Real Intentions for Life

December 2016

3 Tips for a Yearly End-of-Life Assessment

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When the ball drops in New York City on New Year’s Eve, will you be ready?  When the bombshell of a cancer diagnosis hits you in the ER, what will you do?  Listen to the doctor or follow an assessment and plan of your own?

Sara was a 68-year-old woman who was not feeling well and had shortness of breath. The doctor thought she might have a blood clot in her lungs. Her CT scan showed that she had lung cancer that had spread to her liver, thyroid and kidneys. She smoked for many years, but never imagined it taking a toll on her body.

Life, as Sara knew it, ended sooner than December 31.  She needed a moment for reflection and time to make an assessment. She could stay in the hospital, but had the option to go home and sleep on it. A home-base palliative care nurse was consulted and met with her in the ER.

Consider these tips for a yearly and end-of-life assessment:

  1. Count your blessings before taking on hardships.

Sara’s husband immediately broke down with the news of her metastatic lung cancer. If there was any doubt of her finding Prince Charming, it was tearfully obvious. She had a fulfilling career as a teacher and raised two successful children. Given the stress of the situation, Sara had remarkable strength.

With counting your blessings, you take note of your accomplishments. Comfort and joy emerge from realizing that you achieved a lot of your goals. Unfinished business often seems unnecessary and like a hardship. We generally do what matters to us and this is what others tend to remember about us. “All’s well that ends well” when you die with a sense of thanksgiving rather than focusing on the loss.

  1. Create closure before opening the window of opportunity

Just as 2016 draws to a close, your life is certain to end. Will there be a series of celebrations or the feeling of “Bah Humbug.” Denial will keep you from creating closure, certainty allows for acceptance. The serenity to accept the things you cannot change allows you to sleep in heavenly peace.

Sara had to think about how her sisters were going to react to her cancer diagnosis. She felt they were going to insist that she receive chemotherapy. Would they also offer to suffer its side effects? Did Sara wish to die miserably to make her sisters happy?

Closure involves giving others reassurance. It’s a reminder that “when a door closes, a window opens” to a brand new world.

  1. Try out the new normal before making a final decision

Out with the old and in with the new is the message of “Auld Lang Syne.” If 2017 was your last year, would you spend it differently or make other plans for the New Year? Do you have a contingency plan when you can no longer say, “at least I have my health?” Will you focus on your well-being?

Most people view Sara’s situation as the worst thing that could happen. Others might see it as a new lease on life. Sara can now live for the moment and without expectations. Can the end of life truly be carefree? We are often encourage to “try it – you might like it.” Decide how you might reach for the stars without being limited by others’ expectations.

Before another year comes to a close, make a yearly end-of-year assessment of what truly matters to you. Then create your own advance care plan.

 


Subscribe to Dr. H’s Clipboard
Caregivers often suffer in silence while looking after loved ones and grieve in the aftermath of their death.

These twice a month email tips help caregivers understand that pain and suffering are inevitable – grieving is optional through better advance care planning.

Let’s start developing a community that creates and grows understanding, knowledge and support for compassionate end-of-life care.

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Spiritual Considerations Raised after Watching Netflix’s “Extremis” – Part 4

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Yea, though I walk through the valley of the shadow of death,
I will fear no evil: for
 thou art with me; thy rod and thy staff they comfort me.
Psalm 23:4

Yea, I dare you to fear no evil as you watch Netflix’s haunting documentary “Extremis.” The ICU at Highland Hospital in Oakland, CA represents a walk through the shadow of the valley of death. In each room, patients are confronting both their mortality and the demons that lurk in the shadows. “Thy rod and staff” might represent the higher power available to you. Tools for your own spirituality. Yet, most of us mere mortals rely on coping skills, succumbing to demons.

The demons are our own worst fears. These include breathing machines, feeding tubes, losing control and feeling confused. Demons exist as our own worst enemies. Those who claim to be righteous and provide indignation in the name of God. These demons wear the masks of healthcare providers, family members and the man in the mirror. Having these demons exposed through “Extremis” allows us to confront them.

The spiritual battle exists between our own worst enemies and final wishes. There are three intertwined conflicts:

  1. Man against nature

Self-preservation and survival of the fittest wage the battle with our own mortality. Being in conflict with Mother Nature rarely bodes well. Nature often teaches us about life. It seasons tell you that there are times to live, survive and die. Is there life after death? Nature answers this question and offers spiritual guidance. When there is life after death, you can lessen the need to prolong this life. Being in harmony with nature is your best bet to dying with dignity.

  1. Man against man

Physicians and family members often stand in defense of your leaving any time soon. Every potential treatment has to be exhausted. Patients rarely have their say until all is said and done by physicians.  Advances in medicine prompts more patients to go through extremis. Extremist promote extremis. They tend to be righteous through the adage, “What doesn’t kill you makes you stronger.” Most people who stand in the middle ground of dignity believe that less is more. This spiritual truth allows for less medical intervention and more comfort at the end of life.

  1. Man against self 

Personal reflection is necessary to separate our needs from out wants. While wanting to make others happy, we often sacrifice our needs. While wanting to prove ourselves to superhuman, we often sabotage our personal dignity. We often look to others to validate ourselves. Yet declaring self-worth is a spiritual undertaking. No one can give you dignity – you have to feel it from within your own heart. This deep-seated level of certainty allows you to proclaim, “I’m good!” This feeling of fulfillment gives you the sense that life is complete and you can now rest in peace.

Spiritual considerations resolve personal conflicts, allowing your spirit to be set free. Only you can guard against extremis through following your heart and advance care planning.

 


Subscribe to Dr. H’s Clipboard
Caregivers often suffer in silence while looking after loved ones and grieve in the aftermath of their death.

These twice a month email tips help caregivers understand that pain and suffering are inevitable – grieving is optional through better advance care planning.

Let’s start developing a community that creates and grows understanding, knowledge and support for compassionate end-of-life care.

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