Setting Final Things in Order
Balboa Park, San Diego.
I love the symmetry, contrasting shadows and order of this open air walkway, as well as the mystery of what lies ahead.
Carey -
This process can be therapeutic, interjecting an element of control in the journey. Robin found it very helpful that I wrote a “death announcement” for her to distribute via e-mail to family and friends when the time is right. It’s part philosophy and part pragmatic action points. But one could consider including things such as memorial service or celebration of life plans, charities, immediate family needs such as meal trains, and special requests. Mine’s a bit unorthodox. It’s best to have a “Point Person” similar to what we’ve discussed in the section about telling others. Your partner and immediate family may not wish to deal with this in the immediate time period after death. By openly discussing this ahead of time, you can remove misconceptions, guilt and well meaning folks who react out of the need to contribute comfort in some fashion. Accounts, passwords, access to important documents are all included on this list. As importantly, assuring that health related documents are signed and available to designated close family and friends (e.g. medical power of attorney, living will, POST). Open discussions and assuring that these items are addressed remove multiple layers of effort and anxiety for those left behind.
Inverted deck chairs, Staten Island Ferry.
More symmetry, although turned upside down. While no one wants the task of getting “things in order”, the process is really an act of love for those in the aftermath of your death. Take the time to facilitate this and make it as easy as possible for them. This will allow more energy for the grieving process and happy memories.
Nicole -
We should all set time aside and do this now, regardless of whether you have a life limiting prognosis (since we all do!). Death can be anticipated but it can also be sudden, unexpected and tragic. Covid – 19 has taught us this. The realities of life include passwords, bank accounts, insurance and healthcare directives which aren’t fun for any of us to organize. But doing so relieves our mind and is the greatest gift we can give our families.
Grief and it’s aftermath can be devastating and our survivor minds don’t work clearly in that time. Having things in order ahead of time means that grief and sadness will have space to be felt and processed without pushing them down because legal documents need attention. I’ve had widows who never handled bank accounts struggle for a year to figure out what their spouses did with the finances. They tell me that their grief became larger than it needed to be because they were so overwhelmed with paperwork. Organize early, organize now! And remember to do an annual update, too. Dr. BJ Miller has written a terrific book called “A Beginner’s Guide to the End” that is full of practical advice and is a good place to get started.
I worried about discussing a “Do Not Resuscitate” order with Carey in our first visit (which I do with all my patients as a routine part of discussing advance directives). Knowing he was an emergency medicine physician, I was sure that mentioning it would trigger the reality of his terminal diagnosis. But he had strong opinions that if he died suddenly, it was best to allow the natural death that was coming anyway. We opted to wait on doing the paperwork until he felt he was sicker and the risk of sudden death was higher. A year later, he was going on a trip and he had begun to decline physically. Robin was realistic that something could happen suddenly far away in a different state and they both agreed it was time to sign the document. For his protection, so his wishes could be legally followed. Setting final things in order so that a physician like him in a far away emergency department didn’t have to wonder what to do.
Robin -
When we are with people who are planning for future events, Carey will often say “if I’m around” to which he usually gets something like “you’re not going anywhere” or “don’t be so pessimistic” in response. As we might expect he is being realistic and trying to help the rest of us get used to the idea that he is dying and the time we have together is limited. I am sure he has made the journey easier for me with his open and honest approach to his death. I sometimes worry that he has inner turmoil and is putting on the brave teacher face for all of us. When I confronted him about it, he responded that it was all genuine and he was actually in a really good place. I think I believe him.
Some people have definite ideas about what should happen both before and especially after death. I think Carey has done a good job of communicating what he wants and doesn’t concerning “traditional” end of life ceremonies (funerals, memorials, etc). Many of our family and friends have differing beliefs and making his wishes known will alleviate guilt and hurt feelings. He wrote his death announcement to be sent out to friends and distant relatives which was a great relief for me as it is something that I was dreading doing. Reflecting on the phone calls he made to tell people of his diagnosis, I don’t want to have to do that when he dies. We decided to ask a few close friends to help with the phone calls, so I only have to make a few. I feel lucky to have the time to plan with Carey for everything that will happen after his death.
We have discussed what I will do in the first weeks and months and years following his death. It is comforting to me to have him help me through this process. Sometimes the idea of infinite possiblities seems overwhelming and I want to make sure that I actively make decisions in this process rather than accepting what comes because it the easiest thing to do. My anxieties for the future revolve around trying to fill the roles that Carey has filled for the last 40 years like keeping in touch with friends and family, taking the pictures, remembering where we were or when we were there, winding the clock, and cooking new things. I guess on the bright side there won’t be anyone to argue with when I remember something differently. When I look at my list of anxieties - I am extremely lucky to have had the time to work through this with Carey to help- there are only these few minor things left to cause worry. Of course, I then have time to worry about the girls but together the girls and I can and will emerge closer and more resilient. I think I am in a really good place too and I hope they are as well.
Newfoundland, Canada
One of our top 5 campsites. We had our own beach, waterfall, and the rhythms of the surf with whales sounding just off shore.