Posted by: jeanne | December 9, 2010

what elizabeth edwards can teach us about dying

tips for preparing for the end, by joseph nowinski

My colleague Dr. Barbara Okun and I, in our work on what we call “the new grief,” have listened to the experiences of many individuals who have experienced this process that has become dying and death. From them, as well as from the lessons we can take from Elizabeth Edwards, we offer the following advice to those who find themselves faced with a terminal illness. Moreover, we advise them to do these things sooner than later. Here they are:

  • Include an attorney on the “team” that is working with the terminally person, and do so sooner rather than later. If the patient or family cannot afford an attorney, our web site includes resources that visitors can refer to.
  • Designate one or two family members to be “point persons” who accompany the patient to medical appointments where diagnosis and treatment will be discussed, take notes and become knowledgeable about treatment options and prognoses. The patient will have to grant these individuals the right to have access to medical records, in writing.
  • Create advanced medical directives in writing. These include a designated “medical proxy,” meaning someone that the patient empowers to make medical decisions when he or she is unable to. This is critical if you expect a loved one to be able to step up and assert your wishes, especially if this is not what is being recommended. In addition, sign a “springing power of attorney” that designates someone to manage your financial affairs if and when you become disabled.
  • Think about where you would prefer to spend the final months or weeks of your life. Assume that you can get palliative care wherever you choose to be. Would you prefer to be at home, in a hospice or in a hospital? Put your preference in writing, sign it and have it witnessed.
  • Decide under what circumstances you would want to be treated using heroic efforts: if it meant living another six months, a month or a week?
  • Decide who you want to be with you in your final days and what they would want them to do (and not do) for you. Again, put it in writing (you can always make changes if you want to). Remember: The person you designate to make decisions for you at the end may need to persist in the face of resistance in order to do what you want to be done.
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