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Dying & Death Talk

Looking at dying and death for what it is: a part of life.

Hospice Photography Creates Legacy for Families

Courtesy of NextAvenue.org | By Kevyn Burger | Photo Credits: Amanda Reseburg |Originally Published 08.15.2017 | Posted 11.06.2018

 Scenes from a loved one’s final days can be moving and meaningful

Wilma Jensen didn’t mind admitting that she was a little vain. The theater director, Red Hat Society chapter founder and one-time Avon Lady always wanted to look her best, a quality she shared with her two girls.

“We know we look better with our eyeliner on,” said her daughter Erika Bender, now 37. “That’s how we roll.”

That was true for Jensen’s last moment in the spotlight.

Last Moments, Memorialized

A longtime breast cancer survivor, Jensen was 70 when her cancer metastasized in 2014. A few days before Christmas, she went into hospice care in a facility in her hometown of Beloit, Wis.

Her family was gathered there when they were asked if they would like a session with a photographer to capture some of their last hours together.

“At first, I wasn’t sure,” Bender confessed. “I wondered if it would be intrusive and too sad.”

But her mother, never camera shy, rallied to be picture perfect for the session.

“She put on her makeup and took her oxygen out to get pretty,” Bender said. Continue reading “Hospice Photography Creates Legacy for Families”

How to Deal With Grief After a Loved One’s Death

Courtesy of NextAvenue.org | By Amy Florian | Originally Published 07.24.2017 | Posted 11.02.2018

This can be a devastating time, but these tips from a grief expert may help

I’ll never forget that night. I was expecting my husband to arrive home from an out-of-town business meeting, but instead of hearing the garage door go up, I heard a doorbell. My heart pounded as I opened the door, and I felt it would stop when I heard that John died in a car accident and would never come home again.

The death of a beloved person is a scenario we all dread, and rightly so. It is one of the most devastating experiences one can endure. In the initial period of time after it occurs, most people wonder whether they’ll survive.

So if it happens to you, what can you expect and how do you cope? Full discussion would take a book, but hopefully these tips will help. Continue reading “How to Deal With Grief After a Loved One’s Death”

At the End of Life, Denial Comes at a Price

Courtesy of TheNewYorkTimes.com  | By Maggie Jones | Photo By Dana Neely/Getty | Originally Published 04.09.2009 | Posted 11.01.2018

 

Like the rest of us, doctors struggle to talk about dying. These conversations with patients occur haltingly, awkwardly and often not at all. But a study published recently in the Archives of Internal Medicine suggests just how costly that silence may be, both in health care dollars and in patients’ suffering.

A team of investigators, led by researchers at the Dana-Farber Cancer Institute in Boston, interviewed 603 patients with advanced cancer. They asked the patients, who had about six months left to live, whether their doctors had discussed their wishes for end-of-life care. The majority — 69 percent — said those conversations had not taken place. And in the last week of life, those patients who had talked with their doctors wound up with medical bills that were on average 36 percent lower — $1,876 compared to $2,917 — than those of patients who did not have end-of-life conversations with their doctors.

Why such a big difference? Dr. Holly Prigerson, a professor of psychiatry at Harvard Medical School and an author of the study, explained that the patients who never talked about their end-of-life.

But wouldn’t aggressive, more expensive care at least offer dying patients a bit more time at the end of life? Not according to this study. The patients not only did not live longer overall, but based on reports from family members and other caregivers, they also suffered more physical distress in the end.

These correlations may not prove a cause-and-effect relationship between end-of-life conversations and outcomes. Still, Dr. Prigerson said, “The study suggests that as costs go up, the misery and suffering index also goes up.”

Why should doctors be so reluctant to talk about dying when patients are terminally ill? Dr. Susan Dale Block, chair of the department of psychosocial oncology and palliative care at the Dana-Farber Cancer Institute, noted that oncologists don’t want to appear to be giving up on patients by discussing plans for dying. At the same time, family members and loved ones worry that such conversations might upset an already vulnerable patient. And patients themselves often feel their role is to be heroic and to soldier on, against the odds, with yet another treatment or intervention.

According to Dr. Anthony Back, an oncologist at the University of Washington who trains doctors in end-of-life conversations, it is wrong to assume that these conversations rob patients of hope. “People can live with hope and do practical planning at the same time,” he said. “As a family member, you can still be protective of the patient while also thinking ahead: `Of course we’re going to keep hoping, and let’s do this little planning, too.’”

Dr. Back and other experts also suggest that family members and patients pace themselves by having ongoing end-of-life discussions, rather than waiting until there’s only time for one big, emotionally loaded conversation when the patient is near death.

For those in need of conversation-starters with their loved ones, here are a couple: Are there things we should talk about if you get sicker? What kinds of things do you want me to advocate for? If the questions feel too emotionally daunting, try rehearsing them first with a friend.

Dr. Block also encourages families to rely not only on oncologists for guidance — many remain poorly trained in this area, experts agree. Look to hospital social workers and palliative care providers, as well.

As this blog has noted, Compassion & Choices offers free consultations to families and patients through its End-of-Life Consultation Program (800-247-7421). The program’s counselors help patients make decisions about continuing treatment and provide advice on asking health care providers some of the tough questions. The counselors also offer tips on how to speak to providers if the patient’s needs and wishes are not being met.

The best advice need not come just from medical experts, of course. What are your experiences with these conversations — or the lack of them? How often do doctors try to have these discussions before families and patients are ready? When the conversations do take place, are doctors willing to follow through on patients’ wishes? And in those final days of life are we, as friends and family members, also willing to follow through?

Why We Should Think About Death 5 Minutes Every Day

Courtesy of Death Hangout | By Roman Krznaric | Originally Posted 09.28.2018 | Posted 10.31.2018

 

What To Say To Someone Grieving The Loss Of A Pet (And Things You Should Never Say)

Courtesy of Everplans.com | By Gene Newman |  Posted 10.29.2018

For most people, it’s not just a dog, cat, or other domesticated animal. They just lost a part of the family.

It’s not easy to know what to say when a friend or family member loses a furry (or smooth) friend. Maybe you’ve experienced this and can empathize. But what if you’re not really an animal person and have no idea how to react?

Though you might not be able to understand or sympathize with the grief associated with this type of loss, there are certain things you can say to offer support while not inadvertently offending the grieving.  Here are some tips to help everyone be a compassionate friend.

The safe initial reaction to the news

Start by offering one of the simple phrases that we suggest saying to all who are grieving, “I’m sorry for your loss” or “my condolences.”

It’s always hard to say the right thing after a death, but of all the benign things to say, these two are the safest. Even if you never met the pet, this fail-proof phrase is a simple acknowledgement of the pain the friend/colleague/sobbing stranger next to you on a park bench is feeling.

Simply listen

If the grieving person wants to talk about it with you, and you have no idea what to say, just listen.

Remember Thumper’s advice in Bambi: “If you can’t say something nice, don’t say nothing at all.” Even if you can’t relate or think the person is overreacting, it’s important that you keep these feelings to yourself. You’re there to lend support and help.

Also, don’t bring up your own experience of pet loss, or how you would feel if your pet passed, because that can belittle their current pain and make it feel like a grief competition. This is about them, so the best thing you can do is lend a sympathetic ear.

Continue reading “What To Say To Someone Grieving The Loss Of A Pet (And Things You Should Never Say)”

Why Do We Avoid Advance Directives?

Courtesy of TheNewYorkTimes.com | By Paula Span | Originally Posted 04.09.2009 |

 

When I visit my father, I make a point of checking: Is that battered leather folder full of legal documents sitting in its usual spot in the den?

At 86, Dad is managing quite nicely in his own apartment. But the day will likely come when he’ll face choices about how much medical treatment to undergo, and he may be too incapacitated to make or express such decisions. It could happen in 10 years or next week; whenever it is, I want to be able to lay hands on one of those documents, called an advance directive for health care. In it, he authorizes me “to make decisions in my best interest, based upon what is known of my wishes.”

We’ve had a number of conversations about those wishes, he and I. Nevertheless, the document goes on to specify what my father doesn’t want (no C.P.R., ventilator or feeding tube) and what he does want (pain relief) in the event that he becomes “permanently unconscious” or is diagnosed with “an incurable and irreversible illness” that two doctors deem terminal. Nothing on paper can make such a moment less than wrenching, but the lack of something in writing can make it much, much worse.

It’s startling how few Americans have advance directives, an umbrella term including living wills that state your wishes and health care proxies that designate someone to carry them out if you can’t. A Pew Research Center survey in 2006 found that only 29 percent of people had a living will; in 2007, a Harris Interactive study (PDF) put the proportion with advance directives at two in five. Even among “severely or terminally ill patients,” the majority had no advance directives in their medical records, researchers for the federal Agency for Healthcare Research and Quality reported a few years ago.

That can put both physicians and families in an awful bind. If a terminally ill parent lands in a hospital and daughter A tells the staff no, no feeding tube, will daughter B accuse her of killing their mother? If daughter B tells the staff to go ahead and turn on a respirator, will son C argue that no, after the Terry Schiavo case in Florida, their mother declared she never wanted to be kept alive by machines? Sometimes, a hospital ethics committee has to get involved. Sometimes, courts and lawyers do.

“It gets so emotional,” said Ronda Hughes, co-author of the A.H.R.Q. report. A onetime cardiac critical care nurse in Boston, she’s seen “people crying, screaming, threatening.”

“When you’re faced with those decisions, you can’t say, ‘Let me get back to you in a week,’” she said.

If only the patient had left clear instructions!

So why don’t we?

One reason is that advance directives may be misperceived, theorized Nathan Kottkamp, a health care attorney in Richmond, Va., and organizer of this month’s National Healthcare Decisions Day. People may equate such documents with limiting care, with “pulling the plug.” In fact, Mr. Kottkamp said, “Your living will can say you want every medical treatment known to science applied to you at the end of life. Or no treatment. Or anywhere on that spectrum.”

Maybe people may think drafting an advance directive is complicated and expensive and requires a lawyer. But forms for every state (state laws regarding advance directives differ) are widely available on the Internet, at the National Hospice and Palliative Care Organization’s Web site or through the National Healthcare Decision Day site, among others. An advance health care directive doesn’t have to cost more than a couple of bucks for a notary.

People can have dreadful accidents or face incurable illness at any age, of course. Ms. Hughes, after she finished the A.H.R.Q. study, promptly drafted a highly specific advance directive for herself. She’s 42. But most Americans die not suddenly, but of chronic diseases associated with aging. So I’m grateful that my father has an advance directive. As I steam towards 60, I have one myself.

The sad fact is that even with an advance directive, your designated decision-maker may still face a fight in trying to follow your instructions. It’s not uncommon for doctors to disagree with a family about what should be done; it’s not uncommon for family members to disagree — sharply and painfully — with one another. But, as Mr. Kottkamp said, “It’s an uglier fight if you don’t have the documents.”

I hope my daughter is up for the battle, should one arise. At least, I tell myself, I’ve given her the ammo.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions,” to be published in June by Grand Central Publishing.

After Death: 8 Burial Alternatives That Are Going Mainstream

Courtesy of LiveScience.org | By Stephanie Pappas, Live Science Contributor | Image by Stephanie Pappas | Originally Posted 09.09.2011 | Posted 10.24. 2018

 

The ancient world is full of examples of burial customs that seem strange now, from Egyptian mummification to bodies dumped in bogs to departed Vikings launched out on ships-turned-crematoriums. But space constraints and environmental concerns are pushing modern man to explore new options for dealing with the dead.

The most recent of these to land on American shores is a process that uses heat, pressure and chemicals to liquefy a body in just a few hours, leaving behind sterile remains that can be poured into the wastewater system.

But unusual customs, from launching cremated remains into space to old-fashioned burials in hand-dug graves, are a growing trend. Here are some of the newest choices (not all eco-friendly) for the end of life. Continue reading “After Death: 8 Burial Alternatives That Are Going Mainstream”

Options for Body Disposition After Death

Courtesy of Consumer’s Checkbook.com | By Kevin Brasler | Originally Posted 11.2017 | Posted 10.21.2018

There are several options for disposing of a deceased person’s remains.

Burial

Burial is the traditional choice. It can be done directly, with no viewing or ceremonies, or with any combination of viewing, ceremony, and graveside service. It usually requires you to pay for a casket; cemetery plot; fees to open and close the grave; cemetery endowment (upkeep); and a marker, monument, or headstone. Though most burials are below ground, another usually more expensive option is burial above ground in a mausoleum.

Direct burial is the least expensive option: A funeral home files the necessary paperwork, places the unembalmed body in a casket, and takes the remains to a cemetery for burial, usually within one day. This is often accompanied by a simple graveside service. This alternative eliminates expenses for embalming and some expenses for funeral home facilities, and most families choose a lower-priced casket.

Continue reading “Options for Body Disposition After Death”

Kids Meet a Terminally Ill Person

Courtesy of HiHo Kids | Posted 10. 18. 2018

 

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