Episode 644 The Conversation This podcast in intended for anyone who might die. It is also intended for anyone who has a spouse or partner, a son or daughter, a friend or a job that involves extending compassion. I recently received this letter from a listener and I will just let a portion of it speak for itself. It goes like this: “I took what was for me an early retirement. We raised 6 kids and I had planned on saving longer! But the day came when I could no longer juggle a demanding job, two parents with dementia and constant medical needs and a husband in declining health. In these 14 months, my parents have both died and my husband is now disabled (with the corresponding hospitalizations etc). Please encourage your listeners to plan. I could write a book on what happened with my parents. I had a TIA ( 3 days in the hospital - “stress”). My parents made no plans. I repeatedly drove 10 hours each way for several years, to tend to them in a Sun City community and to bring them to look at living possibilities. They so fought losing their independence until it was taken from them. The active adult retirement communities can be great for younger retirees but isolating for older seniors as their peers all pass or move on and their abilities decline. In dealing with finances, transportation and medical services there, I discovered that to be a story unto itself! My mother once told me, the same thing my husband did in response to, “what did you plan on doing?” that they would just drop dead. That is not what happens in today’s world. They were educated, had been very active and had resources. The final couple of years did not have to be so hard. I am still sorting through their lifetime of world travels and other stuff. They were moved to where I live in a difficult trip, Senior psychiatric hospitalizations, two assisted living relocations etc. I think that many of their hospitalizations where they lived and where I live could have been avoided with proper earlier care. Please encourage listeners to make their plans early enough to see them through. If a difficult diagnosis is received and their is supportive family, let them help make those plans. Transitions need to be made early enough for a host of reasons. I have rambled on. I also just sent your most recent podcast to a number of friends. I am very fortunate to have friends much further along on this path than I am and learning that despite this not being the retirement I had hoped for, that there is much to appreciate in each day. Today’s world is full of seniors taking care of seniors. Planning early is an imperative.” End quote. I want to thank my listener for sending such a heartfelt and well intended letter. It is a topic that deserves consideration by each and all. It certainly created discussion around my house. My niece just left after bringing my brother and his wife for a visit. She, my niece, has just retired from a career centered on medical ethics. She taught medical students about ethics through courses at Duke University. Around our dinner table we talked about the situation of end of life planning. It was quickly agreed that a medical advance directive be on record. I talked about this in a previous podcast. It is important you have one and just as important that it is readily available to those that might have to make any decisions. Our children each have a copy of ours on their phone. They might need it in a flash and with it always in their pocket it is always available. But my niece who also worked in DC with the Veterans Administration had more insight into the situation. She said that you want to be sure that whoever is assigned to them the task of making decisions for you at this critical time really understands what you want, and is willing to make the decisions. My brother said that one of his sons told him that he could never tell someone to pull the plug and did not want anything to do with that type of situation. Luckily for my brother he had two other children that feel they could assume this responsibility. Another idea pointed out by my niece is the conversation that should take place. Since advance directives can’t cover every possible situation, we should have comprehensive discussion with those that might be involved to be sure they know what’s important to us. In the face of health problems, some people value their independence more than anything else; others value living as long as possible, or staying out of the hospital, or staying as comfortable as they can. Some of us might be okay with having intensive medical treatments like ventilators or CPR after a serious stroke or heart attack if there is a certain percentage chance of surviving. What might that percentage be for you: 10, 30, 50 or 75? Others may feel like they would not be willing to take those odds and would rather be released from life. It needs to be clarified. I recall reading that most doctors would refuse many surgeries and attempts to extend life that have low possibilities of resulting in a viable, healthy life; especially after age 75. They would not like to live if they will not be able to talk, read, or walk; not be able to feed themselves, bath themselves or take care of toileting. Perhaps they would not want to try to extend their life if they cannot drink chocolate milk and watch football(I read that once as a real choice a medical doctor had expressed). And I think his family honored it. Maybe they truly do not wish to try to extend their life if they will be unable to recover well enough to live at home. Some people would rather live as long as possible, even if they couldn’t care for themselves. Different people want different things. The conversation is the thing. Addressing this issues and asking these questions might be a real benefit to each and all. I have left out many important questions that might be explored but this may give you an idea of where to start and what to talk about. Most of us are not going to go gently into the night while being in a deep, peaceful sleep. So let’s give our families the gift of planning ahead, so they don’t have to make really hard decisions when we’re sick, without knowing exactly what we really want. This is Retirement Talk. If you have questions, comments or suggestions contact del@retirementtalk.org
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