The Conversation
I hope your good weather activities are off to a fast start – and that all your hiking and biking are making estate planning less urgent, shall we say. On the upside, longevity authorities now predict that the first person to live to 150 has already been born. Still, as far as I know, mortality is holding constant at 100%.
Perhaps because of that last statistic, I often get asked whether I find it discouraging that despite all my best planning efforts, I end up losing most of my clients eventually. In the spirit of the campaign season, I usually dodge those questions by asking whether people have made the same inquiries of their physicians.
But let’s not dodge it here. Most of us have come to the realization that we’re not going to make medical history on the order of Methuselah; we just want our brief sojourn here to end the way we hope. That is, please let us die at home, in our own beds, with all our faculties intact, after a vigorous life and a nano period of decline, and with all our loved ones gathered around. Yet, the truth is that 80% of us will die in a medical institution of some sort, and at the end, 50% of us will be incapable of making decisions on our own behalf.
So what do we do to fight back? Well, we could all make sure we have a good, current health care directive, so that if we’re “out of it” near the end, our best interests are in the hands of people we trust to do the sorts of things we’d do for ourselves if we could. But you know that, and most of you have already taken that important step. (You’re in the minority, though, because nationally the percentage is just 25%.)
The problem is, even that’s not really enough. You need to have “The Conversation”, to use the term coined by Dr. Sanders Burstein of Dartmouth-Hitchcock Nashua (and probably others). In other words, you need to get a lot more specific about what you want than the basic choices given you in the canned documents the statute prescribes. Even our versions, which expand considerably on those selections, still aren’t enough.
You need to talk – a lot – with the person(s) who will be in charge if that unhoped-for time comes. Sure, it’s a conversation no one wants to have, which is why it happens so infrequently – like when you need to have that birds-and-bees talk with your teenager. So have it before the time comes, when you can still make dark, nursing home humor about it, even while being completely serious. And someone should be taking notes, including quotes, if possible. If you just can’t bring yourself to broach the issues, though, or if no one will sit down and listen (which is sometimes the case with family members in denial), then put it in writing for them and attach it to the official document. If we’re holding your directive in our safe, we’ll be happy to supplement it with your specific guidelines.
What am I really getting at, you say? Here’s my very brief stab at it: “I love to read history, follow my favorite teams, get together with my friends and family, and take walks on nice days, and I’ve always thought it important to feed myself and make private use of the bathroom. If it gets to where I can’t do the majority of those things, and I can’t decide about what to do myself, then I don’t want any efforts made to keep me going by medical procedures or drugs. I want nature just to take its course, and if it looks like that’s happening, I don’t want anyone to interfere with that process, except to keep me as comfy as possible. You may be reluctant not to do all you can to help me hang on, but that’s not what I want. Life here will already be over for me, so let me get on to wherever else I may be going. I sincerely appreciate all you’ll be doing for me, and I hope being clear about my wishes will put everyone's mind at ease.”
Not bad for a start; I actually feel better already.
Posted 06/10/2016 - Misc.
Perhaps because of that last statistic, I often get asked whether I find it discouraging that despite all my best planning efforts, I end up losing most of my clients eventually. In the spirit of the campaign season, I usually dodge those questions by asking whether people have made the same inquiries of their physicians.
But let’s not dodge it here. Most of us have come to the realization that we’re not going to make medical history on the order of Methuselah; we just want our brief sojourn here to end the way we hope. That is, please let us die at home, in our own beds, with all our faculties intact, after a vigorous life and a nano period of decline, and with all our loved ones gathered around. Yet, the truth is that 80% of us will die in a medical institution of some sort, and at the end, 50% of us will be incapable of making decisions on our own behalf.
So what do we do to fight back? Well, we could all make sure we have a good, current health care directive, so that if we’re “out of it” near the end, our best interests are in the hands of people we trust to do the sorts of things we’d do for ourselves if we could. But you know that, and most of you have already taken that important step. (You’re in the minority, though, because nationally the percentage is just 25%.)
The problem is, even that’s not really enough. You need to have “The Conversation”, to use the term coined by Dr. Sanders Burstein of Dartmouth-Hitchcock Nashua (and probably others). In other words, you need to get a lot more specific about what you want than the basic choices given you in the canned documents the statute prescribes. Even our versions, which expand considerably on those selections, still aren’t enough.
You need to talk – a lot – with the person(s) who will be in charge if that unhoped-for time comes. Sure, it’s a conversation no one wants to have, which is why it happens so infrequently – like when you need to have that birds-and-bees talk with your teenager. So have it before the time comes, when you can still make dark, nursing home humor about it, even while being completely serious. And someone should be taking notes, including quotes, if possible. If you just can’t bring yourself to broach the issues, though, or if no one will sit down and listen (which is sometimes the case with family members in denial), then put it in writing for them and attach it to the official document. If we’re holding your directive in our safe, we’ll be happy to supplement it with your specific guidelines.
What am I really getting at, you say? Here’s my very brief stab at it: “I love to read history, follow my favorite teams, get together with my friends and family, and take walks on nice days, and I’ve always thought it important to feed myself and make private use of the bathroom. If it gets to where I can’t do the majority of those things, and I can’t decide about what to do myself, then I don’t want any efforts made to keep me going by medical procedures or drugs. I want nature just to take its course, and if it looks like that’s happening, I don’t want anyone to interfere with that process, except to keep me as comfy as possible. You may be reluctant not to do all you can to help me hang on, but that’s not what I want. Life here will already be over for me, so let me get on to wherever else I may be going. I sincerely appreciate all you’ll be doing for me, and I hope being clear about my wishes will put everyone's mind at ease.”
Not bad for a start; I actually feel better already.
Posted 06/10/2016 - Misc.