Edgar Phillips

Planning for End of Life: A Gift to Yourself and Your Family

Join us in thanking family caregivers this November by sharing resources and vital information with them. Your Turn To Care is happy to welcome guest columnists, Estee Bienstock RN, Chaplain Jim Johnston, and Gerontologist Mary Winners to share their personal and professional insights and advice for caregivers and their families.

Talking about preparations for declines in health and end of life care is difficult to say the least, but it's important not to bury your head in the sand if you want the best outcome possible for yourself and your family. It's about taking control of your life and tackling fear boldly in the face.

Without planning, people put themselves in a panic filled, crisis mode. People can be their own worst enemy when they pretend that bad things can't happen to them--to you. The best way to approach long term care and protecting you and your family is by facing fear itself and plan, plan, plan.

Decisions for planning for long term care can include, doing nothing. In that case, you may be faced with the County taking you through a long and costly court situation and hope that someone you like can be assigned as your conservator. In this case, all of your decision making power is taken away. The other option is plan. Take a minimal approach or plan every angle of your care.

In making preparations for health changes, I think of my father-in-law. He was an incredible mentor to me and strategically planned the very things that so many of us are afraid to confront. Bob passed away in 2000, yet I will never forget his words on the occasion he went to the hospital for an emergency. He called out to my mother-in-law and said, "Get the papers Marion".

He was referring to some of the documents that his attorney prepared within their Trust; an Advanced Health Care Directive and a DNR (Do Not Resuscitate) order in the event that he could not breathe on his own. He was very firm in his decision in what he wanted medical professionals to do or not do in the event that he could not speak for himself. It didn't make the situation easier, Mom just knew that by bringing "the papers" questions of what dad wanted would be available for all to see. What papers do you have in order?

Bob was pragmatic with a fantastic wit. He was a leader in his company, community and family. During WWII he was a B-17 pilot. The stories he and some of his crew members shared are incredible to say the least. Every mission was methodically planned by superior officers; while he and his crew took specific measures to go through each step of each mission and what their roll was within it.

The fact that he and his crew from the Bloody 100th came home alive was partly luck and partly preparation. I will never forget a story that his co-pilot Chuck recalled regarding preparations for escaping from the plane.

Chuck recounted planning and practicing a speedy exit from his plane while it was grounded, knowing it would increase his chances of surviving if his plane received a direct hit. An Army Air Corp man watched him repeat this jumping exercise and finally asked him what he was doing. Chuck explained and offered to show this bombardier how to copy his escape method. After the first run, the bombardier realized he always waited for his co-pilot to open the hatch and would be a sitting duck if he was ordered to evacuate the plane. Nearly 60 years later that same bombardier approached Chuck and said, "You saved my life."

The man explained to him that he continued to practice and got his time down to 4 seconds. On his last mission, they were hit in the back end of the plane. He went for the hatch and exited the plane with his parachute. After he dropped about 200 feet from the plane, it exploded. He was the only one to successfully exit the plane.

What's my point in bringing all this up? I want you to think about the escape plan you have? If you shared it or practiced it, could it offer you a better quality of life? Would it provide you with a parachute for your family and loved ones to use? Like the bombardier, how often do we think our spouse or other decision makers will handle our affairs for us?

Planning for physical and mental decline as well as end of life is something many people are uncomfortable with. I believe that when individuals plan, they are able to remain in the driver's seat. It's not fun to think about heart attacks, dementia, or bad things that could happen, but we still want to keep as much control of our situation as possible. We plan every last detail for a wedding, the birth of a child or vacation but we avoid planning for "the end" as if not planning will prevent it from happening. Let's face it, we're born, we live, we die. How we live is our choice, and if we think about it, we can make many of the decisions about our death too.

Planning for care is not as difficult as taking a blind leap of faith from a plane with the consequence of ending up in enemy hands. Planning offers quality of life and leaves you in control. Sharing your plan is also a gift to your loved ones because they know they are carrying out your desires and you remove the guilt and potential arguments that can arise when there are too many unknowns. If your family is not familiar with your wishes, how can they possibly provide you with what you want?


G -- Gather Resources
Gather information and weigh out care options for yourself or a loved one. It's important to educate yourself and look at the best situation for you based on your finances and features that you want related to your care.

I -- Inform Everyone Who Should Be Part of the Process
In the process of gathering information, contact individuals that need to be part of your decision making process. This may include adult children, family or friends that you want to name in your documents or assist you with your health care and financial decisions. It will also include your accountant, financial planner and your attorney. Your personal and professional decision makers are your key players.

F -- Follow Through With Documents and Important Items To Completion
After talking with your support team, make certain that all documents and personal wishes are complete with every "i" dotted and every "t" crossed. Regardless of how much you plan and wish for something, without proper written and often times, notarized documentation, your wishes may mean nothing.

T -- Tell Everyone What, Where and How
Once all the hard work is done, make sure that you tell everyone who matters, where your important documents are stored and leave contact information to your key players within that file. Let them know which documents are included and how you want your wishes carried out. Keep additional copies of your Advanced Health Care Directives in your glove compartment to be certain that your voice can be heard on your travels.

Mary Winners GerontologistMary Winners is the founder of About Senior Solutions, a Geriatric Evaluation and referral organization. The company offers support to aging seniors and their loved ones to find the right direction for care and support tools. Mary has over a decade of experience in the business development aspect of healthcare. While physicians and nurses provide medical recommendations, Mary understands the other side of health care - the confusing maze of health care options and unknowns. She has extensive knowledge in acute care hospitalization, Gero-psychiatric issues, Alzheimer's and dementia care, hospice, assisted living and other senior care options. Mary is a strong advocate for seniors in the community and a member of several life enhancing senior programs in Los Angeles County.

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