications in death literacy with which you can arm yourself, there are a number of wonderful, entirely secular, books by brilliant writers who are in the process of dying or supporting dying people, from Jenny Diski’s In Gratitude (to Tom Lubbock) and Marion Coutt’s memoirs, which together form an awe-inspiring document of courage, humility and humanity.

There is a moment which perfectly illustrates how to console a dying person in the Dutch author Connie Palmen’s moving memoir Logbook, when her husband, a leading Dutch politician, lies dying. In a moment of lucidity he sits upright and exclaims, “I am sorry for my sins!”

“I absolve you,” Connie tells him.

Ultimately, our humanity is all the authority we need to offer consolation to dying people.

Complete Article HERE!

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How to Help an Elderly Parent Deal With the Death of a Spouse

 

By Michael Lewis

[V]elta Lewis died the morning of May 15th in the arms of her husband in the home they had purchased upon retiring three years previously. Her death, nine months after the diagnosis of lung cancer, occurred shortly before the couple expected to celebrate their 52nd wedding anniversary during a two-week trip to Paris. My father was devastated. Over the following weeks, I would find him sitting alone in their darkened family room – no television, no radio, no conversation to break the silence – staring with red-rimmed eyes into the past, trails of tears upon his cheeks.

If you have experienced the death of a loved one, you understand how grief can stun, even take you to your knees. In the midst of your own pain, it is easy to forget others who suffer. However, in the case of a parent whose spouse has died, it is at this time that your strength and compassion is most needed.

Dealing With the Death of a Spouse

Members of the Greatest Generation were no strangers to death. My dad had experienced the passing of his grandmother as a young boy, and witnessed her body resting in the parlor of their house for final viewing, as was the custom in those days. He had spent almost a year in Europe during World War II, losing buddies to the ravages of battle. In the ensuing years, he and my mother buried parents, relatives, and friends, the funerals becoming more frequent as they grew older. They were religious people, neither fearing death, sure of their place in eternity.

But generally, the natural order of life is for husbands to go first, not wives. They had worked and saved over the years, expecting to enjoy 5 to 10 years of travel and seeing grandchildren before Dad’s time to go. Mother dying first was unnatural in the grand scheme of things – unlikely, but not impossible. In fact, according to the U.S. Census figures in 2012, husbands are 3.2 times more likely to die before their wives, with 36.9% of women older than 65 widowed compared to 11.5% of men over age 65 who are widowers. To my father, all of their shared preparations for their final days were suddenly pointless.

Even when husbands die first, the toll on the surviving wife can be equally overwhelming, particularly if the death is unexpected. The survivor loses not only a mate, but a long-term partner, an everyday companion, and, commonly, a caregiver. Grief and sorrow as well as guilt for being a survivor are common feelings and take time to reconcile. Many survivors report a deep sense of loneliness and isolation that can take months, even years to overcome; the closer the marital relationship, the more depressed the surviving partner is likely to be.

Their grief can sometimes have fatal consequences if untreated. A 2013 study by the Harvard School of Public Health found that a surviving spouse over the age of 50 has a 66% increased risk of dying within the first three months of the spouse’s death. Physicians often refer to the “broken heart syndrome,” or stress cardiomyopathy, the result of a sudden stress like the unexpected death of a loved one.

If the couple is ill or frail, the consequences of the death of one of the partners is particularly distressing for the survivor. Together, they can live independently by relying on each other. When one dies, the other may not be capable of living alone, and must cope with the loss of their spouse and, possibly, their independence.

Ironically, surviving spouses who are better off economically are likely to be more depressed. According to Rutgers Professor and sociologist Deborah Carr, “Those who own a home may do worse because they have the added strain of caring for a house. They may be more socially isolated, lonely, and even afraid of living in a home alone, compared to surviving spouses who live in apartments and have neighbors close by.”

Since many elderly couples divide the tasks of everyday living – for instance, one may cook meals and mow the lawn, while the other pays bills and handles home repairs –  the loss of one of the partners may leave the other unequipped or unable to add the new tasks necessary for everyday existence. For instance, Jackie Buttimer of Bethesda, Maryland had never balanced a checkbook and rarely used a computer before her husband of nearly 50 years died in April 2010. “It’s a huge learning curve, and I had never lived alone,” says Buttimer.

The Role of Children and Friends

Losing a partner affects older adults in multiple ways: Some may continue to function without appearing to be excessively affected, while others are incapable of completing the smallest task. At the same time, you will be grieving for the loss of a mother or father and perhaps recognizing your own mortality. It is important to handle your own grief and fears, but remember that losing a mate is not the same as losing a parent. If possible, your priority should be to comfort your parent first, recognizing that, at times, you may need to withdraw to grieve and recharge.

Do not be reluctant to ask for help from other family members or friends. Many people are willing to help, but hesitate to intrude during this very emotional time. They need your guidance to help in ways that are beneficial, whether it is providing meals, performing needed household duties such as washing clothes or mowing the lawn, or spending time with your parent in conversation and consolation.

There is no definite mourning period or average time to return to “normal.” People do not easily get over their pain; they eventually learn to cope with it as time softens the loss. Some parents may want to talk about the deceased, while others avoid the subject, especially if the death was painful or unexpected. Take your cues from your parent.

Shortly after my mother’s death, my father and I took a week-long automobile trip to visit the locations of his childhood, the hours in the car filled with his recollection of the memories of their life together. We laughed, we cried, and we both felt better. Remember that grief will usually resurface in the years ahead at holidays, birthdays, anniversaries, and any special family days. If and when emotions resurface, it is important to acknowledge and share the feelings.

The Immediate Aftermath of Death

Even with well-planned, predetermined arrangements, there are a number of responsibilities that require attention following a death. The surviving mate may be overcome with grief so these duties must be completed by a child or another representative of the family. They include:

  • Notification of the Proper Authorities. If the death occurs at home, as in my mother’s case, a hospice representative and a physician are required to pronounce death and dispose of any restricted pharmaceutical drugs remaining unused. If the death was unexpected, a coroner or medical examiner may be required at the scene. The medical personnel typically make arrangements to transfer the deceased to the mortuary of choice.
  • Making or Reviewing Funeral Arrangements. In many cases, arrangements have been made concerning the disposition of the body (burial or cremation), burial sites, and funeral services. The arrangements need review, and occasionally change to accommodate the last wishes of the deceased or surviving spouse. This is a particularly emotional time which some unscrupulous funeral directors may attempt to exploit by up-selling to more expensive caskets, extensive flower arrangements, or elaborate tombstones. The best counsel is to follow the wishes of the deceased as close as possible, assuming the arrangements were made under less emotional circumstances.
  • Contacting Family, Friends, and Clergy. Family members, often spread across the continent, need to be contacted and informed of funeral arrangements, with time between the death and service for those to travel if necessary. Close friends should be contacted personally with the request that they contact others who might wish to pay their respects. Churches often respond immediately when noticed of a member’s death with offers of meals and other help.
  • Notifying Legal, Financial, and Government Authorities. While these duties can be delayed until after the funeral and receipt of death certificates, the Social Security Administration should be notified so that monthly benefits can cease and survivor’s benefits can be initiated, if available. Life insurance claims should be filed. Institutions which provide jointly-owned bank accounts, credit cards, or other property need to be notified and provided with proper documentation to transfer ownership as dictated by the will of the deceased. If an attorney has not been previously involved in estate planning, seeking counsel to proceed most efficiently to probate any will and settle the estate may be wise.
  • Delaying Payment of Medical Bills for the Deceased. In the weeks following my mother’s death, my dad was deluged with medical bills relating to my mother’s care and death, even though the costs had been incurred in her name and covered by Medicare. Information systems in the medical industry are notably inefficient, outdated, and inaccurate. As a consequence, many providers continue to bill my deceased mother, even though accounts had been previously paid or were not legally due. My father, wishing to honor my mother’s good name, would pay the accounts, being unable to determine whether the balance was legitimate or not. In the event of a death, it is wise to delay any medical payments for the deceased for a minimum of three months so that billings and collections can be properly recorded and amounts owed properly reconciled.

Depending upon the planning preceding the death, the ability of the survivor to handle legal and financial matters, and the complexity of the estate, there will almost certainly be additional cases where the help or guidance of a child to protect the interests of the surviving parent will be necessary.

Signs of Continuing Grief in the Elderly

Many people appear to quickly bounce back after a tragic event, but appearances can be deceiving. According to the American Hospice Foundation, some signs that your parent is still grieving include the following:

  • Forgetfulness. Missing appointments, locking keys in the car, or mailing unsigned checks with bills are all signs that your surviving parent may have difficulty focusing. Be patient and suggest written reminders to stay focused.
  • Disorganization. Taking longer or failing to complete one task before beginning another is often seen in grieving adults. Written schedules can help.
  • Inability to Concentrate. Grief causes the mind to wander, so reading a book or watching a television show can be difficult. Be especially alert if your parent continues to drive an automobile or operate dangerous machinery.
  • Lack of Interest or Motivation. Your parent may question the purpose of life or why any effort is worth doing. Listen to them, express love and support, and keep trying to get them involved in something beyond their immediate environment.
  • Fascination With Death or the Hereafter. While it’s natural to think about it following a death, a fixation on death combined with depression can lead to suicide. Involve a therapist immediately.

Specific Problems That May Arise

While most people gradually recover from the death of a long-term spouse, there are unique problems and circumstances that can complicate or extend the healing process. As their child, you should be cognizant of the potential areas which can cause obstacles and seek to minimize them.

1. Loss of Independence

The death of a spouse emphasizes the physical fragility of the survivor. As people grow older, muscle strength declines, and problems with balance and gait appear. Neurological conditions such as Parkinson’s, high blood pressure, neuropathy, and vision problems such as glaucoma and cataracts can cause unsteadiness and falls, and may require certain medications. A pair of people living together can look after one another and call for help when necessary – but a person living alone lacks that security.

If your elderly parent wants to live alone but may be subject to falls, consider improving the physical environment of the home by removing loose rugs, installing railings on stairs, adding ramps, and putting grab bars in the bathrooms. Adding a home monitoring system may give you and your elderly parent peace of mind.

2. New Tasks to Learn

During the 50-plus years he was married, my father rarely wrote a check, paid a bill, or determined which investments were made in the family’s retirement accounts. In other families, the wife may have let her husband take care of all financial matters. Some surviving partners do not know how to cook or to drive a car.

When a spouse dies, the survivor is required to assume new responsibilities, which can be overwhelming. Fortunately, technology has become increasingly simple, so that even the most unfamiliar can learn basic tasks necessary to everyday life. Encourage your parent to sign up for community courses for the elderly in local colleges, universities, local chapters of the American Association for Retired Persons (AARP), or senior centers. They may find friends with common interests and learn new skills that will allow them to connect with a broader world.

3. Financial Complications

Problems with the level or management of assets can arise after the death of a spouse. For example, a husband and wife typically draw two Social Security checks each month. With the death of one spouse, income is reduced. Annuity or retirement plan distributions may also be changed. In many cases, the deceased spouse may have been responsible for making day-to-day management decisions in the family retirement portfolio, expertise that is no longer available with the passing of the partner.

Depending upon the will and wishes of the dying spouse, control of the assets may rest solely with the survivor, potentially complicating efforts to protect their financial interests. Unfortunately, surviving elderly spouses are popular targets for con-men, crooks, and unscrupulous investment salesmen. If you have suspicions that your parent is unable to rationally make investment decisions or under the influence of those who do not have his or her best interests in mind, seek legal help immediately.

4. Loneliness and Depression

Intermittent periods of depression and loneliness invariably accompany the death of spouse. In fact, healthy grieving is a process that can last for months or years. However, as time goes by, the periods of loneliness and depressions usually become shorter while the periods between depressions extend. In some cases, however, months can go by without any sign of improvement. Mental professionals call this condition “complicated grieving.”

Signs of complicated grief include the following:

  • An inability to accept that death has occurred
  • Frequent nightmares and intrusive memories
  • Withdrawal from social contact
  • Constant yearning for the deceased

Grief has physical consequences – loss of appetite, trouble sleeping, headache, fatigue, muscle tension – which generally result in decreased exercise, deficient diet, and an over-reliance on medication. If your parent seems to be stuck in a continuing cycle of depression, seek psychological help and encourage them to talk to friends or a spiritual advisor.

Remember to Take Care of Yourself

Trying to help your parent recover from death-related grief is akin to rescuing someone from drowning. You may be struggling with your own depression and feelings of guilt and regret. If you find that you cannot help your father or mother without sacrificing yourself in the process, ask for help from other family members, a friend, or a mental health professional.

Take time for yourself and your immediate family and seek a support group if necessary. Be sure you maintain a good diet, keep exercising, and get plenty of sleep. And focus on the good memories of the parent who is gone as well as the one who survives. Remember that time will eventually lessen your pain.

Final Word

My father eventually followed my mother in death. He was unafraid, even excited, since he believed that his wife was waiting on the other side, and the two would spend the rest of eternity together.

While helping my dad through his grief at my mother’s passing was at times inconvenient and frustrating, I have no doubt that our relationship deepened and strengthened as a result. If the occasion arises where you are called to help one of your parents after the death of your other parent, welcome the opportunity to share your grief and express your love. Like births, death can show us the joy of life and family.

What other tips can you suggest to help a parent deal with the death of a spouse?

Complete Article HERE!

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Death With Dignity

Longtime lobbyist John Radcliffe, 74, terminally ill with stage-four cancer, is working to change Hawaii’s laws that prohibit access to life-ending medication when suffering becomes unbearable

By Susan Kang Sunderland

[P]utting one’s life on the line for a cause is nothing new to lobbyist John Radcliffe. The deft negotiator made a career of it. But now he literally is doing so to awaken our community to an issue.

If he and supporters are successful, Hawaii will be among seven states to legalize medical aid in dying.

Radcliffe, 74, who is terminally ill with stage-four cancer, has been in the news a lot lately to express his wish to have access to life-ending medication should his suffering become unbearable. But currently in Hawaii that is a crime.

Through legislative and legal action, Radcliffe hopes to empower individuals to make life-ending decisions that do not subject doctors to prosecution in order to assist patients in that process.

Radcliffe’s family is in full support of his wish, but unless things change, this will not be among the options available to him when he suffers prolonged, debilitating pain.

Words matter in discussing this sensitive issue. So Radcliffe is quick to set parameters on what he is — and isn’t — talking about.

John Radcliffe says if the legal system is a barrier to quality of life, you change the law

“Aid in dying is a medical practice to treat adults who are terminally ill with six months or less to live,” Radcliffe explains. “They must be mentally capable of making their own decision to request a prescription for life-ending medication from their physician, which would be self-administered.”

Aid in dying, he emphasizes, is not assisted suicide or euthanasia.

“To a terminally ill person, the term ‘assisted suicide’ is offensive and hurtful,” the Makiki resident says. “I want to live, but my condition is incurable. There is no hope for a better outcome.

“Suicide is secretive and often impulsive, without involvement of family, friends or health care professionals,” he adds.

Medical aid in dying also is known as death with dignity.

“The issue is really about dignity, pain and unnecessary suffering,” Radcliffe says. “I come from the position that you should do as much as you can as well as you can for other people for as long as you can.

“I am in a unique situation to do that,” asserts the government relations expert.

Radcliffe was diagnosed with incurable colon cancer in 2014 that has metastasized to his liver. He’s been hospitalized three times, been in the emergency room 15 times and has had 42 chemotherapy treatments.

He took his 43rd chemo treatment Wednesday, Jan. 18, while seated next to state Sen. Rosalind Baker at the opening of the state Legislature.

That’s a bit dramatic, we say about his unorthodox tactic of persuasion.

“Nah,” Radcliffe says with a laugh. “No one even noticed. That’s why I have to make a point of it. When you talk to legislators about cancer, it tends to be theoretical. Well, this isn’t theoretical to me. This is real.”

As a union organizer and lobbyist for four decades, including 13 years as executive director of the Hawaii State Teachers Association, Radcliffe knows that addressing social problems with lawmakers is not easy.

His credibility is at stake. “The legislators know me,” says the co-founder and president emeritus of Capitol Consultants of Hawaii. “They trust me. They know I won’t lie to them or give them bad information.

“But I can’t imagine that with 80 percent of voters being in support that they would be opposed,” Radcliffe suggests.

A poll conducted last November by Anthology Research shows 80 percent of Hawaii voters across all demographics believe a medical aid in dying option should be legal. Strong support (55 percent) outweighs strong opposition (8 percent) by an almost seven-to-one margin, while 12 percent oppose the option.

“This is about the ability to have a choice when you’re suffering,” Radcliffe states. “It’s comforting to some people to know they have a choice, as it is to me.

“I want to be in control of my life, as I’ve always been. It’s about quality of life. If the legal system is a barrier, ‘you change the law.’”

That’s the second strategy he and the advocacy organization Compassion & Choice Hawaii will mount after years of failing to get legislation passed.

Radcliffe, retired oncologist Dr. Chuck Miller, and Compassion & Choices Hawaii are plaintiffs in a lawsuit against the state of Hawaii asserting that the Hawaii Constitution and existing state law allow the practice of medical aid in dying.

“Mr. Radcliffe can’t wait and see whether the courts or the Legislature will ultimately solve this question, but our hope is that this option will be made available to him as soon as possible. By filing litigation now, we have put the process in motion on all fronts,” says Mary Steiner, Compassion & Choices Hawaii campaign manager.

Aid in dying currently is permitted legally in Oregon, Washington, Montana, Vermont, California and Colorado.

In Hawaii, a Governor’s Blue Ribbon panel on living and dying with dignity in 1998 recommended changing existing laws, rules and practices to give wider choices in end-of-life decisions, including physician-assisted death.

End-of-life options include declining treatment or avoiding unwanted medical treatment, palliative care (pain management) or VSED (voluntarily stopping eating and drinking).

Radcliffe’s is not the only story of a terminally ill person seeking end-of-life options. There are many stories of patients, families and friends who know the plight of long-suffering individuals.

There are heart-wrenching accounts of bewildered care-givers who experience the helplessness and difficulty of aiding agonized loved ones. They suffer in silence.

But proponents of legislation urge citizens to let their voices be heard, whether it’s by letters to legislators, testimonies to help educate the community, or joining forces to add representation to the cause.

“If this means anything to people, they must show up,” Radcliffe urges. “This is the year that this must happen.

“It’s too late for me. But it doesn’t have to be for others,” he implores.

Opponents cite spiritual, moral and modern medical advances to counter the need for more options. In fact, emotions run high when the dialogue is about death — the D word.

“Local people no like talk about dis kine stuff,” Radcliffe says.

Actually, all people don’t enjoy bringing up the subject. Talking about death is a social taboo. It’s just not done

in polite society. But with Hawaii’s aging population, it is an essential and timely topic for private and public discourse.

In Oregon, for instance, end-of-life care reportedly is improved since the law’s implementation in 1997. It is said to be thanks in large part to the dialogue the law encourages between people and their doctors.

Hospice use is high and referrals are up, as is other use of palliative care.

But what of the man to whom we address this living eulogy?

“I want to be remembered as a good, loyal friend and a decent human being,” he says.

“I hope this legislation passes without trouble,” he reflects, citing the move toward patient-directed care. “It would say something about us as a people. If we aren’t humane people, then who are we?”

As an inspired philanthropist once said, “There’s a lot of difference between human being and being human.”

Many will remember the contributions John Radcliffe has made to this community. He has spent his life fighting for causes. This will be his last and perhaps best fight.

As retired teacher Carol Sakamoto says in tribute, “Wish him well, and tell him that all the teachers will be praying for his success and thank him for his many years of service.”

That’s what living well and making a difference is all about.

Complete Article HERE!