Denise Carson, Author of Parting Ways, gives keynote speech on Grief Journeys at the Annual Hospice Care of the West Memorial Service.

I was invited to speak at the Hospice Care of the West Annual Memorial Service. This is one of my favorite communal rituals that the hospice organizes for their families who have lost a loved one that year. All the families come together to share life stories and share in their grief.  I don’t often speak directly about my grief journey. Admittedly it was a cathartic experience. I was profoundly moved by the other folks who stood during the open mic and shared how much my story meant to connecting to their own grief journey. As I listened to their grief journeys and life stories of loved ones lost, I realized how universal grief really is and that awe-inspiring moment gave me the courage to share this deeply personal story here on our blog. See below…

I’m honored to be with you here today. I remember very clearly my first memorial service at Hospice Care of the West in 2006. I wrote Mom on a rock in ritual of remembrance of her. And, I distinctly recall a feeling a palpable sense of community in my grief that I had never experienced before in a public setting.  As I listened to the life stories and reminiscences of others, I felt a sense of familiar and belonging.

At that time, I had been on a journey to write my book Parting Ways that led me across the country from New York City to California on quest to understand how grief inspires us to celebrate life even in our darkest hours of despair and loss. In retrospect, I set out as journalist but also as a daughter in search of others like me, so I would not have to do my grief journey alone.

I have learned to live with grief, as it is not something that you don’t get over after the funeral, or when you’ve cleaned out the closet or a year or even two years after the death.

The first time I learned about grief, in a college class, the sociology of death and dying, some 10 years after my father died of cancer. It was an unveiling of an invisible handicap for me. For a decade, I had suffered alone bottling this indescribable pain. I felt a physical tearing apart from my father. We did not have hospice because no one not even his own doctors accepted that he would die. Veiled in denial, he battled for two years in excruciating pain until his body finally succumbed to the cancer at 37 years old.

I’ve heard grief being described as a thicket that you cannot walk around but must instead walk down the middle feeling your way through the darkness and thorns to get to the other side.

I yearned to hear the timber of his voice, feel the strength of his hug, see his funny faces at the dinner table that always made me feel like everything would be ok.  I did not realize it at the time but I was constantly cycling through the stages of grief: Denial, Isolation, Anger, Bargaining, Depression, Acceptance. This condition that had plagued me for 10 years had a name: grief. But I had never gotten to the other side of it.

I did not fully appreciate that in order to recover from grief, we must find ways to walk through our emotional, spiritual and physical loss until my mother was diagnosed with cancer 12 years later. It was then when the grief of my father’s death surfaced and inspired how my mother and I celebrated her life, even in our deepest hours of despair. It was then that I began the walk through the thicket.

Hospice Care of the West Annual Memorial Service Lunch.

We have an interesting journey through hospice in that we have some indication as we enter the service that time is short. And, that triggers grief that can be paralyzing or inspiring, depending on which lens you’re looking through. The day my mother’s doctor shared that the chemotherapy was no longer working and that hospice was an option started our fast-forwarded journey to her last breath.

Since I had been a journalist at the LA Times, I had begun recording interviews with my mother about her life in a way that I interviewed my sources for a news story. Yet, after the hospice conversation, those interviews took on a new kind of significance. I felt my mother telling her stories with such vibrancy and detail that transported me from her bedside back in time to England where she grew up, her coming to America at 18 years old, traveling across the country in summer 1969 and meeting my father. Yet, when I asked about her career as a banker, she changed the subject.

Until one afternoon, when I asked her if she wanted to do an interview.

She smiled. “I think I want you to clean the clothes out of my closet.”

Usually this ritual occurs after the funeral and marks the acceptance that the deceased will not be returning. Admittedly, it would have been easier to say, “No, I’ll just do it later.” But if I had waited, I might have lost the stories locked in her closet.

I pulled out her business suits and laid them on the bed. She ran her fingers over the skirts and jackets, reawakening the power she felt wearing them in a Los Angeles skyscraper where she was one of the first women in bank management during the 1970s.

“Back then, women had to wear skirts,” she recalled, “Can you imagine the discrimination?” Although she kept her hair short and professional, she declared her femininity in bold royal blue, emerald, red and violet, standing out among the men in black suits.

As she reveled in the past, I realized how much her three-decade career meant. I decided to keep the suits. I’d never really paid attention to her life outside of being a single mom to my younger brother and me.

I pulled out a disco dress, slipped it on and danced around the room. She followed me with her eyes, saying I had my dad’s rhythm as she recounted how they cleared the dance floor when they discoed. They had been divorced, but you wouldn’t know it. At that moment, she was on that dance floor dancing with him in her mind. Just like she was in her childhood home when we talked about growing up in England. Or when she recalled the musty smell of the tent she stayed in during her summers in the English countryside. She had an uncanny ability to transport us to her past during our interviews.

As I worked on her closet, she smiled. “I’m content. I feel like I’m doing the right thing, having you do this,” she said. “One of the hardest things after a person dies is to go through their personal effects… You are learning everything, so in the aftermath, there really won’t be too much to do.”

She succeeded. I feel lucky not to be left with unanswered questions about her life, as I have so many about my father’s. Not long after, we had a living wake at our home. All of her friends and family came to the bedside in her last week of life to celebrate her. She was like a queen, the deathbed her throne, holding court, laughing, sharing stories and carrying on. I knew in a way that she did that for me, so I would not be alone, and to make the last sunset on her life a grand finale.

Something I have never shared publically, that I’d like to share with you now…as it sustained me in those hours after she died, when I did not want to continue living without her. I should say, we are in a very magical time after someone close to us has died. It’s like the walls between this world and whatever is next thin. For a brief time, you are connected to life beyond that which we can see and touch.

I was having dreams about my mother, and a friend of mine, said to me, why don’t you ask her how she is doing in the dream. That night in a very lucid dream that feels as real as you all do in front of me now. I was sitting at Thanksgiving dinner with my mother and family, and she said, ok, time to clean the dishes. I picked up my dish, and consciously followed her into the kitchen. And I asked her, how are you doing Mom? She turned to me and said, Oh, Denise, it is like a reunion here. And I have peace that truly does surpass all understanding. Your father and I, often walk with him in the garden, she said.

I came out of the dream with the deepest sense of gratitude for the time that I had been given with my mother. And I knew then she was ok, and that at sometime point I would eventually be ok too. Since, I understood grief was a very isolating experience, I set out to meet others like me on my journey rather than doing it alone as I had with my father.

While working on my book, I visited my stepmother, my father’s wife for an interview. We talked about his last days, and for the first time we cried together. Then she said to me, Denise, the only thing you remember is his death story. Tears rolled down her cheeks, she left the room. And then returned from her garage with a huge box full of photo albums and pictures. Together, we began looking through the pictures, of our pool parties, disco parties and my father dancing in his Italian tailored suits, and later I watched their wedding video…for the first time I recalled the memories that I had experienced with my dad that I couldn’t because they were blocked by my grief.

Later, I spoke to a grief oncologist. Yes, it’s what it sounds like a specialist in grief brought on my cancer death. It was then I learned that I had complied grief from their deaths. Again, I had a name for what I was living through. But that grief oncologist and many other grief specialists that I interviewed shared that life review that I did with my mother, the cleaning out her closet together and the unexpected joy we experienced from that time was what I needed to hold on to. And her death story, like his death story, I had to let go over. The death is the darkness, the life that we shared with them is light. In our grief, we must go to the light.

It was my mother’s life review, the light, which led me to the Hospice Care of the West through the life review video program as I researched my book. For two years, I spent time at the bedside witnessing patients’ record their life stories in a very raw last conversation that was later edited together with pictures and music. These recording of these life reviews brought families together at a time when they felt like they were being wrenched apart. Through reminiscences, they were transported back to better times, moments of glory, pivotal experiences that inspired wisdom to be shared and passed on to the next generation.

I believe part of the grief experience is to share our stories, as I’m sure all of you have experienced memories from your subconscious mind dump into your consciousness.  It makes us feel a bit foggy, and hazy.

I think this is a life review of the memories we have lived with the person we have had to part with. And it is memorial services like these that inspire us to sift through these memories and make sense of the life we shared with our person. We feel a sense responsibility and urgency to preserve their life story and wisdom to pass on to everyone we encounter, so our person has not lived vein. That is why this memorial service is so profound to me back then in 2006 and even today. It is not just family and friends, but a community brought together through the last season of life.

The post Through the Thicket of Grief to the Light of Remembering Life appeared first on Our Life Celebrations.

 By Dave Boyle

“The first thing to go from my memory after my dad died was his voice. The second, his laugh.”

Denise Carson

Denise was only twelve years old when her father, Richard, passed away in 1987. She still remembers the sterile, unfriendly atmosphere of the hospital room, the tubes, and the unnecessary ambulance rides. She knew, as much as any 12 year old can know, that this was no way to spend the last days of your life.

Her grandparents had met in the Philippines; her grandfather an American in the U.S. Army and her grandmother 100% Pilipino. Her dad was born in 1949 and immigrated to the United States in 1967. He was a great dancer, had an infectious smile, and owned his own business. He was just 37 years old when he passed away from cancer.

“When you lose a father at twelve years of age, you just don’t lose him at twelve,” Denise says, “you also lose him on your 13^th birthday. You lose him on your 16^th birthday. You lose him when you get your driver’s license. You lose him when you graduate from high school. You lose him when you graduate from college. You lose him at all the milestones, as you try to make sense of your life through the lens of his absence.”  Denise has memories of her dad, happy memories, and loving memories. But there are not enough of them and the ones she has are not as clear as she would have liked them to be.

Her mom and dad had divorced years earlier, but this of course was way different. Now she, her brother Ryan and her mom Linda were truly on their own. Denise’s mom was a very strong and courageous woman, and time does not permit the thousands of words it would take to do her justice. The best way to meet Linda Carson would be to read Denise’s book, “Parting Ways.” I usually find myself choosing relatively unimportant sporting events or inane political shows on television over getting lost in a good book, but this book I polished off in a few days. Denise’s depictions of her mom captivated me and made me feel like I know her. I also got to know Denise better, which is one reason why I wanted to celebrate her today.

After her mom was diagnosed with cancer, Denise decided that it wasn’t going to be like it was with her dad. This would be different. Mom would be celebrated. If it’s true that you only die when the memory of you is gone from people’s minds and hearts, then Linda Carson was never going to die.

The first thing Denise did with her mom was Life Review, learning many things  that she hadn’t known before and understanding her mom liked she had never understood her before. Denise could feel her heart melting as she listened to her mom share her pain and admit her shortcomings. Life Review also led Denise and her mom to do something that most people in that situation don’t even think of doing, cleaning out the closet, while the person is still alive. In her book Denise writes the following. “Cleaning out the closet is usually a task performed after a person dies. The ritual marks a state of acceptance that the deceased will not be returning. After the funeral and after everyone stops coming around, you are left to enter the wardrobe wafting with scents of your loved one. And by then the clothes are just clothes, and the books are just books. But what if you cleaned out the closet with the person there? I believe the life review helped us together reach this revelatory stage of acceptance before her death.”

The second phase was the Last Wish. It was now November of 2001, three months before her mom’s passing. How do you celebrate the last Thanksgiving? The last Christmas?  The last birthday? For Denise it was going through recipes with her mom and cooking Thanksgiving dinner. It was trimming the Christmas tree as Linda entertained with stories of the history of the ornaments. And it was inviting close friends over for a birthday celebration complete with cake and candles, as well as a surprise visit from the pastors and members of the choir of Linda’s home church, saying a prayer and singing Amazing Grace for her.

Denise Carson and her Mother, Linda Carson.

The final part of the journey with her mom was sitting vigil at her bedside in her last days and hours. Scripture passages were read from her well-worn Bible. Instrumental praise music hummed on the CD player. Prayers were said, and a sponge bath was given followed by a fresh pink nightgown. A last “I love you” from Linda to Denise, and a sunset. And then at 2:07, Sunday February 10^th, 2002, Linda Carson went into the arms of her Heavenly Father, surrounded by family and friends.

Denise writes in her book, “They say hearing is the last sense to go. I recited the Twenty-Third Psalm by heart. Then I opened her Bible and read Psalm 139. As I read the first verse, a song came to me, a song I hadn’t sung since I was a girl in Sunday School. The song was Psalm 139 called ‘Search Me of God.’ I sang loudly, like a sorrowful siren expelling my grief from the depths of my soul with every note.”

Search me, oh God, you know my heart; try me and know my anxious thoughts.

See if there be any hurtful way in me and lead me in the everlasting way.

Which brings me to why we’re here today. Four years after her mom’s passing Denise crossed paths with Donna Miller, who was then the Volunteer Coordinator with Solari Hospice, and who would soon become the Director of Volunteer Services here at Hospice Care of the West. Denise followed Donna around for two years, interviewing her and chronicling the things that Donna and her volunteers did. And then in 2010 shortly after her own mother had passed away, Deb Robson accepted the position as our Executive Director, and immediately hit it off with Denise. I would have loved to have been a fly on the wall in some of those early meetings as the two of them bantered back and forth about the ideas that they could bring to their new endeavor.

As I go over Denise’s book “Parting Ways” in my mind, I can’t help but be taken by the fact that Denise did a life review with her mom. Denise gave her mom a last wish. Denise sat vigil by her bedside in her last hours. Life Review. Last Wishes. Sitting vigil. Do any of those sound familiar? Shannon, Jay and their team do a fantastic job with the Life Review videos with our families. Caitlin Crommet started the DreamCatchers program four years ago through Hospice Care of the West, providing last wishes for our patients.  And our Volunteer Department provides Vigil Volunteers, so no one has to die alone. Celebration was conceived because Denise and Deb thought it was important to celebrate us as we care for our patients and their families. These are some of the things that make our hospice a fulfilling and very unique place to work, and these are things that Denise, along with Deb and Jay, have helped bring to the fore-front at Hospice Care of the West.

Denise held a celebration for her mom before she passed, and Linda was able to hear all of the wonderful things that people had to say about her, and hear about all of the lives she had touched. We hold Celebration every other month, so we can share our stories of touching the lives of our patients and celebrate each other. Denise has done such a wonderful job of celebrating us, so I wanted to celebrate her today. Thank you Denise, for bringing us your heart, your soul, your wisdom and your experiences. Your story is truly your gift to us.

The post The Journey to Celebration! appeared first on Our Life Celebrations.

Bev Stevens, Hospice Care of the West volunteer, gently puts a cold compress on Iola Van Ornum, 94, at Fountain Care Center in Orange. Stevens also read poetry and gave a hand massage. CINDY YAMANAKA, THE ORANGE COUNTY REGISTER

A vigil to mark the last night of Iola Van Ornum’s life began when Bev Stevens entered her room at Fountain Care Center shortly after sundown.

“I’m Bev, the vigil volunteer,” said Bev, 57, a member of a corps of volunteers who keep watch and accompany those in their final hours of life.

“Well, you must be a very special person,” said Iola’s daughter, Sara Gustavson, 66, of Tustin.

Bev is a part of a new volunteer program at Hospice Care of the West to sit vigil with the dying. Sara received word earlier in the day that her mother, who has Alzheimer’s disease was “actively dying” or “making her transition.” The body begins to show signs of shutting down: Bladder function ends, skin color changes and often the person will have hallucinations, body temperature fluctuations and finally fall into a coma-like sleep.

That’s where Iola was — eyes at half-mast, mouth open to breathe in this coma-like state, lying in a hospital bed. Sara introduced her mother as an artist and a woman who would never follow a recipe. “Iola, was born during the great storm during 1916 in Orange County, and the doctor took a row boat to deliver her at home in Garden Grove.”

Closing her eyes on nearly 95 years of life would take Iola some time. Just as a woman labors a baby into life, a person also labors out of life. Those who help are called doulas, the Greek word for servant.

Being a doula is a calling for Bev because in 2006, she was summoned to the facility where her mother was dying of Alzheimer’s disease in Pennsylvania. She couldn’t get back in time to be with her mom, who died alone. So, now, as a retired schoolteacher, Bev volunteers her time for families who need her help.

Before Sara left for home around 8:30 p.m., she pointed out Iola’s Bible on the bed for Bev to read to her Mom and then left her phone number.

Bev went to work creating a calming cocoon for Iola, with as much care as a mother would swaddle her newborn. She pulled a chair close to the bedside, played soft Celtic music and turned down the florescent lights to warm the clinical, cold atmosphere. She rubbed Iola’s forehead and noticed there was no furrow between her brows, often a sign of pain or distress. Then she gently massaged lotion into Iola’s hands.

After the half-hour massage, she read from “The Best Loved Poems of Jacqueline Kennedy Onassis,” because memorizing poetry was common for Iola’s generation.

She held her hand or massaged her forehead, keeping a constant connection, to let Iola know she was not alone. Bev read “Pilgrimage” by Sir Walter Raleigh: “Whilst my soul, like quiet palmer, Travelleth towards the land of heaven; ?Over the silver mountains, ?Where spring the nectar fountains; ?There will I kiss;?The bowl of bliss…”

Bev gently asked Iola to recall happy memories of childhood followed with playful children’s poems such as “The Little Turtle” by Vachel Lindsay. Iola’s sleep became deeper and her breathing became shallow. Bev swabbed Iola’s mouth with cold water periodically.

Sara Gustavson of Irvine, left, is asked about what her mom is like by Hospice Care of the West volunteer Bev Stevens. They talk near Gustavson mother’s bedside where Iola Van Ornum, 94, transitions towards death at Fountain Care Center in Orange. CINDY YAMANAKA, THE ORANGE COUNTY REGISTER

Bev turned down the lights, flipped on her book light, and turned on classical music. She told Iola softly that she would read the verses that Iola had marked and underlined in her Bible. For more than hour, she read verses that held meaning for Iola.

Bev noticed Iola’s temperature rising and put a cold washcloth over her forehead. Around midnight the charge nurse came in to check on them. Bev told her, “Iola’s breathing has become shallow.”

Then she read Psalm 23, which was heavily underlined in many colors. After the Bible reading, she turned off the book light, and whispered in Iola’s ear.

“Rest, Iola, rest, rest, rest.”

Bev kept watch, cycling through the same comforting rituals until shortly after sunrise. She explained to Iola that her daughter was coming soon to say goodbye.

“It’s been a privilege to take this journey with you, thank you,” she said and then kissed her on the forehead.

Iola died that evening.

The post Keeping Vigil in Hospice appeared first on Our Life Celebrations.

If you knew your time was short, and someone offered you a last wish, what would you ask for? Caitlin Crommett, the 17 year-old Founder of Dream Catchers, started an organization two years ago to make last wishes and dreams come true for hospice patients at Hospice Care of the West.

She was inspired by the movie “Patch Adams” about a doctor who “cared about making his patients happy rather than just treating their disease.” The spark for Dream Catchers came while watching a scene in the film when Patch Adams talks to a woman, nearing the end of life, about why she no longer wanted to eat. He discovers she’d always wanted to plunge into a pool of pasta. He grants her wish.

Caitlin has never encountered a dream quite so zany, but she has made a variety of dreams and last wishes come true since 2009. She had been volunteering for Hospice Care of the West since she was in seventh grade because her father works for the company. So, she had some experience and knowledge about the fragility of this stage of life. Yet, her experience in hospice isn’t what stands out about this exceptional young woman when

you meet or in my case interview her, it is how articulate and compassionate she comes across. She made her own dream about Dream Catchers into a reality by creating a brochure about her vision and then attending a meeting with the team at Hospice Care of the West to request that they offer her service. For those unfamiliar, a dream catcher is a Native American instrument reminiscent of a net or web with a handle that is hung over the bed to catch good dreams and keep the bad ones out.

The first dream that landed in her dream catcher was from a lifelong sailor. His name was Bernie Klein and he could no longer verbalize his last wish, so his wife made it for him. She knew that although he was wheelchair bound, one more sail in the fresh, salty, sea air with friends and family would make his life feel complete. Caitlin decided that she could charter a sailboat with a captain to take Bernie and his crew out for an afternoon at sea to celebrate his love for the ocean and sailing. They left the dock in Dana Point and glided into the Pacific on a classic 82-foot schooner named Curlew. Though, he couldn’t talk the brilliant smile on his face was worth a thousand words to Caitlin and Bernie’s wife.  The sun kissed his face while the wind tickled his cheeks and blew through his hair, all sensations he was familiar with, but missed in his diminished state. He could even for a brief moment forget about his condition and bask in one last sail.

She made Bernie’s wish come true with the help of her parents. Caitlin drew from a saving account that her parents set aside for her to go to private school, but once the word spread through the local media about Caitlin’s amazing vision she started receiving donations from the community. She founded a non-profit organization and a club at her high school to be able to accept donations. Caitlin now has a team of Dream Catchers at Tesoro High School. Together, they work on making dreams happen and hand-making dream catchers to bestow on each dreamer once the wish is granted. She’s served gourmet dinners, taken families to Disneyland, set up family reunions, gave the gift of sight in the form of eyeglasses, brought an orchestra into the home and the list goes on. But the most moving experience for Caitlin occurred when she received a dream from Larry Robinson, 75 years old.  He wished to see his sister one last time. Caitlin has a sister of her own and couldn’t possibly imagine being separated especially in the eleventh hour of life.

Caitlin called his sister, Marilyn Rands, at her home in Washington. She introduced herself, shared Larry’s dream and then offered to fly her out to California to spend time with her brother. It had been six years since they spent time together. They both missed each other. Caitlin had honestly never received so much gratitude in the hugs from Marilynn upon her arrival at the airport. When they arrived home, Larry waited in the hospital bed set up in the living room. He had been steadily declining, losing energy but he beamed when his sister walked through the front door. Caitlin saw him just completely transform, he sat up and was shining. Marilynn sat down at his bedside and embraced him. He just kept repeating her name between long, grateful hugs.

“Marilynn,” he said smiling and savoring each hug. “Oh, Marilynn.”

Marilynn kept saying over, over “I love you, I love you.”

As they reminisced, Caitlin was so touched by their heartfelt reunion that she had to hold back tears. She then brought over an Italian dinner with dessert donated by Tutto Fresco for them to dine the following night. For some reason this dream, she really felt like a part of the dream, like she was participating not just making it happen. After dinner, as customary, when she fulfills a dream, she hung a small dream catcher next to Larry’s bed to remind him that last wishes and dreams do come true.

The post Dream Catchers appeared first on Our Life Celebrations.

End of life in many ways is a journey that you must plan for like any other trip into unknown territory. It’s important to make plans for how you want to spend the time you have left to live. For some people the journey will be months, others weeks, or it maybe even as short as days. Either way, a good plan makes for a better trip that allows you and your family to invite in the kind of memorable moments that happen on a trip into the unknown when you’re not scrambling around lost in fear that stirs chaos and ultimately leads to regret for you and your family members. A good end life plan lights the way in what could be an otherwise dark stage of life.

In most cases, your doctor is the first person to give you some recommendations on which direction to go in and some inclination of what that terrain will look like for you. How each doctor approaches that initial end of life care conversation depends on a number of factors. Often times, doctors are reluctant to give a life-limiting prognosis, often because of their own fears. In reality, when the doctor gives the patient a prognosis, he or she is really giving the patient and the family a “gift”.

Recently, Atul Gawande, a surgeon who wrote an excellent article entitled “Last Days” that unfolded the complexities and costs of end of life care in the New Yorker. And later he spoke at the annual New Yorker conference more specifically about “End of Life Conversations.”  As a surgeon, he admitted that he’d botched these conversations with his patients more than once. In his humility, he decided to ask some of the leading palliative care doctors how they approach these difficult conversations.

As patients and family members, we have to remember doctors are use to figuring out the next step in a treatment plan toward healing, but when there are no more treatments, then comes the end of life conversation. Palliative care doctors have been specially trained to care for patients with terminal illnesses. He spoke to many, but found that Dr. Susan Block, Director of the Dana Farber Cancer Institute at Harvard. She carries a mental list of four questions when going in to talk to a patient about end of life care.

Do you know your prognosis?

What are your fears about what is to come?

What are your goals? Or what would you like to do as time runs short?

What are the tradeoffs you are willing to make for the sake of added time?

These questions help her make the right recommendations for the end of life journey. It’s not about do you want a ventilator, or not, Gawande said, it’s about how you want to live and spend the time you have left?

End-of-Life Agenda

Megory Anderson, the founder of the Sacred Dying Foundation and thelogian who specializes in end of life rituals at University of San Francisco, says that people making plans for the end have a three-tiered agenda. The first is taking care of paperwork associated with bringing closure to your life. The second is reviewing one’s life, making amends with people and saying farewell. The last one is less tangible— getting right with God or preparing to meet God. When you look at this end of life journey through that prism you can see why there is an interdisciplinary team in hospice and palliative care to help you.

The paperwork might begin with a few documents listed below that help you organize

your expectations and ensure your family is prepared with a tangible map that will guide the way.

Living Will

Your living will is a legal document that is used in the medical field to provide doctors and your family with your decisions about life-saving and life-prolonging treatments, i.e. life support like a ventilator or a heart shock, in the event you become incapacitated. In this document you state who is your healthcare proxy to carry out these decisions for you.

The living will is for the medical field.

POLST

Physician Orders for Life Sustaining Treatments

The Physician Orders for Life Sustaining Treatments is a recognized end of life planning document among the healthcare community. The POLST allows healthcare professionals to become aware of the patient’s wishes for care and honor them. The POLST form is a physician order that is representative of the patient’s desires and is instrumental in focusing on the conversation before you become seriously ill. The POLST does not replace the Advance Health Care Directive (AHCD).  ACHD allows you to name a healthcare decision maker if in the future you are unable to communicate your wishes for yourself.

Visit www.capolst.org

Five Wishes

There is a really great resource called The Five Wishes that combines the living will and last wishes into one document that can be ordered online. It’s filled with questions and suggests that help your family and doctor know the following:

•    Who you want to make health care decisions for you when you can’t make them.

•    The kind of medical treatment you want or don’t want.

•    How comfortable you want to be.

•    How you want people to treat you.

•    What you want your loved ones to know.

The End-of-Life Plan

A more informal document is an end-of-life plan for you and your family to prepare for your journey in a similar fashion to a woman who writes a birth plan of how she envisions the birth to go. She writes where she would like to give birth, home or the hospital, the members of her birth team, the interventions she will accept and those she won’t, the people she wants to be present, the music she wants played, the candles she wants lit, the flowers she wants in the room and the list of people she wants contacted with the news. In spending time creating her birth plan, she envisions what she believes will be a peacefully, loving environment for her to give birth.

You also have the right to put together an end-of-life plan that can be verbal or written. It’s good to discuss your expectations, fears and last wishes with your family and caregivers. The end-of-life plan can be a one-sheet or two about how you want your final days to look. You may wish to die at home. You may wish to be surrounded by loved ones. Write a list of those people you wish to accompany you and complete it with contact information. You may want fresh fragrant roses, lilies or irises at the bedside. You may have a specific music playlists of uplifting, comforting music. You may want someone to read you your favorite passages from a Holy Book. You may want a small altar with pictures of your family, or mementoes collected over your life. You may envision a member of the clergy to be present and perform specific end-of-life rituals such as the last rites, or prayers. It’s easier to write down your last wishes to help you feel in control.

There is an excellent kit called Before I Go, You Should Know that you can purchase for $12 from the Funeral Consumers Alliance that can help you ink this plan with signpost type questions and suggestions to point you in the right direction. There will be probing questions followed by blank pages for you to write in your wishes.

Will

The traditional will is a written record of your tangible personal possessions and property accumulated over your lifetime. These valuables are listed and then you direct how you wish distribute them. This can be created with a family law attorney.

Living Trust

The living trust is an excellent tool to protect your family from probate after you pass on. In America after the death, the assets of the estate listed in the will can be tied up in probate court for a year or longer before transferred to your family members. A protective living trust is a legal document that can be created by a family law attorney so that your assets go into a trust and then transfer directly to your beneficiaries when you pass on.

Ethical Will

The Ethical Will is an instrument to guide you in reviewing your life and passing on the more intangible valuables—values, morals and life lessons—gained over a lifetime. These wills date back to Biblical times and are an instrument used to bestow your wisdom on the next generations. In the past, these wills served as reflections of the past, a person’s personal history about influential ancestors and lessons learned in life, while also forward-looking to the future in giving an instructional account of how he wished his children to live on after his death. The ethical will ensured the person nearing the end that his history, the experiences that shaped his values and influenced his spiritual beliefs would live on in the hearts and minds of his children. Some people have a special ceremony where you pass on your oral ethical will to your children.

Location/Storage

It’s recommended that you tell a trusted family member or friend where you will store these important documents, be it a fireproof safe at home, or a safe deposit box at the bank or online.

In the kit Before I Go, You Should Know you’ll find pages that you could list where your wills are stored, the passwords to your email accounts, location and key information for a safe deposit box, the code for your online safe deposit box, your funeral plans and more personal messages such as last words to your family. You don’t necessarily need this booklet/kit but it’s an easy access guide, in lieu of it, you could also create a binder for your end-of-life plan, funeral plan and your other instructional accounts and let a trusted family member of friend know its location.

The Final Plan

The final plans, or more specifically the funeral plans, can be something you deal with a funeral home. Or if you are a member of a faith community often there is someone official that can help you and your family to organize the final plan. Some people like to take care of their own final plan rather than leave it in the hands of their bereaved family. This is personal but if you are going to make your own plans, including the family is often a good idea because the funeral is for the survivors. But certainly having your personal touch, buying your last piece of property on earth and planning your life’s final celebration can be a constructive way to deal with some of the fears that comes from trekking into the unknown. Preparations and choices are the key to diffusing fears of the unknown.  Fortunately, there is a menu of choices for how you want your end of life celebration to look and feel, in fact you can even have a living funeral, a celebration before you pass on. If you know the end is near maybe you want to have a sendoff gathering to say farewell to your family and friends before you go. Either way, you may want to think about the list below to focus your wishes.

Memorial service is a ceremony without the body present. And a funeral has the body present either open or closed casket. So the first question is do you want a memorial service or funeral?

Then of course, where do you want this celebration of your life? It can be any place that represents you.
What kind of theme will best evoke you religious or self –themed?

Do you want a military funeral?

What kind of music do you want played?

Who do you want to give your eulogy? Or do you want it to be an open-mic ceremony?

What flowers do you want to be displayed?

What holy book readings or inspirational poems would you like read?

Do you want to return to the elements by earth or fire? Burial or cremation?

What do you want the post-ceremony party to look like?

At a glance now with these tools in place, you and your family have a clearer vision of where you will go on this journey, it no longer feels so unknown which frees you from some of your fears so that you can focus on spending meaningful time, making lasting memories that celebrate your life.

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