Comment from Jim: I want my funeral to be more of a party instead of some quiet, somber event. Is this OK and what would be a good way to enable this?
Jennie Chin Hansen: Sure! How we want to be remembered is very important. Make sure whoever you designate to do your final arrangements/celebration has that in writing.
Comment from Karen: Is the U.S. the only country that seems to “shy away” from talking about the end of life? What do other countries do?
Jennie Chin Hansen: In 2010, the Lien Foundation of Singapore devised a “quality of death” index, similar to the “quality of life” index used to rate living conditions in various countries.
Using the “quality of death” index, a study of 40 countries showed that those with long-standing hospice and palliative care programs ranked the highest, with the United Kingdom (UK) being first, followed by Australia and New Zealand.
The U.K. has made “quality of death” an important public policy issue, something that many developed and developing countries have yet to do.
Comment from Erica: Wills, Powers of Attorney, Medical powers of attorney, it's all confusing. What is the best/easiest way to start?
A third resource is the American Geriatrics Society — a public education website with an entire section dedicated to End-of-Life Care and Advance Directives.
Comment from Kevin: What is the difference between a living will and a durable power of attorney?
Jennie Chin Hansen: Advance directive is a general term used to describe living wills and medical powers of attorney.
Living Wills, sometimes called medical directives, outline the type of care an individual wants in the event that they can no longer make their own medical decisions.
Advance directives only cover health decisions. It does not cover financial decisions.
Comment from Nicki: I’m researching nursing home facilities for my father-in-law. My husband and I have heard good and bad things. We are quite nervous about making the right decision. What should we be aware of before choosing a place?
Jennie Chin Hansen: When touring a prospective nursing home, ask to see the nursing home’s license. Also ask if they are Medicare and/or Medicaid certified.
You should also find out what services they offer. For example, does the place provide wound management for seniors who develop bedsores, physical rehabilitation services, or a specialized unit for those suffering from Alzheimer’s disease or other forms of dementia?
Comment from Barbara: At 65 should I be planning things for myself? I only have one child and no other close family? I have MS and I have refused care to date. I am still independent.
Jennie Chin Hansen: Yes. It's important that your values and wishes are known to your child so that how you want care provided when you find it acceptable is important to be explained in your voice. It is never too early to do that.
Comment from Guest: Hi, Jennie, it's Lisa. I"m so glad to see you as our Guest. Quality of Life is so important. I find the phrase Quality of Death helpful. How could we use this phrase more often in the U.S.?
Jennie Chin Hansen: Lisa, this a great suggestion.
Singapore has devised a quality of death index so that this phrase has now surfaced.
Most important is that we develop comfort and ease of talking about this more openly.
One good resource is the Conversation Project, which makes this a kitchen table discussion.