Director's Message
The End of the Journey May 2005The End of the Journey May 2005As I sit to write this month, the news is filled with the deaths of Terri Schiavo and Pope John Paul. These very public events brought the subject of death into print and conversations, something otherwise quite rare.
I want to encourage you to take this opening and push it a bit further. Talk with your loved ones about death. This is probably the hardest conversation to have. Research shows that Americans are more likely to talk to their children about safe sex and drugs than end-of-life issues. It is as if we believe that not talking about it will keep it from happening—but it will, to all of us. We plan for weddings, for college, for retirement, but we can’t bring ourselves to talk about how we want to be cared for at the end of life.
Does your family know what you want? Terri Schiavo was not able to tell her family after she lost consciousness. Pope John Paul is said to have been conscious and involved in the decisions made in his final days. The time to talk is NOW. Use the news or events happening to people you know to open the subject and stick with it through the discomfort. Share your values, ethics and preferences. Do not leave it to your family to guess when they are scared, grieving, and trying to advocate for you with the health care system. Do not create a situation where this becomes a painfully divisive issue between family members.
The reality is that death is often not a single either/or question such as “do we remove a feeding tube”, but a series of incremental questions about antibiotics, IV fluids, medications and interventions. Families have to weigh questions of whether continuing care causes suffering, whether they are giving up too soon, how hard to pursue other options. A living will (or “Will to Live”, as some are writing) can guide your family, but can’t anticipate every question they will face. The more detail you provide, the more helpful a guide it can be.
These issues get more complex every year. As medical technology improves, the decisions get more complex. There is also more likelihood of staying alive after a major health event such as a stroke or heart attack. It is likely that you will need more care, at greater expense to your family, or to Medicaid, which all Americans pay for. Long term care insurance can address some of these costs for some period of time, but many people do not have it, can not afford it, or do not qualify for it. Families will not be able to avoid the financial implications of their decisions.
If you wrote an advance directive several years ago, it would be a good idea to review it and to complete a new one. The forms were changed after the HIPPA law was passed, and also reflect the growing complexity of end-of-life decisions.
So, please, have these conversations now. Write an Advance Directive and appoint a Power of Attorney. Give a copy to your doctors and your family. You can also post it at a national website. For more information go to, abanet.org/aging/toolkit, myhealthdirective.com, caringinfo.org and uslivingwillregistry.com. If you want to know more about the Will to Live, go to the National Right to Life Committee at nrlc.org. If you want a referral to an elderlaw attorney, call PSRC or go to naela.org. Susan W. Hoskins LCSW |
Previous MessagesJune 2013 - Age Friendly Communities June 2013 - Age Friendly Communities May 2013 - Navigating a Changing HealthCare Landscape March 2013 - Navigating Life’s Transitions February 2013 - Partners in Caring Princeton January 2013 - Men as Caregivers December 2012 - The Safety Net October 2012 - Documenting Your History September 2012 - A Journey of Transformation July - August 2012 - Gratitude & Moving March 2012 - Patient-centered Care February 2012 - Can you Spare an Hour? January 2012 - Challenges & Opportunities December - Are you Prepared for Emergencies? October - Chocolate for Memory September- Looking Back and Looking Forward Lessons and Legacies, March 2011 Independent Living February 2011 Witness to my Life December 2010 Elections, benefits and open enrollment November 2010 Strategic Planning September 2010 Hiring Home Care December 2009 Annual Giving by Sharon Naeole November 2009 Flu Pandemic 2009 October 2009 Healthy Memory, Healthy Mind September 2009 A Personal Perspective on Caregiving July/August 2009 Wei Ji: Crisis, Danger and Opportunity April 2009 Write your own obituary March 2009 Hope and Vision in Challenging Times Medicare Changes 2008: Take A Look! December 2008 Scams, Frauds and Rip-offs November 2008 Engaged Retirement: Beyond Financial Planning October 2008 September 2008 Caregiver Dilemmas Finding Rhythm and Purpose July/August 2008 V + OA = ER (Volunteering + Older Americans=Engaged Retirement)May 2008 Have You Had the Talk Yet? March 2008 Get Moving with FitRhythms™! February 2008 What Are Social Services? November 2007 Plan for the Future September 2007 The Up-side of Aging Summer 2007 National Conference on Aging: Let's ReThink Aging April 2007 Season of Giving December 2006 April Hill McElroy October 2006 Civic Engagement September 2006 White House Conference on Aging May 2006 Are You Prepared? October 2005 Watch Your Language September 2005 The End of the Journey May 2005 New Dietary Guidelines February 2005 Civic Engagement with GrandPals October 2004 The Challenge of Giving Care May 2004 Seniors On The Move April 2004 Random Acts of Kindness December 2003 Civic Engagement November 2003 |