End-of-Life Choice, Death with Dignity, Palliative Care and Counseling

I’ve Accepted I’m Dying. Now What?by Jay

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By Carolyn McClanahan
Forbes
March 23, 2012

Since too many people don’t plan for the end of life before they become ill or while they are undergoing treatment for an illness, today I discuss what plans need to be made once you really understand you are going to die soon.  This is the last of my four part series on end of life planning.

The emotional part of the realization you are going to die is nothing anyone can prepare you for.  Even though you knew it was a possibility, it is still a numbing shock.  Your mind obsesses over little things, some important, most not important.   Without knowing how much time you have left, or how sick you will feel, paralysis becomes the overwhelming reaction.  What and how much can you get done in this situation?  Hopefully, you have involved a palliative care team or hospice in your care.  If not, make that call immediately.  This will make it easier to take care of all your other important matters.

Precious things matter first, and for most of us, that would be our friends and family.  As Maya Angelou said, “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”   When you are dying, the last thing you may think about is how you make people feel.  However, the last memory of you is an important one they will carry forever, so tell your family and friends how much you love them.

Consider creating a video sharing your history, your memories, and your dreams for your family’s future.  It doesn’t matter how bad you look, it is your voice they will love hearing.  If that isn’t possible, write letters.  I once sat at the bedside of a dying neighbor who was too ill to do anything.  She dictated beautiful letters for me to send to her family and friends.  It was hard keeping my tears from dripping on the letters and I was so careful to use my best handwriting (remember I’m a doctor.)

The “practical” items should be done next.  Make certain your financial affairs are in order as best possible.  Check beneficiary designations on all your retirement plans and life insurance policies.  Nothing is worse than your surviving wife finding out your surviving ex-wife is the beneficiary of your life insurance policy.  Hire a fee only financial planner to help figure out how to do any last minute cleanups.

Part of my job is to help families settle estates.  The two fights I see over and over – fights over “stuff” and fights over the funeral.  If you want your family to get along after you die, try to take care of these two things while you are alive.

Give your personal items away while your brain is still working.  One of the best memories of my mother’s end of life is all of us sitting around her bed with her jewelry box.  She gave out each piece as she saw fit – and there was no fighting.  It is really hard to fight about these things sitting in front of a dying person you love.  When she finished, she remembered secret hiding places of other items, and would instruct us from her bed where to find these precious objects.  It was like a treasure hunt, since my mom was one heck of a pack rat.  One “find” was a canister filled with quite a few $100 bills – she delighted in splitting all her hard earned casino winnings with us.

Plan your funeral!  Last summer, I attended three funerals in a very short period of time.  One was an acquaintance who was ill for a very long time, and struggled treating his illness to the last day.  It was obvious that the director of the funeral knew nothing about the incredible person we all cared about.  In the next funeral, the first hour was spent sharing stories of our dear friend, which was wonderful.  Then the director took advantage of a captive audience and evangelized for over another hour to try and save our souls.  I have a feeling my very impatient dead friend would have not been pleased about that.

The last funeral was the most incredible.  My friend had struggled with ovarian cancer for many years.  When she accepted that no more could be done, she thoughtfully planned out every detail of her life celebration.  It was fabulous.  We laughed, we cried, and we even danced.  After the ceremony, she had a wonderful party with her favorite food and beverages and many more stories were told.  She was an inspiration for many both in life and in death.  We should all be the same.

Thank you for hanging with me in my desire to get everyone on board with “How to Die Like a Doctor.” Many of you shared great resources and stories, for which I am grateful.  Keep up the good work!  For those interested in the here and now, I’ll get back to the exciting subject of health care reform next week.