Let them eat CAKE

A few months ago I was surfing the web and came across CAKE, an end of life planning app.  The unusual name caught my interest and here’s what I found. Suelin Chen and Mark Zhang teamed up and created this app which is a MassChallenge finalist in 2015.  I don’t think it's available to the public yet; however, when it becomes available, it will be a great way to start the conversation for young people. 

While I may be showing my age, having an app to make you think about what you want at the end of life is definitely a younger generation trend.   The article I read mentioned that after you sign up, the app asks a series of 35 yes/no questions.  Some relate to basic information like funeral home choice and some require serious thinking.  One that was mentioned was “yes or no, I want people to have a stiff drink on the anniversary of my death”.  I’m sure there are more serious questions but this is a good one.  Would we want our friends to celebrate our lives each year?  Would we be too embarrased to ask them?  Is drinking the best way to memoralize a friend?  Maybe yes, maybe no.  Would a more appropriate statement be " Yes/no, I want my friends to make a donation to a charitable cause on the anniversary of my death."  Cultural influences certainly apply to what is seemingly a simple question.

You can find the article by Dylan Martin at: bostinno.streetwise.co (http://bostinno.streetwise.co/2015/10/09/end-of-life-planning-app-cake-helps-make-final-wishes-known/) .

I wish this company well.  The more we talk about it, the easier end of life issues are dealt with.  And kudos to these young people who are using their ingenuity to open doors for those of us who are hesitant to talk about uncomfortable yet inevitable subjects.

Image: Carlos ZGZ

ICE Reinvented

The younger generation is so much more in tuned with technology.  I love being corrected by my grandkids.  And I am sharing this bit of information with you.

Several weeks ago, I talked about ICE – In Case of Emergency.  With a locked phone, the ICE listings are not available to first responders—or so I thought. On most cell phones there is a place to push for emergencies.  This will get you to a screen to make a call or to go to the Medical ID app.  Silly me thought the “emergency” would automatically call 911.  My granddaughter informed me that it wouldn’t and that I should complete the Medical ID app which would contain Emergency Contacts, prescriptions I take and any pertinent medical information I want to include on the app.  The app also asks if I am an organ donor.  How cool is that?  And how many people who have a cell phone never read the instruction manual to learn about all the neat things the phone can do.  Yes, I am one of those people.  Check out the Health App on the iPhone and look for the Medical ID tab.

If you learned something new, please let me know.  My goal is to educate the important people in my life and that’s YOU.  And please share this information.  

Face to Face or via the Internet

Leslie is a hard working psychologist, wife and mother.  She also has a rare autoimmune disease that currently requires a monthly infusion which is done in a hospital.  She actually carries her living will in her purse at all times.  Why?  Because she has educated herself about the progression of her disease and she wants to be in control of her situation.

Leslie told me about a program she has been using for over 20 years-- “Legal Shield”.  I’m not recommending this or any products or services; however since someone I respect uses the company, I thought I would pass on the info.  If you have read my past posts, you know I use a local lawyer.  Leslie, however, uses this company for her will, advanced directives, financial power of attorney, etc.  Check it out at www.legalshield.com.

Getting back to the advanced directives…I recently scheduled shoulder surgery and was asked to bring in my advanced directives.  The intake clerk scanned my document into my medical record.  Take note—even though it is now part of my record at a large medical center, I have been told that I need to bring my advanced directives in each time I have a procedure or surgery because- get this- frequently, the staff cannot locate the document on the computer!  We, as consumers, have to be on top of things.

So keeping a copy of advanced directives in your purse may not be a bad idea.  Not sure where a man would keep his; perhaps on a flash drive on his key ring.

Have you written a will?  What made you do it or what is stopping you from doing it?  Share your thoughts.  If you are reading this on your phone, click to read the post on the web and then you will have space to respond.

Thoughts about Advanced Directives

I just finished reading Atul Gawande’s book, Being Mortal.  It’s about end of life issues from a physician’s point of view.  Though Dr. Gawande is not an internist, gerontologist or palliative care specialist, he is a thoughtful surgeon who needed to deal with difficult decisions for his patients and his own family.  He discusses a situation wherein the patient, a highly educated academic, who has made his daughter his healthcare power of attorney, becomes ill.  The daughter and father talk about the prognosis and she realizes that she doesn’t know what her dad really wants.  So she asks and is surprised to hear that he wants treatment if he can engage in the pleasure of two situations (chocolate ice cream and football) neither of which he had ever indicated an interest.  This out- of- the- blue declaration became her measure for agreeing to surgical procedures for her dad.  He lived an additional two years.   Had she not specifically asked the question about what was important to him, she would have let him go earlier. 

I found this description in the book to be particularly poignant.  We don’t know what another person is thinking unless we ask.  And more importantly, we must listen.  And when we listen, really listen, we open up new avenues of knowledge. 

Most hospitals have some type of form for advanced directives.  I can’t imagine what it would be like to be faced with completing the form when I am in a state of crisis.  Would I check all the boxes that would keep me pain free or would I want any and all forces to be used to keep me alive?    Having already had this conversation with myself and my loved ones I am comfortable with my own decisions.  These are tough questions to answer.  Sort of like creating a fantasy of what could take place and wishing it never would. 

For people on Medicare, a change in the benefits may help individuals address the difficult subject of “what happens if…”.  Beginning January 1, 2016, Medicare will pay for voluntary discussions of end-of-life issues between the patient and the physician.  According to the Pittsburgh Post-Gazette of November 28, 2015, Medicare will reimburse physicians up to $86 for a 30 minute discussion about the choices for a terminally ill patient.  As more and more medical schools prepare doctors to get comfortable with this topic, the culture will change.  Let’s not wait.  If you have not thought about this, the time is now.  Educate yourself, talk with your physician, and then talk with your family.  This is one topic that does not lend itself to delegation.  You must take the initiative.

Image: James Daisa

Vital Information Form

It occurred to me that some of my subscribers did not download the Vital Information Form so I decided to devote a post to it.

The form is to help you get your information in one location.  Some people have a box, a notebook, a safe.  Whatever you have for your family, congratulations.  This form may spark new ideas for your own personal situation.

A few new subject lines are in this version.  

Vital Information for:                                                              Date:

(To be kept with important documents in a safe place, the location of which should be shared with a trusted person)

Copy and paste this into aWord Document so it can be customized to meet your needs which may change over time.  This form can be as long or as short as you prefer. Remember, however, this document can provide critical information to your family in order to relieve them of searching for important documents and phone numbers during a stressful time.  Think of this as a map- it doesn’t provide the nitty gritty information- only directions to the location. Topics should not be deleted; skip over them if they are not pertinent at this moment in time. This is a fluid document that should be updated annually- maybe on your birthday, anniversary or tax day.

Social Security #: 

Attorney: 

Financial Planner: 

Accountant:

Insurance agent(s), policy numbers (including health insurance):

Investments: names and account numbers: 

Bank accounts:  How titled?  Account numbers for checking, savings, credit union, MAC card      (include phone number if known)

Credit/ Debit card names, numbers and Customer Service phone number: 

Burial Information:  plot location, clergy, obituary information, charity requests, funeral home, other thoughts, e.g. clothing, prayers, etc.: 

Name and phone number of church/synagogue:

Information I want on my tombstone: 

Are you a member of a burial or memorial society that may make special arrangements for funeral/burial ceremony- e.g., military honor guard?  Which one(s):

Combinations and location of safes: 

Name of financial institution of a safety deposit box and location of key:

Names, addresses, emails of people to be notified: 

Location of warranties, instruction booklets: 

Location of tax records:

Location of deeds, vehicle titles:

Location of installment books or contracts and payment dates and company phone number:

Location of honorable discharge papers and VA claim number: 

Name and phone number of newspaper delivery person:

Location of Will, Power of Attorney:

Recurrent household costs, eg, landscaper, snow removal, etc. (names and phone numbers):

Utilities (company name, phone number, account number):

Garage code:

Location of the mail box key:

Answering Machine number:

Digital

Password to get onto the computer:

Passwords for email accounts: 

Passwords for social media accounts: 

Facebook has a legacy feature:  Go to More, Privacy Shortcuts, More Settings, Security,    Legacy Contact

Passwords for all sites or the password manager user name and password:

Automatic bill paying--names and account numbers and dates when bill will appear in email or be directly paid by the bank: 

Pets

Pets name(s):

Food Preferences: 

Veterinarian and phone number: 

Medical issues/ Medications (location of medications and food):

Name of person(s)/ organization who will care for pets:

Medical History

Write down your medical history and that of your parents, siblings and first degree relatives (uncles, aunts, first cousins) if you want your children to have access to this information.

Plants/ Gardening/ automatic sprinkling system

Write down unique instructions about your plants and the schedule for your sprinkler (if applicable)

History/stories about family, art, jewelry, household items.

Fido and Fefe

Fido and Fefe want/need a say in life conversations.  I have included a section in the Vital Information Form about pets.  And I am thinking about including plants/ gardening in the form as well.  Thoughts? 

But let’s focus on pets for now as the plant idea percolates in my brain.  Kids or friends may not want a pet and if there is no mention of care for the animal(s) in the will, what is a family to do?  The Pennsylvania SPCA has a solution.  Anyone who sets up a planned gift that benefits the PSPCA will be assured that their animal (limit of 2 dogs or cats) will be taken care of until an appropriate home is found.  And this information must be known to family members so that when the time comes, the surviving member knows who to call to care for the animal.  We can plan meticulously but if no one knows what we are thinking, our plans may go out the window.  

The website for the Guardian Surrender program is:  http://www.pspca.org/support-us/planned-giving/gifts-of-bequest/.  Other avenues for pet protection are trusts, “pet protection agreements”, or a written bequest to a specific person.  The latter may have a specific amount of money for the care of the animal attached to it.

Even if one does not have significant funds to leave to a beneficiary, an individual should write down what he/she wants for the pets.  If an individual has to go into a nursing home, the pet may go to the nearest shelter or may be left alone to manage for itself.  Either way, if we took on the responsibility of housing an animal, we need to take on the responsibility of giving direction to others to care for our pet when we are no longer able to do it ourselves.

Image: Margaret McMullen

Being Superstitious

Superstitions can be funny- bringing salt and bread to a new home for good luck – or terrifying- a black cat walking across your path.  The Stevens kids have been trying to talk to their parents about a will, a living will and a durable power of attorney.  But the parents will have none of it.  Mom even lied when she was admitted to the hospital for back surgery that she had a living will.  She can’t talk about it much less think about it.  Why?  Because when she was a teen, she overheard her parents talking about writing a will and purchasing a burial plot.  The next day, they were killed in a car accident. In Mom’s mind, the mere discussion of death issues irrationally became associated with death .  And now that mom and dad are in their 80’s, mom still refuses to talk about anything related to death.

Her kids are in a bind.  Though they all live in the same city, each of the three belong to a different church.  They know their parents do not share the same level of spirituality.  Mom is a church goer, dad is not.  So what are they to do when their parents die?  They want to honor them but their parents are keeping them in the dark.

Finding an intermediary to help start the discussion can be helpful.  Calling a family meeting at a time when there are no other social or family obligations is one opportunity.  Using the death of another family member or friend is often the catalyst that will jump start the conversation.  Adult children should acknowledge fears and superstitions while at the same time, help parents to look more rationally at the situation.  This is hard, no doubt about it.  But the conversation must begin. 

Share your thoughts and experiences about how you encouraged your parents to write a will and living will.

Image: Pixabay.com