Editor’s Note This is the second in the series of three Northfield News articles covering various phases of end-of-life planning. The next article in the series focuses on Northfield’s death midwives who assist the dying client in their journey towards a peaceful ending.
“Death finds us all eventually.”
That’s the opening sentence of a 40-page advanced planning booklet produced by Compassion & Choices that guides people through the process of charting their own end-of-life journey.
The journey can be easier by taking the time to think through various options and transcribing those prescriptives into a written advanced directive. A group of advocates here in Northfield, who have been certified to help ensure people get the care they want and avoid what they don’t want while they still have the mental acuity, recently gathered to discuss why advance directives are a key part of any end-of-life plan.
To give the Northfield community members guidance and support on the full range of end-of-life options, a local group has been hosting open houses staffed by volunteers. Last Thursday night, five women were on hand at the Northfield Public Library to help guide people through filling out these forms.
Anne Meyer Ruppel is a nurse practitioner and hospice assistant; Karen Mader is a nurse and hospice assistant; and Barbara Krause is a death midwife, author and public speaker. All have all been certified to help people plan their personal advanced care directives.
Retired teacher and artist Amy Pfefferle acted as a greeter in the library’s Bunday Room, while attorney Erika Campbell was on hand to offer legal assistance.
The volunteers said that planning for the end-of-life process starts with taking a person’s own values and priorities and thinking through different end-of-life scenarios.
“We ask them to picture themselves in an end-of-life situation,” explained Krause. “We ask them what sort of care would they want.”
Karen Mader hopes she can help ease the burdens family members go through at the end of a loved one’s life using her skills in nursing and hospice care.
“I have seen families struggle with decision-making at the end of a loved one’s life,” said Mader. “While I hope to be able to speak for myself until my last breath, my advance directive feels like a gift to my family. It explains what I value in my life filled with sacred moments.”
When it comes to decisions about your health, the volunteers emphasized the importance of stating health care goals, values and wishes and making them known. They explained that, in the event of a sudden injury or illness, a person may not be able to communicate his or her choices. They encourage individuals to begin by thinking about what matters most, and then by having conversations with family, friends, cultural and/or faith leaders, and their health care team.
“Only 37% of Americans have completed an advance directive,” said Krause. “Decide what you want and who will speak for you if/when you can’t communicate your wishes about medical care. Your loved ones will thank you. Chance offers too many surprises.”
One of the first suggestions made at the health care directive open houses is that people fill out the official forms regarding their end-of-life choices and then have the document notarized well before a crisis occurs.
{span}Anne Meyer Ruppel has also been {/span}with families grappling with decision-making at the end of a family member’s life. She said that, at a time often fraught with emotion, having one’s advance care directive completed allows an individual’s wishes to be honored and can help diffuse conflict among family members.
“It is important to me that my own family understands my wishes in the event I cannot speak for myself, so I have had those conversations and completed my directive,” said {span}Meyer Ruppel.{/span} “Everyone ought to complete an advance care directive, as it allows one to discern what one’s values are, what one’s wishes are in the case of being unable to speak for oneself, at any point in one’s life, not just at the end of life.”
Erika Kroetch Campbell, an attorney at Estes Campbell Law Firm, has been doing advance medical documents as part of people’s estate planning for over 15 years. She explained that, when people come to her, they often have done no estate planning, so then she can prepare the medical documents along with their wills, trusts, and general powers of attorney.
“Then, of course, they have the benefit of my expertise and experience,” she said.
Campbell added that more often in the past five years, clients come in with their medical documents already done but want the rest of the estate plan to be done by an attorney.
“In those cases, I review the documents that they’ve gotten from somewhere else and make sure they’re properly executed, with witnessing, notarizing, etc.,” she said. “I integrate those documents into the rest of their plan. Either way, the medical documents are a key component of giving folks peace of mind, knowing that their wishes and values are expressed and will be honored and carried out.”
As the newest member of the end-of-life information team, Amy Pfefferle said she has worked on her own advanced care directive for the usual reasons — making her wishes clear to avoid unnecessary procedures and unwanted hospital stays — but also to save her family unwanted conflict and stress, and maybe even give them some peace of mind.
“As a person interested in the death positive movement, I’ve held a number of “Death Over Dinner” events for friends and family, along with another former teacher, Becky Gainey,” said Pfefferle. “Our goal has been to get folks comfortable talking about death, and move on to topics that can ease worries for themselves and their loved ones — advanced directives, organizing important papers (thenokbox.com), thinking about end-of-life wishes, ethical wills (documents sharing your values, memories, and advice with loved ones), alternative options for after death (green burial, natural organic reduction, home funerals), and really, again — just getting comfortable with a topic that we all have in common.”
Pfefferle said that giving people more knowledge and planning tools, can ease much of the discomfort and fear surrounding death.
“We have even started collecting favorite song and book titles of our own, to share with others when we pass. I have a ‘death playlist’ I would like to hear at my life’s end,” she said.
Mader said she has added a group of friends who offer “voices of reason” to her own advanced care directive, so that her husband, Packy, has backup.
“I don’t measure a lifetime statistically by decades, zip code, and gender,” said Mader. “As I have witnessed, each lifetime is 100 percent for an individual whether one dies at 3 days old or 99 years old; both lives making an impact on so many people.”
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