This is the first of eleven articles in a series that will be featured in the next several days - The articles are written by a physician who is also a financial planner - There will be useful information to help not only in the financial thinking and planning process but also in the mental and emotional aspects -
What might be helpful to most on the financial planning perspective would normally be posted on the regular blog page but because of the sensitive nature of the topic it was felt that the Wise Words Page would be more appropriate - Comments will be open for these featured articles and will be available for public viewing upon approval - It is hoped that you will be more knowledgeable and prepared with your wealth management / financial planning whether for yourself or loved ones after reading these articles --
Do Conversations Around End Of Life Really Matter?
By Carolyn McClanahan Oct. 7 2012
The most heartbreaking topic I deal with both as a physician and financial planner is the end of life discussion. End of life issues take a toll on patients and their family from all sides – physical, emotional, spiritual, and financial. For something we know is a certain event, we truly bury our heads in the sand.
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The nisus for my post today is the case of SungEun Grace Lee. This unfortunate 28 year old has a tumor of the brain stem that cannot be cured. It has paralyzed her from the neck down, and she can no longer feed herself or breathe on her own. However, she can communicate. This brain tumor will slowly kill her.
Initially, after all potential treatments failed and she was placed on life support, she wanted to stop treatment and remove the support. Her parents did not agree with this decision. Her father went to court to obtain guardianship so he could make her medical decisions for her. Rightfully, the New York State Supreme Court Justice Thomas P. Phelan denied the guardianship request. Personal rights do remain, thank goodness.
What happened next? After much thought, Ms. Lee granted a health care power of attorney to her father, and has agreed to stay on life support for the time being. Once she becomes incapacitated, her father can make health care decisions for her. In the Time’s article, her attorney states Ms. Lee did it to make peace with her parents and to make peace with God.
It is apparent from the series of articles in the Times that Ms. Lee’s family loves her very much and they do not want her to die. Her father is in serious denial about her prognosis. I see this all too many times. The family holds on hoping for a miracle and they refuse to talk about dying. Because of a focus on illness and cure, they miss out on conversations about the patient’s legacy.
These missing conversations are an empty hole in the heart when they should have been great memories after the patient has died. Also, planning should be started for the life celebration. Families experience such angst over simple decisions such as cremation versus burial. And unfortunately, treatment continues that may be torture and not comfort for the patient. This is sad.
How do we keep these stories from repeating themselves over and over? Legal precedence protects our rights. However, we can scream about our rights and desires until we are blue in the face (yes, I have a sense of humor) and none of it will matter unless everyone who has great influence in our lives agrees with our decisions. We need to tackle this issue from within and do it early before illness takes away our ability to think and communicate.
How do we do it? How do we have this conversation and agree on our general end of life desires long before the occasion arises? We need to change our culture around dying. Conversations about end of life need to become the norm and not the exception. Our family and other centers of influence need to know our end of life wishes just like they know our phone number, address, and the current car we drive.
If each of us makes the change, it will become the norm. It is up to you to start. Fortunately, tools are available to help you change your culture and initiate this conversation. Recently released is “The Conversation Project.”
This initiative began in 2010 by some very wise and experienced people in end of life care. They developed a great website that walks you through the end of life discussion through a free tool called “The Starter Kit.” You are encouraged to have contemplative thought about end of life. Use the tools on how to open the conversation with your loved ones, and finally take the time to document these conversations.
The beautiful part – The Conversation Project encourages you to think not about what you want done at the end of life, but how you want your life to be. How will you know if you want a feeding tube, tracheostomy, or other medical intervention? This should not be the question.
The important thing to ask your doctor is “What will be the quality of my life?” If the intervention supports the quality, then follow through with that intervention.
In my financial planning practice, clients choose various life qualities they cannot do without. Almost all say once they have permanently lost the ability to communicate, they want only comfort care provided. Consider what is important to you – is it important to feed yourself? Are you comfortable with depending on others to bathe you the rest of your life?
My “litmus test” for a move to comfort care is if the doctor says I will never have the ability to wipe my own rear end ever again. Yes, it sounds disgusting, but think about it – if I can’t provide that self-care, then either my brain does not work or my hands will not function. For me, those two items are vital for my sense of well being. We are all different, so it is important for you to make AND share your decisions.
Do conversations around end of life really matter? In my experience, they most certainly do. And we all need to follow through, come to agreements with our family, and document our wishes so stories about people like Ms. Lee are few and far between.
_We added a Wise Words page to our blog in hopes of contributing encouragement and inspiration during positive happy times as well as emotionally hard times --
Frustration - anxiety - and disappointment can easily creep in and take over our positive outlook with the waiting of the fruition of this investment and especially if one is experiencing a financial crisis or an emotional trauma --
A strong mental attitude is a great tool when faced with either of these - Wise Words are a great aide in strengthening the mental attitude --
Please take a few minutes to read over the quotes and allow them to sink in so you can ponder on them and be encouraged and strengthened by them --
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