Thursday, October 16, 2014

I have only thought about half of the things that are important to my elderly and also dead self.



I have been thinking a lot about getting older lately. My new husband and I have been talking about creating a will and ensuring that we have each other as financial beneficiaries should either of us die. As a previous medical social worker, one thing that I always think about with will-related paperwork is advance directives, which is when you create a legal document stating your wishes for how you want to be medically treated in the event that you are incapacitated. Some people know this as do not resuscitate paperwork, but there are all kinds of medical options to be considered, like if you want to be an organ donor or who your health care proxy will be. I, personally, am fine with being resuscitated but not with being placed on any machines or feeding tubes, and I would like to donate my tissue and organs. As a future mental health therapist, I have also thought about how the people I support would be notified and who would be their emergency mental health contact in the event of my death. Two things that I never gave any serious thought to are how I want live my life as an elderly person and how I want my body to be treated after I die.

The thought about how I want to live as an elderly person was sparked yesterday when I heard an interview on NPR with surgeon and Harvard professor Dr. Atul Gawande. He has started a larger conversation about how we treat our elderly population and what we should be doing differently. Dr. Gawande makes the case for giving older individuals more support in the community, in order to keep them in their homes, and more life choices when they are in care facilities. In most facilities, care is focused on keeping the individual alive versus their quality of life. In his book, Being Mortal, he examines case studies where the elderly are given opportunities to make medical decisions based on their life values, to see their friends when they please, to take care of animals, and to eat the foods that make them happy. In these examples, he found that the older individuals are living longer, taking less medication, and are thriving. These are also all things that I assumed that I would have in my life when I got older. Who thinks that they give up the right to see their friends when they enter a care facility, because it might be “risky?” Who wants to turn ninety and then be told that you can’t have a cookie because it might spike your insulin? If I make it to ninety, you better let me have an Oreo with my friends. Damn! This new, more person-centered, choice-based care requires a perspective shift by professionals as well as a push for changes in care from all of us. And the sooner the better, I want my parents to have cookies too should they ever need to enter a nursing home.

The question of how I want my body to be taken care of upon my death came about when I was recently introduced to the work of CaitlinDoughty, a mortician, writer, and founder of the Order of the Good Death, which is a group of “Funeral industry professionals, academics, and artists exploring ways to prepare a death phobic culture for their inevitable mortality.” They want us to get past our fears in order to see death as a part of life, to embrace a natural burial and decay, and for our bodies to be cared for by our loved ones. They want us to think beyond the typical embalming, cremation, or donation of our bodies when we die. We have so many more options; yet, we never even talk about them because death makes us uncomfortable.

I have always joked that I would like to be cremated and for my ashes to be placed into little baggies to be taken home by the funeral attendees as funeral favors. BUT I have never thought about it seriously, done the research, or put my wishes down on paper, which is really unfair to whoever would take care of my body after I die. I need to read up on this, make some plans, and file some legal documents!

Do you ever think about these things? What do you want the closing and then end of your life to look like? 

- Lauren, death tackler and conversation continuer

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