LeaveLight

A recent blog post at the Harvard Health Publications site spells out how end of life planning can increase communication among family members and make it easier to leave without unfinished business. Authors Barbara Okun and Joseph Nowinski encourage families to share their feelings about end of life so wishes are known and understood in advance of a crisis.

Talking with family and loved ones about end of life and dying can be daunting, but it’s better done in advance to avoid trauma and conflict.

Photo courtesy of U.S. Administration on Aging

Just days after a new rule came into effect that would pay physicians to hold elective consultations annually with patients on their wishes for end of life care, the Obama administration reversed itself and said it would remove the regulation. Sadly, end of life planning has become a political hot button, with opponents claiming that  such planning leads to ‘death panels’ and medical care rationing.

The political brouhaha over this issue masks the fact that everyone, particularly aging seniors, can benefit from advance care planning. According to an article by Emily P. Walker in MedPage Today:

“Recent studies on advance directives have shown that planning improved the likelihood that a patient’s wishes would be followed and reduced emotional trauma among family members.

In one study, patients who documented their wishes for only limited care or comfort care received it in 83.2% and 97.1% of cases, respectively, according to Maria J. Silveira, MD, MPH, of the VA Center for Clinical Management Research and University of Michigan, both in Ann Arbor, and colleagues who interviewed patients’ healthcare proxies.

The few who requested all possible care didn’t always get it (five of 10) but were much more likely to get aggressive care than those who didn’t request all care possible, Silveira’s group reported.

In another study, hospitalized patients older than 80 who were formally assisted with documenting their end-of-life treatment wishes and with designating a surrogate were almost three times more likely to have those wishes followed (86% versus 30% in usual care, P<0.001).”

Putting plans in place for advance care can help you receive the care you want. Talking about your wishes and needs with your physician and family members helps avoid emotional trauma and unwanted treatment. If you haven’t created an advance directive, now is the time.

Carla Zilbersmith, a singer, solo performer and humorist, who died at 47 from a degenerative disorder called amyotropic lateral sclerosis, laughed in the face of death. She wrote her own obituary in which she guaranteed the memorial “to be the funniest funeral that you have ever attended or your flowers back. Costumes encouraged but optional.”

Carla’s courage and determination to live life with joy despite increasing physical decline inspired the award-winning film “Leave Them Laughing,” a Musical Comedy About Dying.

Unable to deny the ravages of her disease, Carla made a conscious choice to face death with love and humor. Her life and work remain a gift to those left behind.

Emergencies can occur without a moment’s notice. The Vial of Life saves lives by providing vital information needed by emergency responders to give care. By preparing a Vial of Life for yourself and loved ones, you go a long way to ensuring that health needs will not be overlooked.

A Vial of Life is one component of advance planning that can make the difference between life and death.

Alice Herz Sommer, the oldest living Holocaust survivor at 106 years old, shares her love for life and music in this inspiring interview.

“They [took] our belongings, food, and clothing, but music is the one thing that they could not take away from us, music that evil could not destroy.” – Alice Herz Sommer

Born in Prague when it was part of the Austrio-Hungarian Empire, Alice became a concert pianist. She was captured and sent to Theresienstadt concentration camp by the Nazis. There she played with other musicians in the camp orchestra.

Alice’s optimism and joy are contagious as she talks about her love of music, people and life.

When was the last time you had a serious conversation with someone – a conversation that went deeper than what you are planning to have for dinner or where you want to go this weekend?

A study by scientists at the University of Arizona and Washington University in St. Louis in the journal Psychological Science reports that people who spend time engaged in meaningful conversations report a greater sense of well-being than those who engage in small talk.

Substantive conversations bring depth and meaning to our lives and result in a greater sense of happiness. In our hectic rush to get through our daily to-do lists, it’s easy to forget how satisfying it can be to talk with a friend or family member about what we truly value.

LeaveLight encourages deep conversations with those you love about what’s important to you in your life. Getting your affairs in order and having meaningful conversations with your loved ones while you are young and healthy can not only bring you the relief of knowing that you’ve taken care of business but also engender the happiness and sense of well-being that results from talking about what matters to you.

Ill health in later years is troublesome for all of us, but you would think that J. Bruce Llewellyn would have had it easier than most of us. As a rags to riches successful businessman and one of the wealthiest African-Americans in the country, with celebrity friends such as Colin Powell and Bill Cosby,  J. Bruce Llewellyn had a lot of advantages.

Yet he spent much of his last precious bit of time on earth struggling to live life as he wished. Despite insisting that he wanted to leave an assisted care facility, Llewellyn was kept there by his wife, who was certain that he needed that level of care to stay healthy.

Llewellyn’s story points out the need to not only document one’s wishes, but to keep those documents updated and to communicate with your loved ones regarding your choices. Circumstances and attitudes change. Knowing your wishes for end-of-life care and talking about them with your family and friends can help avoid conflict and heartache.

His story also illustrates the importance of selecting a health care proxy you can trust will follow YOUR wishes. In this case, Llewellyn’s wife felt strongly that she had his best interests at heart, however Mr. Llewellyn wanted to leave the facility.  She would not heed his wishes and kept him there against his will.

LeaveLight motivates you to not only record your wishes for end-of-life care in documents such as advance directives but to keep your family members and friends aware of your choices. Select someone for your health care proxy that will honor YOUR choices.

This morning I was brought to tears by a poem read by Kevin Young on NPR’s Morning Edition. Kevin has edited a collection of poems called The Art of Losing.

Poetry can capture the essence of grief and loss, life and death, in a precise way that is unique and compelling.

The particular poem that caught my heart is called “Written to a Child That Was Never Born,”  by David Wojahn.  You can hear that poem and others in the NPR interview with Young.

The interview closes with a poem by Phillip Larkin called The Trees, which speaks to movement and hope in the journey of grief and healing.

Steve Jobs addressed Stanford grads about life’s impermanence in a commencement speech in 2005. He communicates to this young audience the importance of living each day to its fullest and how to live before you die.
Here’s an excerpt from his speech:

“No one wants to die. Even people who want to go to heaven don’t want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because Death is very likely the single best invention of Life. It is Life’s change agent. It clears out the old to make way for the new. Right now the new is you, but someday not too long from now, you will gradually become the old and be cleared away. Sorry to be so dramatic, but it is quite true.

Your time is limited, so don’t waste it living someone else’s life. Don’t be trapped by dogma — which is living with the results of other people’s thinking. Don’t let the noise of others’ opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.”

It couldn’t be said better. Jobs recognizes the immediacy of death and the importance of making the most of life.

Life brings unexpected changes, and for physical therapist Eric Galvez, at age 31 a brain tumor made dramatic changes in his life. His video shows the strong web of friends and family that sustained him through his ordeal. Positive energy exudes from each image. Galvez has written of his experience in Reversal: When A Therapist Becomes A Patient and has created MassKickers, an organization to help people diagnosed with cancer.

When he was diagnosed, Galvez probably did not have end-of-life plans in place. He was, after all, only in his early thirties, and at that age, most of us think we will live forever. But his life-changing illness has motivated him to recognize how precious life can be. Grateful for his recovery, he wants to fully enjoy living the rest of his life. Along with writing his book, he has raised $11,000 for the National Brain Tumor Foundation. By deciding to help other people through sharing his experiences and talents, Galvez is leaving a legacy that will last far beyond his life on earth.