Uncomfortable

I consider conversation between people to be one of the most rewarding and exciting aspects of life. Recordings of the written word comes in second in my humble opinion due to the fact that what is written is subject to misinterpretation depending on many factors. Not to negate the misunderstanding caused by language barrier and incoherent speech patterns, but generally when you hear something it is pretty much just “what you heard.”

At no other time in history have I been more aware that there is such a massive amount of uncomfortable conversations occurring. Sadly, much of the most offensive exchange we are currently exposed to is not verbal but texted, posted, printed, or pre-recorded. The convenience of these methods of information exchange is undeniable. The quality is questionable.

The volume of discourse over the current political landscape is beyond comprehension, not only in America, but across the globe. The shifting sands of opinion and time will eventually settle, and new dialogue will resurface about whatever balance human existence regains.

Having witnessed these tumultuous events, and recognizing the multitude of newly vehement revelers of political opinion which had never, before now, given the topic much consideration, I began to wonder: Why? Why now? Have there not been millions of debatable issues over the past 40 years that failed to become more than a C-Spanned, red-eyed, remote flip of boredom? Certainly we have all been affected by this shuffling of interests in world affairs both public and private. But in the past many of those personally involved were understandably limited to the professions directly designed to be appropriating the need.  This political slugfest seems to have engaged everyone, from every perspective and every varied opinion into an extremely uncomfortable national discourse.

Yet when attempts are made to encourage everyone to become involved with their own end of life issues, the resistance is equally universal. Very few people seem to want to begin discussions with a loved one; that is until an acute trauma or terminal diagnosis is ripping the lives of their family, friends, and acquaintances apart.  As is common within proper social etiquette, there is a general outpouring of prayer, shared grief, and unified offers of support.

What will it take to make this “uncomfortable” conversation as popular as the raging debates around the world today over truth, rights, and political control? It is every bit an undeniable fact that we have a new President as it is that everyone will eventually die. Life goes on, and ends; the disproportionate lack of acknowledgement of death will not change the fact that it will occur for all of us.

What can help make conversations about death more comfortable? I believe it is honest, compassionate examination and understanding of the emotional, physical, and psychological needs of each other coupled with genuine, meaningful communication before a medical crisis occurs. Enough can never be said to help each other with what is often the most frightening, “uncomfortable” event we all will ever (and must) face.

The outcome of these “uncomfortable” discussions may even be peace of mind, increased knowledge of legal and financial responsibility, understanding of desired preferences for services and care due to changed independence, emotional release, insight into unanswered concerns, repaired personal conflicts and family dynamics, expression of personal choice, acceptance of everyone’s opinion, etc. You will never know if you don’t ask.
Just start talking!

© Caring Choices 2017

Animal Intuition

My husband, Jim, and I have been on the receiving end of caring kneading from some of our cats over the years.  Mercie (rest her soul) used to knead the back of my neck in bed at night which was especially welcome when I had a headache.  The methodical push of her soft-padded paws accompanied by her melodic, low purring was better medicine than the ibuprofen I’d taken before going to bed.  Just the other night when Jim wasn’t feeling well, Sundae seemed to sense this and kneaded his stomach in all directions with positive effect.  We know others who have similar stories about the comfort and care they receive from their furry friends.   It’s not difficult to find a story online about a cat in a nursing home who lays on the bed of a resident as they take their final breaths; or a dog that can sniff out cancer.  Animals are so well connected to the metaphysical; they just seem to “know” when it’s time to provide comfort or time to let go.

A few weeks ago, we chose to end the suffering of our oldest cat, Soxie, whose final seizf639e582_1028976ure was so intense and vivid, she seemed possessed.  It was horrifying to watch and hear; it will be a very long time before I can close my eyes and not see what she experienced.  When she was able, she retreated to an odd location where she’d typically go when she wasn’t feeling well.  She knew it was her time and she was “going inward” to prepare herself … and us.

Animals just seem to “know.”

We humans are animals too; some would say more evolved than cats and dogs.  Perhaps we’re more evolved in matters of business, literacy, art, and intelligence, but I’m not certain we are more emotional or more compassionate.

Some of us have such difficulty listening to our intuition when someone we love is sick or dying.  We tend to pursue all possible healthcare options until there are no more medical interventions to impede the natural progression of disease or age.  We focus on the next treatment option, the next surgical procedure, or the next drug; sometimes at the exclusion of the emotional and metaphysical components of the one who suffers.  This focus is sometimes so intense that we forget to look at the person right in front of us (or in the mirror) and ask “what do you need at this moment” or “how can I care for you today.”

Some people spend so much energy waiting for the other shoe to drop, we forget that there’s already one foot immersed in the disease and daily symptoms, or contemplating their final hours.

We need to pay more attention to our “animal” intuition.  We need to listen to those we love who are living with a chronic illness or a terminal disease.  We know our bodies and our minds better than anyone else in our life – family, friends, healthcare professionals, clergy.   Be mindful of the one who suffers and seek to understand what they need.  We need to recognize when it’s time to stop doing and just be still.   Then, provide care and compassion like we just seem to “know.”

©2017 Caring Choices

“You can’t take it with ya.”

Earlier this week, as I lay iced up on the therapy table after my session, I overheard a light-hearted laugh and discussion about plans for something that involved what I imagined to be a pretty hefty amount of cash. Having only caught the last exchange of the entire conversation due to unintentional proximity, I was struck by the gist of the ending phrase as the parties were walking past my doorway and continuing on about their day.  All that I could hear being said was “… might as well, you can’t take it with ya.” Now it’s not that I have never heard this saying before. In fact, very likely I have heard it hundreds, if not thousands, of times. But that day, it registered in my mind with a completely different reaction as any other time. Maybe it was the light-hearted giggle and soft tones, or maybe it was the representative acceptance of what I now imagined the meaning that this common phrase infers.

Having worked as a nurse for over 25 years, I have been exposed to the traumatic effects of the loss of independence and death. I have witnessed the impact of these events on patients, their families, loved ones and friends in a multitude of settings, circumstances and degrees of intensity too broad to include in this forum. In all of this time however, there were very few, if any, references to any material assets which would not be taken “with ya.”

There are, unfortunately, innumerous examples I can remember that involved the inability and unpreparedness to accept the new reality that had now been forced upon the present.

But when we say the phrase “you can’t take it with ya,” it seems there is an undeniable acceptance of death or changed realities already so well in hand that that it can be so casually joked about.  Why, then, is the reaction so intense for the grief stricken who are seemingly left helpless at this change in condition when it becomes a reality? Why is the reality of “can’t take it with ya” such an unimportant consideration until death becomes impossible to avoid?

The answer for myself is that I never want to imagine the “with” part of that statement.  I personally have filled out my Will and Five Wishes forms.  I write these blogs hoping to get others to address the possibilities of “with” before it becomes “now.”  I still don’t feel very casual about the “with.”

But this fact has not stopped me from recognizing the importance of planning for the time when I have lost my independence and have left this world and my family and friends to remain and deal with my departure in however they best can. (One glimpse of this inevitability came just last month when I underwent a right posterior total hip repair.) No one gets to choose how they die. Very few know when. Even fewer look forward to it sincerely. But there is nothing in this world stopping anyone from discussing how they may wish to be cared for in the event of a loss of independence, on any level, or how they would like to be treated and have their physical body and material things handled when that “with” finally becomes “now”.

Please, by all means with every breath of your life, hope for the best. But my friends, please also strive for happiness, love, and compassion in the world around you.  Perhaps more importantly, be prepared for the worst. Discuss your wishes, feelings, and beliefs with your family, friends, and loved ones. Get as much in writing and scanned into medical records backed up by legal consents and authorizations in the hope to lessen the tragic impact of inevitable changes on you and those you love. Don’t let the burden of “with” become someone else’s problem “now.”

©2017 Caring Choices

Pain

Pain is not something I have ever been a fan of. Actually, I have always been afraid of it in lethal doses as with torture, cancer, trauma, or acute disease (myocardial infarction) or the myriad exacerbation possibilities of chronic diseases. I have made a career of trying to eradicate pain from the lives of all patients, but especially hospice patients.  With the help of my wife in promoting end of life conversations, we have tried to lessen and soften the emotional, mental and spiritual pain of inevitable changes we ALL will face.

As a nurse for over 24 years, I have witnessed the devastating effects of chronic conditions and diseases. Too long to name here, the lengthy list of aliments that have the ability to affect our quality of life is known to many people. Most everyone knows someone who is living with an awful disease. Some may often be preventable, and many are treatable.  Certainly there are always behaviors we can eliminate and choices we can make that may promote the general wellbeing of our future health.  Many of us hope to grow old, with dignity and good health. Many wish for a peaceful end for our lives which, despite all hope, often does not go as we expect. Hope for the best, prepare for the worst I like to say.

Personally, and I say this very seriously … I did not expect my fate would be to fall prey to, of all things, something as common as Arthritis!  More pointedly, “end-stage arthritis” as the orthopedic doc I saw this week phrased it. It never occurred to me that arthritis could be the source of such mind numbing, relentless, severe pain as I have been experiencing with growing intensity for the past 5 years. Although arthritis, in and of itself, is not really fatal, the death of my independence and function as it once was, occurred none-the-less. And there are millions who experience this around the world every day.

I always thought arthritis was an “old person’s” disease. I never would have dreamed in a million lifetimes that this is what would finally break my armor and take me down.

I once believed in the “no pain, no gain” slogan often spouting from the competitive nature many have within the rigors of physical achievement in sports and general athletics. This mantra of Spartan-like stoicism in the face of brutal resistance even spills into academia, politics, and religious worlds of all who believe that they will achieve their goals “no matter what” the costs. Just ask any nursing student who has worked full time throughout their entire nursing education. Or ask any Evangelist who builds wells in Africa in the midst of civil war and political coup. We all fight our fights, pick our battles, and slay our demons as we struggle toward our personal (or unified) goals.

So, yes, in the majority of the circumstances I agree with the “No pain, No Gain” philosophy. Just my own experiences with backpacking the Grand Canyon for many days at a time ring true in this sense.

But then there are the situations like the one with which I now have come face to face; the ones where no amount of suffering will yield a positive outcome.  Fortunately, I can have hip replacements to alleviate my pain and be able to regain some of my independence for a while longer.   I won’t die in arthritic pain as some may have in generations before me.

Clearly there is a reason most human beings died before age 60 in the past. There just wasn’t anything to gain from prolonged suffering. There were few options to constant unrelenting pain. With the exception of opium, alcohol, and barbaric, antiquated surgical measures, humans suffered and died long before 50 became the new 30.

And yet even with the modern technological advances in medicine and surgery, there are many who now find themselves in states of mind-numbing pain. Whole disciplines of science have been developed over the recent years to combat pain, cure diseases and even stave off death. But one factor has been sadly overlooked.

There are not enough resources to cover the continually growing numbers of people approaching “older” status. There are too few doctors, nurses, social workers, aides, clinics, hospitals, ancillary staff and even funding to handle the growing populations across the entire planet.

Escape Fire is a documentary (available on Netflix) that exposes this “Achilles’ heel” of our medical profession today. This is not alarmist, fatalistic, or negativism. This is reality. Unless we, as a country, align ourselves with forward-thinking neighbors in other countries, the world is destined to fall into a “Survival of the Fittest” mentality. But unfortunately there may be no relief from pain for anyone unless you are affiliated with the “winner.”  To me, this is a frightful prospect to ponder.

As humans, we possess the capacity for the most beautiful artistic creations, marvels of scientific advancement in space travel and DNA modification, architectural designs, agricultural success and compassionate empathetic behavior worthy of sainthood. Yet we focus much of our resources on defensive posturing and aggressive superiority in matters of future concerns. My hope is that we may all join together in the united effort worldwide to alleviate fear, hate and pain for everyone. We were all given free will, but some do not wield this compassionately.

“The value of life. That people have to be kind to each other…” Helga Weiss- an interview with a holocaust survivor.

So where do you stand?

©2016 Caring Choices

 

Birth________ Death:

Like a book, what is in between is what matters most.

When reading a book, was it the cover that attracted us to it?  More likely the impact of its content is where appreciation and fulfillment lie.

Why would we suddenly then be afraid of that last page or back cover? Certainly the better the book, the more likely we would feel varying emotions as it draws near. There is also the option to stop reading the book by stopping somewhere along the way. Some believe that once started the book must be finished no matter what. This is a choice as well. And for some, reading is never a possibility. There may be too many obstacles to overcome. I have also heard “Never judge a book by its cover.” Often people are anxious and excited to reach the end of the story. Now apply this to life.

Why would we suddenly be afraid of what we all know is the inevitable outcome: The end of the book. Why would we care more for the beginning of the book than the end? Depending on the content, the comprehension of the reader and the expectations, the stage is set. The pages of our lives are turning each day. To a degree we often have the ability to do some editing. Others may be helpless to do anything. But we all will finish this life book someday.

In our excitement to improve and lengthen life, we have unknowingly vilified death, or the end of the book. Long ago, we cared for our loved ones in stoic acceptance as they died in our homes. We honored and comforted them. Loving, laughing, crying, grieving and sharing in their care as they died.

Today, everything is an emergent crisis which we must repair! Death has become unacceptable. And in many cases, the trauma, disease or advancing natural decline is so severe that no amount of medication, procedures or diagnostic testing can reverse the process. And there is often unnecessary suffering endured in place of honest communication. Afterwards, when all the possibilities have been exhausted, we warehouse these poor souls and give the buildings softer names to offset the harsh realities within their walls.

Quantity of time has become preferable to quality of life in hope of miracles, cures, new science and luck.

I have been a nurse since 1993; and 11 years in Hospice. Each day passes with a new chance to lessen the stress for those around me. I have seen the acceptance of our mortality, and at times, together with faith, replace the fear of death, with appreciation and anticipation of what the next book may be. If even one person has a softer path from this life, to that final page and the back cover because of something we have done or said, then we are sincerely thankful.

Caring Choices is committed to this mission.

© 2016 Caring Choices

 

Just Be

Most people shy away from being around dying people.  That seems to be a normal reaction.  But, being around death – experiencing death of loved ones at home – used to be a very natural occurrence in American households.

Before we “medicalized” dying and death, people were cared for at home by family and friends.  There was an inherent knowledge about caring for aging, ailing, and/or elderly family members as they reached their final months, days, and hours.  More than 80% of Americans say they want to die at home yet fewer than 25% of us actually do that.  This disparity is likely because we’re rushed to the hospital by ambulance after panicked 911 calls, or we’re involved in a traumatic accident and traverse the ER-to-ICU pathway, or because palliative and hospice care are discussed/started much too late in a disease’s process.

Caring for a dying loved one at home is challenging and, as I’ve shared in this blog previously, very rewarding.  Beyond the demands of providing actual care (bathing, dressing, feeding, toileting, medication management, etc.), there is also the emotional experience of caring for and watching someone you love fade away.  It’s this emotional state that I want to address.

I was once witness to a family caregiver’s phone call from a friend.  I could see the happy anticipation in her face as the caller expressed desire to come by for a visit.  The caregiver’s demeanor and spirit lifted as if a burden was removed from her shoulders knowing that she would have an hour or two with a friend to sit and enjoy a cup of tea and feel not so alone.

As quickly as her smile appeared, though, it faded away as she shared with her friend that her loved one was not responding to conversation anymore.  Her joy and soul were crushed, and her heart was broken.  It was painfully obvious that her friend decided not to come by … and equally obvious that she felt abandoned.

It’s not always easy to know what to say to our friends who are caring for their dying loved ones.  It’s easier (for us) to avoid the situation by offering excuses like “I don’t want to remember her this way” or “I can’t watch him like this.”  Family caregivers do not have the luxury of avoidance.

I believe this avoidance is typically caused by fear.  Fear of not knowing what to say.  Fear in not knowing what to do.  Fear in recognizing our own mortality in the face of our friend’s dying loved one.  Fear in upsetting our friend with the “wrong” words or by reminiscing occasions spent with their loved one.

We don’t need to know the “right” words.  Sometimes we don’t need to say anything at all.  It’s so important to just be there for our friends as they provide care for a beloved family member.  Sometimes they just need their hand held or a strong, supportive hug.  Sometimes they just need our presence to share a cup of tea or a simple meal, or to bring them a bag of groceries, or pick up something at the drug store. Hands - Just Be

We don’t need to be armed with clever sayings or big gestures.  We need to just be able to sit with them, let them share their experiences, and listen.  We need to … just be.

© 2016 Caring Choices

Dear Death

Dear Death

“….I need a friend.”

Good morning Death, I see you may plan to visit a woman who has been my friend for 5 years now. She called me this morning from the ICU at Tempe St Luke’s and asked me to come to her. She told me she is dying.

And I am wondering now Sir, What can I say? What can I do Yama? I give her a part of me in life, but what can I give to her in death? Should I cry with her?

My card says “It seems like we’ve been friends forever.” And now forever has come to take her. She will be free. I give her a poem which holds my soul in words- simply my opinion as I have no knowledge worth her life. I can only hold her hand and smile with fear that I may not say the right things to my friend who has said so many right things to me.

I share a little more of my time with her.

If she goes with you tomorrow, I will know that we shared love today. I felt the sun in my heart. 

Today, oh Death, we learned of education. Plato could say the right things to my friend. We listened of love and I learned that love does not come to an end, and this has helped me to stand straight at my friend’s bedside as I share that idea. To her I can say, “I hope that you will remember we share love, and it does not come to an end.”

Now I must go to her as you too may be ahead of me. When I see you Death I will not recognize you. You look different to me today than you did yesterday. I’ll try not to be afraid. If when I get to her she has gone with you, please give her my love.

                                                                                                    Respectfully Yours ,

                                                                                                    JMD 6-13-1990

————————

The above writing was the result of a phone call I found on my answering machine late one morning after night shift at the steel-mill and early morning Philosophy class at Mesa Community College. My friend recovered from her condition. 26 years later after 20 plus years in nursing this letter to death carries much more meaning to me now than it ever did then.

In our excitement to preserve life, we have indirectly vilified death.

Working with end of life care and Hospice has led me to a place now where I hope to share the importance of having conversations with loved ones, friends and caregivers long before such a situation as above takes place.

© 2016 Caring Choices

Tomorrow is Too Late

“Yesterday is rarely too early but tomorrow is frequently too late.”

This was the inspirational quote in my inbox this morning.  It made me think of a woman I spoke with recently who shared that she was taking a family member to the beach today because it was the family member’s last wish.  They aren’t waiting for warmer (beach) weather.  They aren’t making elaborate plans and reservations.  They are simply packing warm clothing and blankets, getting in a car, and driving today to honor a last wish.  Waiting would likely reduce the last wish to regret.

Procrastination is a habit we get into in life.  There may be things deemed more important on which we spend time.  Some tasks are too daunting when seen in the whole so we put off starting them.  We typically procrastinate on doing things that are not fun.

Anyone who has children can understand how time flies.  “Yesterday” my son was born.  A few months ago, he turned 30.  Life flies past us more quickly than most of us like.  Tomorrows arrive (and are in the rear-view mirror) more swiftly as we get older.

Procrastination is very strong when it comes to talking about healthcare choices and making decisions.  Facing a medical crisis, traumatic accident or terminal diagnosis doesn’t usually allow for procrastination.  They often demand deliberate, thoughtful but prompt decision-making.  Given the experiences we’ve had and witnessed, waiting until tomorrow is frequently too late (as the inspiration quote states.)  Emotions run high when faced with the immediacy of unprepared decision-making.

Learn how to start important conversations with people you love today so you can reduce the emotional burden of tomorrow.  April 16th is National Healthcare Decisions Day (#NHDD).  Be like the woman taking her loved one to the beach today.  Don’t wait for “beach weather.”

© 2016 Caring Choices

Intrusive Assumptions

Facebook is famous for quizzes to find out silly and random “facts” about ourselves.  Quizzes determine which Bible character we are like, what our favorite song reveals about our personality, or even the color of our soul.  Recently, I saw a quiz that would determine which friends will take care of me in 2016.  With a quick scan of my Facebook presence, the quiz returned a list of five friends who will “step up”.  If only it were that easy to determine who can step into the role of caregiver.  My husband was not among the five friends which is curious since he would be the first person in line to take care of me in 2016 no matter what life throws at us.

This quiz got me thinking about the randomness with which many people approach the need for personal caregiving when age or health undermines our ability to care for ourselves.  In my work, I see people of varying ages in many different stages of chronic illness. In my family and community, I see the same.   When I meet with families who are trying to determine their next step after age or health has altered their loved one’s course, I often hear that the first choice is remaining in their home.  It then becomes my job to “intrude” on their personal lives to help them decide if that really is the right/best course of action for them.

Since beginning Caring Choices, I’ve heard the word “intrude” from a handful of people, as in:

  • “I wouldn’t want to intrude on their personal decision.”
  • “I wouldn’t want to intrude on a family matter.”
  • “Asking questions about [their situation] would be intrusive, wouldn’t it?”

To a degree, I can understand the hesitation to “intrude.”  Typically intrusion is from the perspective of outside, looking in – someone outside of the situation, being afraid to ask questions or offer assistance/guidance/suggestions.

But what happens when the intrusion is generated from the inside outward – much like the Facebook quiz that chose my 2016 caregivers for me – without asking important questions like “who will do what.”

We should not assume that our Facebook quiz caregivers (or other family/friends) will be able or willing to handle the demands of caregiving.  Yet, many people make this very assumption.  The act of caregiving is a huge commitment.  Caregiving runs the gamut from picking up prescriptions or groceries to preparing three meals a day to providing a bath to administering medications via a PICC line to very personal hygiene after elimination.  Not everyone is comfortable with every aspect of caregiving.  To assume that others will “step up” can be an intrusion.  Certainly friends and family do step up when they are needed.  I’ve seen this.  I’ve done this.  But there are also times when friends and family are not able to manage caregiving amid their own life’s demands – job, raising children, their own illness.

The best way to avoid the randomness of caregivers is to have conversations with people you care about.  Talk about who can pick up the groceries and how often.  Determine who is available to cook/provide meals and when.  Pull together a schedule so you all know whose turn it is.  Find out who is comfortable and able to give you a bath or change your soiled sheets or, literally, wipe your behind.  Seriously, these skills and abilities are not present in everyone’s toolbox.  The less prepared we are for the caregiving role – as either provider or recipient – the more awkward and intrusive the caregiving becomes.  Put a time table to the chores of caregiving.  How long will you need someone to do “X”?  What happens when they are no longer available?  Who will you turn to when family and friends have burned out?

Caring Choices knows that staying in our homes is the optimal choice for most people.  If you want to stay in your home, make a plan now that makes that option feasible.  Don’t simply rely on the random availability of family and friends.  Family and friends may not be able to meet all of your needs 24/7.  They may not be comfortable providing certain kinds of care.  Begin conversations now so that the roles of caregiving are carefully considered. Know before a need arises who can help you and in what ways.  Planning now can alleviate the intrusive worry of needing or providing care.

Que Sera, Sera

Recently during a meeting about nursing home safety measures to reduce fall risk and prevent future injuries, a resident said “whatever will be, will be” (which reminded me of the old Doris Day tune, titling today’s blog post).  His opinion about said safety measures was that regardless what we plan to do, we won’t prevent all falls and he may be injured in a fall at some point.

To a degree, I live my life under the motto of “whatever will be, will be” because we don’t know what the future holds and we are not able to control every aspect of every situation we encounter.  However, I also recognize that we do have control in how we react to things that occur.  We do have the ability to affect change in our circumstances when life throws us a curve ball.  We do have the power to make plans (Plan A, B and C) to prepare for future happenings.

One thing we all know for certain is that each of us will face death, our own and that of people we love.  We don’t know when or even how it will happen.  We likely won’t be able to control or predict when it will happen.  BUT, we can help manage the emotional burdens for those we love.

We can impact the future for ourselves and people we love by making plans about healthcare choices and having personal conversations with them about our hopes, values and expectations.  Plans do not need to be elaborate constructs of detailed, step-by-step processes.  Simply telling our loved ones a few key things can help them face our illness and death with less trepidation and burden.  For example, some things I say to people who love me:

  • It will be okay to place me a nursing home if you are not able to take care of my needs in my home. Visit me as often as you can but know that daily visits are not necessary.  If I’m still able to see/read, make sure I have my iPad, books and magazines to occupy my time.
  • I do not want to take a handful of medications especially if they will no longer benefit me or give my life quality. You know that I cannot swallow pills without great trouble so limit what I’m given in pill/capsule/caplet form, make sure it’s crushed (or an appropriate alternative  if manufacturers say not to crush!) and in pudding!
  • I am in favor of receiving hospice care for as long as I am eligible. Don’t wait too long to begin this vital service which will benefit me and you.
  • Know that I have made my choices and decisions based on my values, beliefs and life experiences. I have made these choices and decisions to reduce/eliminate decision-making burden on you.  My Five Wishes form will guide you in future decisions if I am unable to communicate.
  • If I’m no longer able to express myself, know that I love you. Your presence in my life has made it much richer and more meaningful. I will see you again someday. It is okay to say good-bye to me and for you to tell me it’s okay to leave you.

This isn’t morbid or maudlin.  This is life-changing knowledge I give to my loved ones so they can know they’ve done things in the manner in which I’ve instructed (and chosen for myself).  They will not need to second-guess decisions or question what I would have wanted when a healthcare professional questions them.  They will be able to confidently advocate for my choices and stand up to people in positions of power who may disregard my choices because they deem it more appropriate to follow regulations and rules under which they provide services.

Taking some of the unknown out of “whatever will be, will be” for my family and friends is important to me.  Planning for their emotionally-whole passage through loss, grief and bereavement is something I do as much for them as for myself.  Conversations, writings and my Five Wishes will aid them in decision-making; but they will also aid them after I’ve gone to the other side of the garden wall (nod to Jackson Browne).

Caring Choices.  Make them for yourself and for those you love.  We can’t account for everything, but we can pave the way to reduce emotional burden of decision-making and caregiving.  Don’t leave your and your loved futures up to “Que Sera, Sera.”

© 2015 Caring Choices