On Death and Dying: My Personal Story

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On Death and Dying: My Personal Story

    Something that people don’t want to deal with is confronting the fact that their parents are going to eventually die. In our culture we don’t encourage people to talk about death because we honor youth and vitality, not old age. Consequently, many people have never had a discussion with their parents about what happens when they are in place where their health fails, where they are not going to continue to live. Because we don’t think about or talk about what people’s wishes are, we are ill prepared to honor those needs and desires at end of our lives. The first time that I had that conversation with my parents was when we started to talk about the importance of having a health care directive. They were already in their 80’s but we had never discussed what they wanted. It was very clear from my discussion with my Dad upon filling out his healthcare directive paperwork, what his wishes were.  One thing that he made very clear to me was that upon getting ill, if he found himself in the hospital, he wanted to make sure that there were no forms of artificial means used to sustain his life if he was going to die anyway. He wanted to be allowed to just die naturally. Here’s the tricky part, in a health care directive you are required to identify a person to act as your agent on your behalf if you are unable to communicate about your wishes. A person can identify someone or number of people to serve as their agents. In my case, my father decided to identify both my older sister and myself as the agents to fulfill his wishes and desires if he was unable to do so.

    When my father shared with me that he had elected to identify both my sister and myself to serve as his agents, this initiated a whole different conversation between us. I asked him to please explain why he had decided to have both my sister and myself to be his agents on the health care directive. My Dad explained, true to his nature, that he thought this was the fairest way to deal with the responsibility and burden. My response to him questioned his decision in appointing two individuals who had never been able to make decisions without conflict. My mother was not a part of this conversation. I then said to my Dad that I thought that it was crucial that instead of doing what he thought was fair, he should evaluate which of his children would be able to execute his wishes without allowing their own emotions to get in the way. I pointed out to my father that he ought to reconsider his decision. I told him that I wasn’t willing to have my name equally involved with making decisions with my sister because that would cause conflict and would reduce my ability to act as his agent. I asked him to respectfully withdraw my name on the health care directive as his agent. This same issue was the case for both my parents. After my father thought about it he came back to me a couple of days later. He had decided it was in his best interest to just have me be on his directive and that’s how the situation was resolved.

    Two years later, my father was diagnosed with late stage pancreatic cancer and was hospitalized. They attempted to do immediate surgery but the cancer was inoperable. While in the hospital his condition worsened, and a decision was required regarding honoring his desires to not have his life maintained artificially. I was required to pick the date and the time when his life would be stopped. What are the life lessons involved in this situation? I would say one is the importance of having that conversation ahead of time, before your parent becomes ill. The other take away is to encourage your parent to choose the right agent for the job. The third lesson is to not be afraid to talk to your parents about dying because it is natural and part of our life process. Make sure your parents have a current will and make sure you have a copy of a will. Yes it’s cheap and convenient to create online but you’re far better off getting an attorney to write your will if you are able. Also very critical is the documents that make up the advanced health care directive. This consists of several items and in most states the forms are readily available and free.  Usually, these consist of a POLST or Physician’s Orders for Life Sustaining Treatment, a general power of attorney, and a health care directive that specifies wishes regarding health related scenarios.

If you are having family conflicts or struggles in caring for your aging loved ones, please give Dr. Davis a call. His personal experience in dealing with these issues helps to give him a unique and valuable perspective on the subject matter. He is recognized aging expert and gerontologist. His patient, kind and knowledgeable manner will immediately set you at ease.

Is Caring For Aging Parents Making You Anxious?

I’ve just been talking to colleagues here in Marin County about helping to educate our community about anxiety, a problem that affects so many.  Here is some information we’ve gathered to put on our local Psychological Association site to help everyone get a better understanding about anxiety.

counseling_136_132Anxiety, according to the American Psychological Association, is  an emotion that creates feelings of tension, worry, and increased blood pressure.

Does this sound familiar?  Many adult children caring for aging loved ones feel that tension and worry.  They may also have penetrating, recurring thoughts. These recurring thoughts and worries can arise from day to day activities or specific events. Anxiety can physically manifest itself in symptoms like sweating, rapid heartbeat, dizziness, and trembling.

When these symptoms are extreme, a person might feel that she is suffering from a heart attack. Psychologists might call the more pronounced forms of anxiety a disorder that needs care and treatment. Those suffering from the more severe form of anxiety may find it challenging to accomplish even the simplest of tasks for fear that something bad may happen to them or the possibility that something might go wrong. They have trouble staying in the moment or living for now.   They  focus on the “what if” scenarios. They complain that they can’t turn off racing thoughts through the mind that evoke a sense of panic. Besides the negative emotional toll on the mind that anxiety can take, the physical residual effects are detrimental as well.  Symptoms might include weight loss, weight gain, hair loss, and stomach discomfort, back or other pain.
Excessive, irrational fear and dread are hallmarks of a problem that can benefit greatly from treatment.  The good news is that there are many good treatment options for anxiety. One treatment option that clinical psychologists offer is called cognitive behavioral therapy. This technique helps a person change the connection between specific thoughts and their irrational fear and dread. The ability to self-monitor one’s own  thoughts can help the person gain control over their emotions. This directly aids in stopping the perpetuation of anxiety or depressive feelings.

In addition, psychologists help people learn breathing and relaxation techniques that can be used to eliminate, manage and assuage anxiety. In some cases especially when anxiety has been present in a patient’s life for many years, medications maybe the best way to provide rapid relieve of emotional symptoms.  Newer anti-depressive mediations called selective serotonin reuptake inhibitors (SSRI’s) are often used as a first line of defense in the treatment of anxiety disorders. People often report experiencing less anxiety and improved mood from taking these medications within two to four weeks.

It is critical to understand that medications do not cure anxiety or anxiety depressive disorders.  Professional treatment (“psychotherapy”) is needed to develop new coping methods, along with a deeper understanding of the complex workings of one’s mind. Once a person learns the techniques, successful alternative action strategies can assure and sustain ongoing changes for the better.

The heavy pressures of caring for aging parents in declining health, the rising demands on one’s time and the sadness of seeing a parent get worse over time can make anyone anxious. If the symptoms you are feeling are getting in the way of doing what you need to do in your life, don’t wait to get professional help. The problem is likely to only get worse over time.

Anxiety is often irrational and cannot be treated logically. Many people do not truly understand anxiety disorder, and think they can just will themselves to be cured. Or maybe the anxiety symptoms will just magically go away if they try to no longer think about them. Most people can’t cure themselves. There is no need to suffer when help from a professional can relieve the emotional pain.  If these symptoms sound like what you are feeling, reach out.  You can find a professional to help you through your local Mental Health Association or your insurance provider.  Low cost services are available in many counties for those who do not have insurance or who are low income.

If your aging parent worries are getting you down and you need advice and support, contact me at drmikol@gmail.com