"No one here gets out alive." Jim Morrison

Sorry to disappoint.  This isn't going to be a discussion of Jim Morrison and I'm sure when he made this statement, he wasn't talking about end of life planning.  But the statement is very true.  No one gets out alive.

All your life you plan for the future or someone plans for you when you're young.  By the time you're in high school you're doing the planning.  College?  Trade school?  The military?  Once the career path is started, there's planning for your first house, a bigger car, your kids, their education and your retirement.  Life moves on, one plan after the other until, if you're lucky, all those plans work out and the retirement plan that was put into place is functioning as it should.  You're retired.  You're taking it easy and, suddenly, all planning stops.  Why is that?  Do you think you're going to continue in retirement for eternity?

No, sad to say, you're going to die.  Well, yes, but there's no need to plan for that.  Plan or no plan, no one gets out alive.  True, but we don't disappear or blow up on a certain date and that's that.  Some will die peacefully in their sleep or in a quick accident, but far too many will have a long and lingering death.  And some of those will linger in a mental state that makes it impossible for them to make decisions or communicate with caregivers.  What then?  What's the plan?

You can't stop planning when you reach retirement.  You have to keep the plan going as long as you are above ground.  What decisions do you want made if you can't make them?  Who do you want to make them?  In these days of medical miracles and longer lives, it's absolutely essential to consider what you want at the end of your life.  And then you need to write it down or create a living will.  Make sure the person you select "to pull the plug" is someone who can actually do it.  Don't put that chore on someone who can't let you go.  Maybe your spouse or children aren't the best to nominate for this position.  Whoever it is, talk to them before their services are needed and let them know what your wishes are and when to take action.  Don't leave your end of life planning to others.

You can consult with attorneys or find forms on the Internet to help you figure out what may need to be done and who best to do it.  http://www.caringinfo.org/files/public/ad/Tennessee.pdf is a good place to start.  If you're not in Tennessee, there are forms for every state.  This will give you an idea of what to think about and what to discuss with your family and friends.  And you can prepay your funeral expenses and even write your own eulogy.  But don't put it off for too long.  Although no one gets out alive, not many of us know when we're going.

Death and Taxes

My father had his CPA office in our home and across the street from our house was a large cemetery.  Now I have my office in my home and I live across the street from a funeral home.  Death and taxes are always linked as two events that can not be avoided.  To paraphrase a doctor I saw on television this week -- no matter what strides have been made in medicine, the final out come, death, is still 100%.  Death is a depressing topic that everyone wants to avoid, however, it is unavoidable and ignoring it might make life easier on you, but more difficult for those left behind when you die.  Everyone should prepare for death and here are some ideas about what to do.

I've been watching a series of shows that Nashville Public Television has been producing on aging in the United States, particularily in Tennessee.  Death is not a general topic of conversation around the dinner table, even though everyone at dinner is dying, to a greater or lessor degree.  Therefore when death is imminent few, including doctors, know what to do.  Generally doctors are trained to do everything they can to keep a dying person alive, no matter what quality of life that person will have during and after the treatments.  Quality of life has a different definition for everyone.  By talking about death and dying before death is staring you in the face, everyone will have a better out come. 


Everyone at every age needs to consider how they want their life to end.  Do everything possible?  Do everything possible only if I'm not going to remain a vegetable?  Pull the plug if there is no hope?  Donate all my organs?  Donate none of my organs?  Who will carry out these decisions if you are unable?  Start thinking about this now and let people know.  No doubt this won't be a once in a life time decision.  As you grow and change and the people around you do the same, your ideas about death and dying will also change and your documents will have to be updated.

Here are some web sites and forms to review to help you record your final wishes.  One is  www.stjosephhospicefoundation.org where you can find a free download of the Five Wishes form.  The Five Wishes form was developed by the St. Joseph Hospice Foundation to give people an outline of what needs to be considered before death.  It asks the hard questions.  Do you want life support no matter what?  Do you want your organs donated?  Do you want to die at home?  Who do you want to decide that it's time to stop medical care if you're not able to make that decision for yourself?  It even offers suggestion about activities you can request.  Do you want someone to hold your hand while you are dying?  Do you want to be surrounded by people?  You can write it all down, sign it and notarize it.  Do not put these forms in a safety deposit box.  Put them in a file.  Spread them around.

Some think the Five Wishes form is contradictory and too "religious" based.  If you'd like a basic legal form to do much the same as the Five Wishes form, then go to www.compassionandchoices.org.  From this site you can find state specific forms.  Click on the state and go to the forms that apply to the state where you live.  Fill these out and have them signed and notarized as well.

Remember you'll probably need to do this more than once.  Life changes.  Each decade you should review your forms and make changes.  Maybe the person you chose to make your end of life decisions has died before you.  You'll need to pick a new person for that role.  Maybe your feelings about organ donation have changed.  Or about drastic medical care to save your life.

There is nothing wrong or sad or depressing about thinking about your death and what you want to have happen when you die.  It's just taking care of business.  It's making sure the people you love don't have to wonder about what you wanted.  It's making sure that they don't have guilt, shame and confusion to contend with while they are mourning your loss.  Dying is part of living and it's time to recognize that and talk about it.