When my mother, Dorothy, died twenty-one years ago, I made a decision, as the only child, to have a closed casket at the wake. Truth be told, I didn’t want to have a wake, but out of respect for my mother’s cousins and other relatives, I conceded there. But as to sitting in a funeral parlor and seeing my beautiful, vibrant, best friend in a casket - no. That was NOT an image I wished to have anywhere in my consciousness. It was hard enough to wrestle with the images of her on a ventilator, for heaven’s sake. (Thank goodness her final illness came suddenly and her true suffering was measured in days, not months or years. For that mercy, I am still grateful.) Well, the morning after the wake, the family assembled at the funeral home for a private service, and I had given the funeral director permission to open the casket so that any of the relations and friends who wished a viewing could have one. I sat in the lobby. After the funeral, my mother’s cousin made a point to castigate me publicly for not having the traditional Irish three-day wake, complete with open casket. And she was livid that I had "disrespected" my mother by "refusing" to view her body. And I told her I never wanted to speak to her or hear from her again. And I never did. And somewhere, I know Dorothy was applauding. She once said to me after we had attended a wake that there was something really ghoulish about the whole three-day process, and that seeing someone "made up" by a funeral home cosmetician was a combination of horrible and hilarious. So I knew I had done the right thing for her, and for myself.

After a recent death in the family, my two cousins, Jayne and Joanne and I were driving home following the wake, discussing the fact that we should all probably get our last wishes, health care proxies and medical directives in order and in one another’s hands. So I think that, for us, Jane’s book will be MOST helpful. Personally, as I said to my cousins, I am hoping to be strolling with them along the sidewalk when the fatal heart attack or stroke comes and knocks me out of this realm. My wishes? Let this happen on recycling day so that they can simply roll me to the curb, observe a moment of silence, and then continue with the day. Eventually the biodegradable truck will pull up and load me in and that will be that. (After all, except for my dental implants, I am biodegradable.) Well, OK. That’s a fantasy. But I am leaning toward donating my body for use in an anatomy and physiology lab at a med school. I’ve had a lot of surgery, so there may not be a lot left to look at, but I’m sure there would be something to be learned.

I’d better get to work and start updating things - thanks Joan and Jane for a wonderfully informative and important interview.

In fact, the PBS documentary on aging and dying in America, featuring the gerontologist (physician) in the NE clarified what I have personally experience—many, in fact most, people who have signed DNRs, and/or made known how they wanted their remaining days to be if (critically ill, terminal illness, last days, “take me out behind the shed and shot me…”) changed their minds, and wanted to fight for their lives.

_________________________________

I suspect most people do change their mind and these directives present a problem if something happens and you are not able to communicate your wishes.  My father changed his. At the very end.

If you have a directive, keep a copy ON you. In your wallet. If you are in an accident, that is where most emergency room personnel will look. They will not call the ambulance driver or the police and ask them to look and see if there was a directive in the glove compartment. 

If you take ill at home, live alone, and call for an ambulance, the ambulance personnel most likely will ask you if you have your wallet on you. And get it for you. 

As for safety deposit boxes, I am forever amazed at how many people will put the directives there.  Even a copy in a file at home is not going to be noticed. If you give family members a copy, they may lose it. Or not be able to find it.  I would never have one.  I would prefer to trust a doctor. Not myself. And certainly not the next of kin.  It is my life. Miracles do happen. These directives can ensure they don’t happen.

But if you do have one, it should be in your wallet. Where a doctor or a nurse can find it easily. Before they "hook you up." 

As for "natural death" and hospice care much has changed in the past 20 years and palliative care has become intertwined with what is known as terminal sedation.  A friend was terminally sedated at a hospice that was founded by another friend of mine and I know my friend never agreed to terminal sedation and I know the founder would never have allowed it. It had merged with another hospice which apparently did allow it.  Terminal sedation is a nice word for euthanasia.  It was horrible for all of us when the family finally notified us. She was comatose at that point.  There is nothing illegal about it as long as the patient agrees to it. We don’t believe she did. And we consider it murder. 

Death and dying is a difficult subject in our society. It is not a pleasant subject so we ignore it. And act gallant about it, often writing directives, and believing it will be an easy passage.  It is not.  And none of us should decide how we will die because we really can’t. We can, however, accept the reality and hope that our end comes naturally and we have time to enjoy the last of our lives with some sense of peace. 

And we do change our mind along the way. Despite the gallant acts and gallant directives.

My father had a long journey with cancer. At the end he was diagnosed with cancer of the bronchia, one of those cancers that for the most part is untreatable, and knew he was finally going to die.  And he was adamant he did not want to die in a hospital. He moved in with my brother. He called me one morning and said he had no feeling in his legs.  I told him that was natural.  He was dying.  And told him I would be right over. He said no he wanted to go to the hospital.  He said he would rather die there.  Despite saying all along he didn’t.  Have no idea why he changed his mind. But he did. 

I don’t know that any of us die "well" but we can die perhaps more peacefully and with more acceptance than we do. I look forward to reading your book.

My deceased mother was right on target. She was an organized woman She always lived a simplistic and holistic lifestyle. Before my mother died  she made certain everything was in order. I did not have to hunt for documents nor did I have a lot of clutter and furniture to discard. I love her and appreciate her for that. I believe It took only a day and a half to donate furniture and clothing. This included turning in her keys to the management.

I remember management standing with me in the apartment with this odd expression. I asked, "Is there anything wrong?" The response was I’ve never had the experience of someone leaving an apartment so clean." I told management "this is a reflection of how my mother lived."

I’ve never liked clutter. I have adopted my mother’s simplistic and holistic lifestyle. I’m also a very organized person. My so-called junk draw is organized. Something tells me it does not qualify as a junk draw.

I’ve prepared for my exit. Everything is in order. My family will not have to go on a search to locate documents. I know which members in my family and friends like certain things so that’s what they’ll get. Some things have been given away already. I’ve never been attached to things.

The only project that required time was finding the proper dress in the color and style she wanted. I found it in a cute little boutique off the beaten path. My mother looked like a beautiful angel resting in lovely white clouds.

The bottom line is document document document. Even if you’re healthy document what you want done in the event you cannot make decisions for yourself.

I know which members in my family and friends like certain things so that’s what they’ll get.

_________________________________________

A friend who has no children decided to leave this and that to her nieces and nephews. And told them. Which resulted in quite a maelstrom over the "value" of this and that.  So she decided everything will be sold at auction. They can buy what they want. And everyone will get an equal share in the end. When her sister died the clothes she intended to leave to her daughter who had died before she did went to the nieces.  Her closets quickly turned into boxing rings. One niece in particular was of course looking at how much this or that would bring at the resale shop. 

And that of course is usually what happens when someone decides to leave this and that to specific people. Inevitably someone else really wanted it.  Usually because it’s worth more than what they were left.

Ah, Ms. Larsen, as a "committed community member" you have often passed along the best of free advice…and now THIS!  Well done, my darling!

Thank you for bringing Jane Brody’s book to my attention at a time when it could serve such a vital purpose in my own life.  You are a gem.

Prepare as much as you say you can—being a Nurse and helping so many cross that threshold—and nearly passing myself at 50 from Heart Surgery—

I can tell you there is no real way to ”plan” for death.

It happens when and how it wants to.

I have always considered myself a spiritual person but when I was ”dying” I had no thoughts of anything spiritual at all.I just thought how quick it all was.(life)

You can plan the money and property stuff all you want to—and pray that your loved ones follow it.

More do not follow your wishes now than I have ever seen before—

someone gets to a security box before the others—

someone raids the home—

someone hits up the bank—on and on—

on to court it goes!

From what I have seen you need to sit down with EVERYONE mentioned in your will at the SAME TIME at the SAME TABLE and tell them EXACTLY how your will -will be carried out.

Then no one can ”make up”things they say you said to them in” private”.

Plan your funeral=prepay for it if you can to make it easier on others-burial/cremation-ect…don’t leave those choices up to others.

Find someone you can trust to be your Health Care Advocate-not your bestfriend or Mom —-someone you know without a DOUBT is SMART ENOUGH to handle these TOUGH situations.

Write out EXACTLY what you do or do not want—in a crisis situation—

do you want to be revived?—

with the works?-

with only medicine?—

with just CPR and meds?

A Doctor can help you go thru all this.

If it is written no one will have to WONDER or feel any GUILT down the road.

Thank You Jane Brody for all your insight …I cannot wait to read your book.

Unfortunately I have learned thru trial and error-( as you did-)as a young woman who lost so many family members right in a row—young and old.

So hard for us—but we all end up there don’t we?….Lynn

I am a young adult cancer patient and author of Everything Changes: The Insider’s Guide to Cancer in Your 20s and 30s.  When researching my book, I found few resources for young adults facing death.  

This past week, I spent two days with a young woman in Maryland who is near the end stages of cancer.  I interviewed her on video and hope to make available on my website and elsewhere the incredible insights she shared about being single and facing death at a young age. What were her two biggest wishes: To die peacefully in her sleep.  And to be held and snuggle with a guy one more time.  

I am 50  and I hope for the same—I hope she gets her desire and what a good thing you are doing bringing this to the forefront.

Medical personnel are usually at a loss for words when someone is diagnosed as terminal at a young age.

I remember a 25 year old being told right out after waking up from surgery by an MD that her cancer in her breast had spread thru her whole body and was so serious there was nothing anyone could do to save her— she had maybe a year if she went to a New York Clinic for experimental treatments -all FDA approved—

then he just walked out of the room and left me standing there!

She grabbed a picture of her 3 kids all under 6 I might add and started screaming hysterically,it was awful. All I could do was hold her in my arms.

She had just moved from across the country and knew no one—her husbands job had transferred her here. I did keep in touch with her off/on for that  almost 2 years she lived.

All she wanted was to see her 2 daughters make their first communion(catholic) and she did make it—shunt in her liver and all…..

At her funeral I remember they played ”the circle of life” I think of her everytime I hear it still—-she would be 45 years old now……………

Of course losing a loved one is difficult reguardless of age, my father died at age 64 in 1966 of a massive heartattack, my mother died at the age of 99 in 2004.  I think of both of them daily.  What I don’t understand is why someone who is 70 some and up clings to life no matter how much pain, physical and emotional, wants to go on and will insist on medical procedures to go on and on living. I do believe the medical people already without discussing it with everyone in the family,  help the suffering person die, not by killing them but just letting nature take its course, so why are people so horribly upset by what they think the national health plan is going to let people die???????

My mom had a wonderful life, children, grandchildren who loved her and spent a lot of time with her thru the years, very good health and a wonderful mind till the last 2 weeks of her life, yet she was ready to die years before she finally did. 

I have a living will, my children absoutely know how i feel about dying and are ok with it. I am 73 and in relatively good health, diabetic but totally under control.  I am ready anytime now, 3 children, 9 grandchildren, and I know they will miss me, but………  I miss my parents, grandmothers, etc., and I know everyone will get on with their lives after my hubby and I are gone, I do not understand why people have such a hard time discussing dying with family members, is it guilt because some really wish that the care of the parent is not close at hand for them? Afraid that the parents will be angry because they don’t want to die, I wish I had the answer for people who fear death, but I don’t and we all need to learn to live with our own mortality.