We had an interesting panel discussion covering end of life topics last month. The panel members included an attorney specializing in retirement and life planning, a funeral director, the security manager, and a social worker.
It was a good reminder to learn about what documents we need so others know what we desire as we get close to our end days. Some of the takeaways for me:
- Documents: that are needed are; a will, durable power of attorney for finances, advance health care directives, and MOLST form.
- Family needs to know the Charlestown procedures upon the death of a single residence in an apartment.
- Pre-planning of burial arrangements is a good idea.
- Joint accounts with relatives may not be the best arrangement. Creditors or a divorce attorney could come after those accounts and claim one-half of the assets since both names are on the account. It is better to use a durable power of attorney for finances.
Many people are not aware that Charlestown changes the lock on the apartment when a single resident died. A letter of administration from the Register of Wills is required before anyone can access the apartment. This policy was instituted so that the person’s wishes are honored as to who takes belongings from the apartment. The executor determines who else can enter the apartment.
We also found out that the EMS staff will resuscitate unless there is a written DNR order. That means that a Medical Options for Life-Sustaining Treatment (MOLST) is needed. The Maryland MOLST must be signed by a physician or NP or PA. At Charlestown, the form has to be available for the EMS team to see, on the back of the front door or in the vital of life in the butter dish in the refrigerator. It is better to have a bracelet with the DNR notice as a person could collapse outside. The survival rates for older adults after CPR is very low so this is one area that needs to be discussed with family and the doctor.
The timing of the program was very good since I finished reading Being Mortal: Medicine and What Matters in the End by Atul Gawande in December. He makes the point that we are indeed mortal and as we face decline in our later years, there is a point when medical interventions may do more harm than good and can reduce the quality of our life. He is an excellent storyteller covering the last days for several patients including his father.
I am now reading The Conversation: A Revolutionary Plan for End-of-Life Care by another M.D., Angelo E. Volandes. He believes that a life well lived deserves a good ending and that we need to talk with our family about the end of life decisions. He also heads up a non-profit foundation providing videos about Advanced Care Planning choices at the end of life.
I discovered that there is a game, My Gift of Grace is a conversation game about living and dying well. I met with other residents to talk about how to bring this experience to the rest of the community.
We can’t forget our digital estate. I have my computer password, the password for my password manager, 1Password, written down in a safe place for my executor. A resource to collect that information is available from Mike Vardy who has prepared the 1Password Emergency Kit
Another excellent reference for learning what is needed is a website with a catchy name, GetYourShitTogether. This website has templates and checklists for planning.
Our culture is so youth-oriented there is a denial of aging that shows up in every facet of our society. Ageism is alive and well even in retirement communities. We are all aging. Get over it!