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Life Is Not Only About Living Well but about Dying Well...with a PLAN (please if possible) to only have things go Your Way medically or without interventions...

on Sun, 10/08/2017 - 02:31

I spent some time lying on the lawn at dusk looking up at the sky in Central Park in New York City after taking the www.Doulagivers.com Consultant Training to be a non-medical consultant. about End of Life matters.

The information regarding End of Life decisions and paperwork, policies for medical people or responders can vary state to state as to what is required. That word Required is one that applies to many aspects of one's care, medical issues, legal and medical aspects of our society and choices about how one lives and how one dies (and even post-mortal points such as having time for family and others to spend time with or to tend to the care of one's deceased body in any setting and much more...)

Everyone needs to be aware of in terms of 'what's required to have legal coverage to make your wishes clear and acceptable in the eyes of the medical folks and the law' if life-sustaining measures become an option for you or someone in your circles...

If you needed help eating (feeding through a tube), drinking (or hydrating through fluids being given to you when unable to drink), breathing (as in put on an artificial respirator) or even have CPR if you're heart stopped...when would you want that done and when would you rather not have that done..

These are the kinds of issues anyone could face and need someone they have designated to decide for them (possibly without the person in need being conscious so not able to weigh in when it really matters.)

Okay that's a lot to consider, but that's what I'm learning about in depth (as I have studied this before over the year with workshops offered by Elder Law Attorneys, meeting with a person who helps fill out such forms at a hospital (not the doctor or medical person.)

I will share some highlights, but maybe googling the topic could help people understand the importance of having an online or on the phone or via mail or in person conversation, even briefly from time to time about these matters in general..and then putting the main points of an Advance Directive (a living will and a health care proxy or representative) on paper and getting that signed by two witnesses and notarized.

To have legally recognized forms, that information needs to be put on MOLST or a POLST, a medical order about life sustaining treatment or a physician's orders about life sustaining treatment.

Without the legal paperwork in place (ideally with one's doctor or hospital as well as with the proxy and back up and handy in one's home for family, etc, one may go through many medical interventions required by the medical system to sustain life.

If one wants to be a DNR, a do not resuscitate, that order also needs to be well-understood by everyone caring for the person and have the order handy such as near or on the fridge. Without it, responders would likely also have to seek to revive or sustain life. Think twice about when 9-1-1, police or an ambulance would be called and learn your optioins in Advance...and learn a little at time steadily rather than deny the importance of all of this (even wills and such, especially if one has children whose custody would need to be determined.)

Comments

 I thought everyone needed a will, but apparently that's not the case. There are set rules to guide the dispersal of one's assets and settle one's debts which a state will follow (although maybe that is via probate and will come with fees so keep this all in mind as Possibilities, not gospel or any formal teaching.)

Raising questions and exploring options is what I promote. There do need to be clear plans about your desire for who would have custody of your children (and maybe even your pets...a big concern for many whether thay have minor children or not.) I would hope more people would consider finding adults to look out for their grown children as well.

If people have a natural network that may work out, but it doesn't hurt to check in with people and set up funds or ways to encourage connections and care. I think any family members from widows to widowers (wives or husbands, partners and so on, even 'ex spouses, etc') could take time to consider the social landscape and people who could provide some outreach and companionship on a social and possibly caregiving level.

When all the focus is on 'the dying person' or the one who died, everyone else can feel disoriented..and wonder who will be in their lives after a change, a move, a time of mourning and so on as life levels out to a 'new normal', a Plan B strategy for one's future when Plan A did not work out (as a FB high positioned woman shares in her books and Lean In circles which would also be a good thing to know about.)

Support groups for parents such as Compassionate Friends, or for those in their 20s and 30s called The Dinner Party -- a place for that age group to gather in support of having lost a loved one whether brother, sister, parent or friend..

.One could Plan In Advance with a few caring people, one's faith group or others about Options to support one another with a few get-togethers and plan out something more formal as may be desired as months or even a year or more goes by.

Depending on what one learns from online (legal zoom or nolo.com for instance) and from forums online or in one's area, speaking with an Elder Law Attorney (some of whom offer free general consults but not necessarily any details for one's own case or a consult for a fee which sometimes is applicable to the cost of hiring them to do the legal work if a will or a trust is desired.)

Ask about options such as trusts (a family trust, a living trust, a revocable trust, an irrevocable trust, an AB Trust and more...even about having an LLC (Limited Liability Company), learning about Land Trusts or Non-Profits that could work with one to help manage one's assets and more. Some non-profits and faith groups will offer workshops or consultants for free or a low cost.

Anyone with a will needs to go to probate..so look up Probate Law and the fees associated with that, paperwork that is needed and timelines. Basically the more that can be decided earlier on about estate planning, generally the better things can flow for having options (see the 5-year Federal Look Back period that can allow one to transfer assets that would then not be counted in toward one's Medicaid eligibility..although selling one's home and such would result in a fair amount of money that would still be in one's possession so would be needed to be part of one's 'spend down'.

See more about being able to gift assets or  money to others 'without penalty' (before a 5 year look back period for instance) and more about Medicaid eligibility by the time one is one's 50s so there is plenty of time to plan accordingly...

I am not a tax or legal attorney so these are things I am sharing in a general sense having heard them at workshops but again need to do more research. In the US and likely other countries but not all, it seems if one has the unfortunate experience of needing help due to health reasons or age-related decline in a functioning, their assets get tapped. Whereas if one is in good health, they don't need to worry about parting wtih huge sums of money and their assets.

The more we could work toward helping everyone have access to care, the more 'fair' the system would be to all people. Medical and even social and support care should be a human right. Likely we would need a way to have more people train and timebank hours, get credits and so on, with other perks (maybe barters for housing even if not with the person they are caring for), rides, food, education and so on. It would take some thinking through yet with some advance planning likely many options would emerge.

Aging in place is a common desire or the option to be in a warmer climate in the winter or colder parts of the year could also be promoted so people havea  better quality of life. All of this takes statewide and nationwide consideration, networks, ongoing workshops and insights from many fields. The book Change Here Now by Adam Brock speaks about social permaculture which likely has some helpful insights as well as the nuts and bolts these posts are covering. More people have to understand the many factors shaping our systems and options.

And more creative caring networks and responses to growing concerns need to emerge in timely ways. Hope everyone can build up small group networks for basic back up and social support to bounce ideas off of and feel connected...even if online or with folks from farther away but with some consistent exchanges. Look up Walk Our Talk in Great Barrington MA (covered in the Berkshire papers in Oct 2, 2017 issue either the Eagle or the Edge...) which helps women network and keep in touch via a private FB page with an overall interest in supporting one another in a variety of ways.

Generosity circles and neighborly care efforts can go a long way to address short-term needs, goals and more. Sometimes there are non-profits to partner with and raise funds with or get grants from (such as Berkshire Taconin Foundation which serves a large area, as does The Torrington Foundation.)

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