Mandatory Advanced Planning
The thinking and talking I advised in Part One and Part Two of this article are important…very important…but eventually one must put pen to paper and provide some direction for the people who may be suddenly thrust into a terribly critical role…that of decision maker and caregiver for you.
Oh sure. We all plan to live forever, but that ain’t gonna happen, and as one who cares for a person who is so old she doesn’t even buy green bananas (mom was born in 1925), I can assure you it is useful to have some guidance. Even then, things can get messy and complicated, especially if there are quibbling relatives involved, or as is more often the case, when they are involved.
Do you want to be resuscitated? Do you want doctors to use extreme measures to save your life, or do you prefer a natural death? How much do you want your family to know about your situation? Who is designated to make decisions on your behalf in the event you can’t make them yourself? In the event you pass, what do you want done with your body? Do you care?
There are dozens of questions to answer, but not hundreds. You can get this done, and honestly, you must.
If you or your loved ones do not have an Advanced Care Directive, then here are two good resources for getting started:
- The Conversation Project: A FREE public engagement initiative with a goal that is both simple and transformative: to have every person’s wishes for end-of-life care expressed and respected.
- An Advanced Death Care Directive from the Rev. Olivia Bareham: A $10 planning booklet for after-death care, funeral and disposition. Note I interviewed Olivia about home funerals in 2017. You’ll find that interview here.
Worry Less. Celebrate More
The result of your efforts is a set of documents making your “future life preferences” (aka code language for how you will live as an elderly person, and how you will die) very clear. I finally got mine done and have discussed them with my kids and medical proxy (the medical Power-of-Attorney authorized to make decisions on my behalf in the event I am not able to myself.) They know where to find them for when my time comes. I truly hope that will make it easier for them to worry less, save money, and eventually, celebrate a life well lived (mine) without a bunch of hassle.
Brant’s Stairway to Heaven
If you are fortunate enough to live until a ripe old age, chances are at some point you will need assistance. There is a lot of confusion about the different types of professional care available to older folks. Nursing homes? Assisted Living? Independent living? Yikes! What does it all mean?
It would take more than this one blog post to answer that question, but I can give a quick primer in one simple picture, which I call my Stairway to Heaven. You’ll find it below. Use it to make some decisions about where you want to spend your sunset years (and money)
All professional care costs money, and lots of it, but surprisingly, it can cost less than aging-in-place (at home) with a professional nurse in attendance. That’s because at home, the nurse is likely dedicated 100% to you (or your loved one), and thus, you pay 100% of that resource. In a facility, the nursing costs (by far the most expensive element of care) are shared.
A useful tool for knowing how to pay for senior care is found at the aptly named Paying for Senior Care.
Beware the Medical Machine
As you plan, it’s important to understand that the medical system is like a machine with one gear: save the life at all costs. That is a doctor’s prime directive, enshrined in the Hippocratic oath they take as medical students. If you want them to do something different, such as allow for a natural death (as with a “do not revive” directive), then you must be aggressive, often with the help of an advocate, in order to force the medical machine to change direction. Even then they might not, and you could end up with an experience you don’t want.
I urge you not to let that happen.
One Last Tip
None of this work will do you (or your family) any good at all at all IF folks don’t where to find it in a hurry. Keep in mind these documents are needed because you are still alive, but perhaps in trouble, maybe even on the edge of death, and time and clarity are of the essence.
So where should you keep these documents? Well, signed originals on paper should be in your filing cabinet, but we need something fast. After trying out some fancy online lockboxes, I went cheap and found Dropbox Paper useful for compiling the essentials into an access from anywhere/anytime repository. Did I mention it is free?
My Dropbox link, which is private, is inscribed on a medical ID pendant I purchased from Lauren’s Hope and that I wear around my neck. That pendant also includes the telephone number of my medical proxy. Now first responders can very quickly access everything they need to know in the event of an emergency. Here’s a screenshot of what mine looks like. Note the clarification video, just to make things abundantly clear (see “Beware the Medical Machine” above). Not shown is a link to my final wishes, which detail how to handle things after I die.
Everything is backed up by real paper, and both my medical proxy (one daughter, a Registered Nurse) and the person I asked to handle the situation in the event I croak (a second daughter) know exactly where to find everything, as does my wife, whom I expect to be so distraught with grief that folks will need to hold her back from throwing herself on a ritual funeral pyre so that our spirits might be unified in the afterlife.
Ok, that’s prolly not gonna happen, but a guy can dream, can’t he?
Good luck. Get started.