Tips for Preparing for End of Life | Geralin Thomas | Raleigh Cary, NC

Preparing for End of Life

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What does it mean to prepare for the end of life?? Is it simply a practical matter of completing paperwork ? wills, care directives, instructions for looking after your pets?? Plato?s famous claim that the task of the philosopher is to prepare for death suggests it is more than that, something deeper than documents.? But is the deeper part just for philosophers?? What about bookkeepers and baseball players, soldiers and sanitary engineers?

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Organizing and Planning for End of Life Reduces Uncertainty

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I think it?s everyone?s business, not just those among us who spend their time thinking deep thoughts.? And I think that getting the paperwork right, that even being able to approach the paperwork in a clear state of mind without crippling fear and anxieties, requires several different types of preparation, which may take some time:

• Personal ? Developing an internal sense of completion
• Interpersonal ? Communicating with loved ones and potential caregivers
• Societal ? Ensuring that what you want will be respected

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Societal:? ?Ensuring that What You Want will Be Respected

There is an unexpected benefit to specifying your instructions legally.? Not only does it help ensure you will get what you want later, it also provides considerable peace of mind along the way.? Unfortunately, figuring out the best legal steps is not simple, so the act of trying to settle things can actually become unsettling.

Instead of trying to achieve total certainty, I recommend envisioning a spectrum of uncertainty.? Every step you take reduces uncertainty some.? The more you do, the more you approach certainty that your end-of-life wishes will be respected.

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8)??? Complete the Health Care Proxy Forms:? You?ve done your conversing and interviewing.? Now make sure you fill out the forms, get them signed, and notarized if necessary.?? File a copy with your health care provider.? Keep a copy at home and a copy in your wallet.

There are organizations which will store the forms online and give you a QR code so that anyone, an EMT for example, could scan it with a smart phone and retrieve your documents instantaneously.

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9)??? Complete a POLST:? POLST (Physicians Orders for Life-Sustaining Treatment) is both a form and a movement, or a ?paradigm program? as the founders call it.? POLST was created in 1991 out of the realization that advance care directives were often ignored or ?ineffective.? They were imprecise.? They didn?t address questions clearly and succinctly.? And they weren?t legal documents.

The POLST solution is a form that is precise, clear and succinct, and un-ignorable.? Physicians pay most attention to orders from other physicians, because they speak the same language.? And if those orders meet the relevant state laws where a physician is practicing, they have to be followed.? Anyone who has thought much about end of life will have thought about the questions contained in the POLST.? The difference is ? an advance care directive is a wish list from you, while the POLST is a doctor?s orders.

POLST has now been adopted by a majority of states in the U.S.? If you live in a state or another part of the world in which the POLST is not (yet) recognized, you may consider using a simple template like Five Wishes.

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10)? Complete a Living Will that Addresses Alzheimer?s and Dementia:? Many of us will experience some form of dementia for months or years.? We may even be in pain and unable to express ourselves to get relief.? End-of-life treatment in a state of advanced dementia is not addressed in most advance care directives or the POLST.

One option, known as ?natural dying,? involves foregoing food and fluids.? Using this approach successfully in the later stages of Alzheimer?s and dementia requires education,? advance planning, and a durable living will in order to overcome possible challenges later on.? One organization that can help is Caring Advocates, whose Natural Dying Living Will comes closer than any other to achieving certainty in having your known wishes prevail.

Many of us act as if there will be a certain point, which we will somehow just know, where some combination of dependency, dysfunction, pain and nausea might make us want to hasten death.? Not everyone feels this way.? Plenty of people don?t think about the end of their life at all, and for those who do ? some will prefer all possible life prolonging measures until the legal definition of death is reached.

Until recently I had no question that my Certain Point was quite early in the dependency and pain progression.? Immobility seemed like a pretty good time to start the check-out process.? I wonder about that now.? Maybe some dependency won?t be all that bad.

The more I know I can begin hastening death when I want to, with the help of others if needed, the longer into dependency I intend to go.? The more I? can influence, if not control, my own dying, the more I plan to stay alive.? Like most things that matter in life, I understand that the experience I have in dying will be partly a function of preparation ? and partly a function of luck and circumstances I can?t even imagine.

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Previous Posts on the Preparing for End of Life Series:

Part I -?Personal?- Developing an internal sense of completion

Part II -?Interpersonal:? Communicating with Loved Ones and Potential Caregivers

Thomas B. Nickel, Ph.D., is the Executive Director for?Continuing Education?at?Alliant International University.? He is an instructional designer who has worked with subject matter experts to produce programs and online events ? on everything from boxing and Buddhism to traumatic brain injury and transracial adoption ? events which have been delivered nationally and internationally since 1981.

Dr. Nickel has made training in?end-of-life?issues a centerpiece of the CE program he directs, with material available on counseling, fiduciary matters, and multicultural considerations.? He is also the creator and producer of an online course and in-person workshops focused on preparation for?end-of-life, called ?An Instructional Design for Dying.?? His work was recently featured in ?Counseling Today,? the journal of the American Counseling Association.

Dr. Nickel has served as a hospice volunteer for Kaiser Permanente and currently serves with the?Zen Hospice Project?in San Francisco, CA.? In 2007, he was diagnosed with a chronic, manageable cancer.

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About Geralin Thomas

Welcome to Metropolitan Organizing or "Metrozing". I'm Geralin Thomas CPO-CD?. I specialize in working with chronically disorganized clients in Raleigh, NC and we'd like to help you declutter and organize your home and your home office. If you're a DIY-type, I've created a Spanish-English Housekeeping Task list to help get your household chores under control. Learn more and purchase them on my products page. If you are a professional organizer, you'll want to explore the many ways I can help boost your business and take the worry out of organizing your organizing business. Feel free to call me: 919 380-7718 and meet the Metrozing team on my website.

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Source: http://metropolitanorganizing.com/managing-modern-life/preparing-for-end-of-life-part-iii/

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