ozarque ([info]ozarque) wrote,
@ 2007-01-13 08:43:00
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Death and dying; part four...
[info]mmegaera (in response to my "part three" post in this discussion) notes that the post "assumes that every person has either household or family to handle things after the person is gone," and wants to know what people who do not have -- and perhaps prefer not to have -- a social network should do instead of those items on my list and the additional ones that have been added in comments.

[info]mmegaera writes: "I simply refuse to believe that I am the only person out there who lives alone, is not close (geographically or otherwise) enough to and/or does not trust my relatives to the point where I want them involved, and whose friends are either a) older enough than I am to most likely not be around when the time comes, or b) not close enough that I would want to burden them with this. So what do people like me do? Aside from developing relationships for this express purpose (which is what it would be -- I like my life the way it is, darnit!)?"

Very good question, and no -- of course [info]mmegaera isn't the only person out there who is living in the manner described and prefers to do so. It does mean being someone who is either fully capable of getting everything done independently and/or is financially able to hire things done when necessary. Anyone who meets those conditions and can freely choose that lifestyle is blessed, and has my congratulations, although it's not a situation I would want for myself.

In my opinion, however, some of the basics still apply. In particular: "One major part of dying a good death is the serenity that comes from feeling that you've put your affairs in good enough order to avoid having left messes behind for other people to deal with." My suggestions.....

There still needs to be a will, written with the assistance of a lawyer or legal aid service, because unless you can predict the exact moment of your death you are going to die with some belongings and assets on hand, and you should make it simple for the individuals who find you after death to dispose of those items properly. The will can specify just three things: (a) that you want your belongings to go to [organization or charity or church or (other) of your choice, including "to the trash" if that's your preference]; (b) your preferences with regard to the disposal of your body and any memorial or funeral (including a statement that you want nothing of that kind done, if that's the case); (c) information about the way that those final arrangements, and any personal bills that may not have been taken care of, are to be paid for. A small term life insurance policy would be one way to handle item (c), and if that's your choice your lawyer should write the will in such a way that he or she is the beneficiary and is instructed to spend the funds for that purpose, with yet another lawyer listed as a backup in case the first one predeceases you.

And there still needs to be a Living Will, or whatever is the equivalent of that document in the area where you live, so that you have a reasonable chance of not being tormented during a final illness with medications and medical procedures you don't want, or of being denied medications and medical procedures that you do want. You should prepare it with the assistance of the lawyer or paralegal who helped in the preparation of your other will, and that person should have a copy of the document. One of the consequences of choosing an old age without a social network -- a choice to which you are fully entitled -- is that if you suffer a sudden illness or injury that requires hospitalization there may be no one around to intercede on your behalf. You will therefore need an "In case" card that specifies that your lawyer or paralegal be contacted. As a number of LJers have pointed out in comments, this won't guarantee that your wishes will be honored, but it will increase the chances of that happening.

Finally, if you know that you are dying, as opposed to being taken by surprise, it would be wise (and courteous) to put a file folder or manila envelope -- with your will, Living Will, life insurance policy information, and your lawyer's phone number inside -- somewhere in your living quarters where it would be hard to miss it, with a line like "To Be Opened After My Death" written on the top.


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[info]dale_in_queens
2007-01-13 03:10 pm UTC (link)
I do live far from my family, though I do have friends. Because of HIV/AIDS and because of my work (just that I indirectly supervise a group about the size of my home town--which is very small), I have been the only to deal with the death of a person who had no social network several times.

The suggestions above are excellent.

I'll add a few more. Be sure that your job, if you're working, has current information on who to contact in the event of your death. If you live alone and have a job, the beginning of the process after your death is likely to fall on your co-workers. In one case, an employee left copies of the "to be opened after my death" envelope at work and at home. He was 95, still working, and just knew it might be helpful. As it was indeed.

If you don't work, you should establish some sort of "how will you know I'm dead" routine. Someone you call at least once a week. Or to whom you send an email or make a private entry. And decide what this person should do if you don't call or email or post. Living alone without friends nearby is a fine choice, and one I've made a few times thus far in life. But one never knows when death will come by.

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[info]euryale000
2007-01-13 06:50 pm UTC (link)
You can designate anybody that you think will be competent to execute your will (and take care of all that other stuff that you've theoretically prepared as per Ozarque's suggestions). My dad once got designated to execute the will of a woman whose taxes he had done a couple of times. She had kids, and everything, but they were vultures and she apparently decided that the guy who kept her square with the IRS would be better at getting it done. Of course, if you want to designate somebody who doesn't have some kind of social obligation to you (family member, close friend, etc) you'll probably want to set up a redundancy system (if this person refuses, try this person, then this person, etc)

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[info]mmegaera
2007-01-13 09:48 pm UTC (link)
Okay, will, check (I am not so alone that there aren't things that I wish to go to relatives/friends, just alone enough that I don't want them dealing with the logistics (okay, it's mostly a control issue, and I will be the first to admit that), if that makes any sense). Living will, check. Although I was told specifically by the lawyer who wrote both for me that in the state of Washington I had to have someone to declare as executor of both, and she simply wouldn't give me any answer other than "you've got to come up with *somebody,* and no, it shouldn't be your doctor or lawyer, but someone who is related or otherwise invested in you as a person." Even after I explained at great length that I did not have and/or want someone like that in my life.

Also that it wouldn't be possible for the wishes in my living will enacted (esp. no extreme measures, etc.) to be acted upon unless I assigned someone to have the authority to carry them out.

Which is why I've been so frustrated about all this. Basically I threw up my hands and resigned myself to what happens, happens (both if I become incapacitated and as to what happens to my body afterwards), because I don't have anyone I can assign that role to.

No, I haven't pursued this further with another lawyer. I probably should get one to show me exactly where in the laws it says this, but frankly if it does that doesn't make things any better, and if it doesn't, I haven't a clue how to go about getting things dealt with in the manner I wish it to be. So what's the point?

Anyway, thanks for listening.

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[info]janetmiles
2007-01-14 01:06 am UTC (link)
As far as I know, there's no reason your lawyer couldn't be the executor of your will (although laws may vary from state to state). If you do all your banking at one place, you might find out if their trust department could handle executing your will.

Living will -- that's harder. I can see why a lawyer or doctor wouldn't be comfortable taking that on.

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(Anonymous)
2007-01-14 05:24 am UTC (link)
The people you put in charge don't have to be local. They can give or withhold consent by phone. Maybe not in all states, I don't know, but at least in some. Signatures can be faxed if necessary, but it rarely is.

Meg Umans

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Response to mmegaera....
[info]ozarque
2007-01-14 01:31 pm UTC (link)
Please don't throw up your hands yet -- not without getting an update. The law (and the medical and hospice practice) regarding Living Wills varies from area to area and is in a state of constant change. Your lawyer in Washington, if I understand your comment correctly, told you that your wishes wouldn't be respected unless you'd given someone power of attorney to make medical decisions for you. I believe you'll find that that's not necessarily true. What's most important in your situation, it seems to me, is that there be some way for your wishes to be known. What happens then is out of your hands, but at least those who are caring for you will be aware of what you do and don't want done.

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Re: Response to mmegaera....
[info]mmegaera
2007-01-20 06:29 pm UTC (link)
I have the living will. What I don't have to make it functional is the power of attorney that must go with it, according to the law. So my wishes will be known, but don't have any better chance of being carried out than any other course of action.

And I belong to an HMO -- depending on *them* to see my living will wishes carried out is a lost cause [wry g].

Thanks for the time and care you spent replying to my query, though. I really appreciate it.

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[info]fibermom
2007-01-14 02:56 pm UTC (link)
It sounds as though there is an expectation that you would need an advocate. However, if you have a doctor and lawyer you trust, you may not need an advocate, and someone distant and uninvested might be fine. In what may be a comparable case, I talked with my doctor before my babies were born and explained what I wanted, and asked that the nurses and so forth be clear on this, so that I wouldn't have to deal with such things (offers of pain medication, for example) when I was in labor. I always felt I had to be polite when I was in labor, and I guess I'll probably feel that way when I'm dying, too. Having your preferences clearly written down somewhere may be enough.

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[info]mmegaera
2007-01-20 06:30 pm UTC (link)
I hope so.

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Re: Response to mmegaera....
[info]victoriacatlady
2007-01-27 04:49 am UTC (link)
One of the suggestions made with respect to advance directives (living wills) here in B.C. is that you give a copy to your doctor. I don't mean to say that your doctor is necessarily a person you would trust to make decisions for you, but at least if she/he knows in some detail what you would want those decisions to be, they're less likely to make decisions diametrically opposed to your preferences.

It also gives the doctor at least a modicum of legal basis for following a DNR order, for instance, if she/he has your living will saying specifically that that is what you want in certain circumstances.

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[info]kelsied
2007-01-13 11:43 pm UTC (link)
I've been meaning to respond to this all through, but as soon as I got home from work the day you started this discussion I came down sick! Oh well! *grins* If my writing is disjointed, I blame it on lingering oxygen deficiency. Dratted head colds!


What I do notice missing from your definition of "living well" is the notion of finishing everything you need to have accomplished to feel good about leaving this Earth.

That is... there are many things I want to do: have children with my husband, go to law school, promote in my current job, etc. If I don't accomplish these things, it will be disappointing, but I will not feel too badly about it -- they are simply goals that I have not managed to accomplish yet. Not having kids will be a serious disappointment, but ultimately... c'est la vie.

By contrast, if I have not managed to make the world better somehow before I die -- if I have not managed to leave a positive balance in my wake -- it doesn't matter how much planning I have done, I will not feel at rest. (Though, in that, I thank my stars I am catholic, and can hope for a chance to redeem myself after death -- I've always thought it might be awesome if there's an opening for "patron saint of wayward teens" when I die.)

Estate planning is important, but if I haven't lived my life right up to that point, it doesn't have the ability to give me peace of mind by itself.

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[info]kelsied
2007-01-13 11:45 pm UTC (link)
Well there's a freudian slip! I meant "dying well" of course! *grins*

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Response to kelsied....
[info]ozarque
2007-01-14 01:34 pm UTC (link)
Understood. I've been working my way through the legal/technical aspects of dying well, and will eventually get to what I perceive as the really hard part -- the emotional and spiritual aspects. Thank you for your comment.

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Re: Response to kelsied....
[info]kelsied
2007-01-15 08:57 am UTC (link)
Understood. Thanks!

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Health Care Proxy/Living Will etc.
[info]amysuemom
2007-01-14 05:19 am UTC (link)
I have been guardian (both full or medical) for individuals with no family, support network etc. It wasn't easy. The worst was when I became guardian for an older woman incapiciated by Alzheimer's, she had been institutionalized most of her life and was born with Down Syndrome. I had actualy been her case worker for many years and had once promised her she'd never go back to a state institution. I was able to keep that promise, something I've always been very proud of. We used hospice at the end and I can't say enough wonderful things about hospice and the people who do this work. The hard decision was making her DNR and choosing to not have a ventilator or feeding tube put in place. The woman in question was never high functioning enough to give informed consent and I had no family members to consult with. I certainly had her physicians and other caregivers to speak with but the decision was mine and ultimately I decided she'd had everything she worked so hard for taken from her (Alzheimer's is a terible disease) and the least I could do was allow her some dignity and a graceful exit. It still was hard, she died early on a summer morning and several hours later I received a call teling me my infant daughter was waiting for me in China (a call I was not expecting for months). A very bitter-sweet day. My daughter has two Hebrew names one for my father and one for this feisty woman who I came to love and respect so very much.

Got a little off topic there I think. I meant to say that there are lawyers who specialize in family health issues and often they are able to put into place the wishes of individuals who lead independent lives and may not have a traditional support network available.

In this vein, I'd like to add another request to those thinking about these issues. If you have a seriously disabled child or family member, who are themselves not competent to make decisions, please leave information about them and plans you've put into place available for their caregivers. Don't assume that the situation your loved one is in will remain unless you've made arrangements and expressed wishes that someone can carry out.

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Re: Health Care Proxy/Living Will etc.... response to amysuemom...
[info]ozarque
2007-01-14 01:35 pm UTC (link)
Thank you for posting this.

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Re: Health Care Proxy/Living Will etc.
[info]mmegaera
2007-01-20 06:32 pm UTC (link)
How does one go about finding a lawyer who specializes in family health issues?

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Re: Health Care Proxy/Living Will etc. ... response to mmegaera...
[info]ozarque
2007-01-20 07:07 pm UTC (link)
To find a lawyer specializing in any branch of law, contact your state or county Bar Association (or its equivalent where you live). It may be that if you just ask for someone specializing in "family health issues" that won't get you what you need; it would probably be better to say specifically that you're looking for someone who can advise you on Living Will/Health Care Proxy matters (and whatever over matters are on your list).

If that doesn't work, or if the attorney you're referred to lives inconveniently far away from you, I'd suggest calling a very large law firm in your city or a city nearby and asking for help there.

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Re: Health Care Proxy/Living Will etc. ... response to mmegaera...
[info]mmegaera
2007-01-20 11:22 pm UTC (link)
Thank you. I will do that.

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Re: Health Care Proxy/Living Will etc. ... response to mmegaera...
[info]mmegaera
2007-01-20 11:47 pm UTC (link)
My local bar association, it turns out, has a referral service. I will call them on Tuesday.

Thanks for talking this out with me. I really appreciate it.

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Age doesn't matter
(Anonymous)
2007-01-14 08:24 am UTC (link)
One thing I'd like to add is that the question of a living will/testament/etc. is not a question of age. I am only 28 and have both in place, and update them on a regular basis. I have a DNR order standing with a letter of explanations in place which specifies the circumstances under which I do not want my life extended. I have no reason to believe that I will die soon, but I have to drive a lot and highways are dangerous, even if you are a decent driver.

Fortunately I have a grandmother who is approaching 90 and I talk about death and dying with her. To her it's a natural process and we sort of took care of things together. I know where to find all necessary documents in her house, etc.

Oops, off topic... anyway: death doesn't care for age, the sooner one gets to think about the matter the better. I sleep a lot better since I know that I've done all I can to prepare for the eventuality of my death. (My parents think I am crazy for having already put all of the above in place...)

STephanie Kader

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Re: Age doesn't matter... response to Stephanie Kader....
[info]ozarque
2007-01-14 01:38 pm UTC (link)
I'm with you on this. As long as everything gets updated periodically, I believe that it's far better to get it out of the way earlier.

It's splendid that you have your grandmother to discuss all these things with, and that she's willing and able to discuss them. That's a genuine blessing.

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