Tuesday, September 1, 2015

A Passing Plan of Action

If you are dealing with end of life issues, I highly encourage you to sit, think about the situation and outline a plan of action.  Think about what you will need to do when the person you're involved with passes.  Think about what needs to happen and the order in which it needs to happen.  No matter how much you love your person and no matter how much it hurts to think of their pending death, you need to put a plan into place for how you will deal with their death.  You need to do it at a time when you're not feeling high emotions, when you can think and make decisions with as little emotion, particularly guilt, as possible.  Doing so is not a betrayal of them.  You're not hastening their death or wishing them dead now.  You're being honest with yourself that action will need to be taken and you need to be prepared for that action.

Mom and I have these discussions at least once a year if not more.  Sometimes, especially when Lyn is at hand, we may only be able to obliquely refer to them.  When we're in physical proximity, we have been able to carve out an hour or two to discuss the topic.  We discuss the following:

  • Who needs to be called? 
  • What needs to be done?
  • When do we make the first, most important call?
  • Where are the documents?
  • How much time will be needed for me and my family to arrive?  How much advanced warning will we have?
  • Finally, in what order do those things need to happen?
So, here is our plan as it stands today.  We evaluate annually and the following may change.

Mom will not interfere with Lyn's death.  While she will not hasten it, she will take no action to delay it.  Let's be realistic and honest here.  Lyn's got a terminal disease and she's transitioning to the later stages of that disease.  If she were to aspirate on a bite of food and not breathe for a couple of minutes while Mom struggles to clear her breathing, what would the impact of that event be?  Would she ever be able to recover to where she was before?  No.  She can't.  So why torment ourselves with hope that she'd get better?

When Lyn stops breathing, Mom will wait until Lyn is clearly dead and rigor is starting to set in before calling 911.  Why wait?  Why not call immediately?  Simply put, we don't want them to take action to revive her.  They have to.  It is their job.  Our directives can and will be ignored if they arrive on scene and she's got even a flicker of a pulse.  

After the call to 911, Mom will then call the case manager and service coordinator.  Death is an "unexpected or unusual event" which Mom has to report.  

The office of the Medical Investigators will be called by the first responders to come and confirm there is not concern of foul play and that the death was of natural causes.  We will request that no autopsy be done.  What's the point?  We know what's causing her body to fail.

Mom will then start to notify others.  She's not going to call in the middle of the night.  It isn't an emergency or an unexpected event for us despite how the state labels it.  She'll call me and my brother.  I've offered to call others on her behalf.  At this time, she has declined the offer.  It stands and she can change her mind.  She may send a few emails and post it on FaceBook.  I'll update here and on FaceBook as well.  An obituary is already drafted and will be submitted to their local newspaper.  

I'll make travel arrangements for me and my family.  While we may arrive together, I anticipate staying behind to help Mom.  Depending on the situation, if Mom wants me there beforehand, I'll go early.  We don't know if we'll have advance notice of her passing.  Some families do and some do not.

A memorial service will be held in their church.  There will be no open casket and Lyn will not have a lift despite what has been done for previous family members.  Lyn will not be on display.  Lyn will be cremated.  

My grandparents cremains are in niches at a graveyard in Rio Rancho.  Those niches only have enough space for 1 each.  However, there are family plots in a graveyard in town.  I suggested we inquire about the feasibility of interring Lyn's cremains there.  Mom has no intention of keeping Lyn's cremains with her.  

From there, the plans become more fluid.  I can stay and work from Mom's house to help her out as she plans for the next stage of her life.  Perhaps, she'll travel. 

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