Protecting End of Life Wishes

One of the most important things we can do for ourselves is to discover how we want to live. However, this understanding not only includes how we walk this earth but also how we leave this earth. There is great honor in being privileged to walk the journey of life alongside another person and in respecting their journey.

Recently my beloved great uncle passed away. As my parents, myself and others walked alongside him, he shared his life and afterlife wishes with us. He did everything within his earthly power to ensure his wishes were known and established prior to his passing. In spite of his insistence and clarity, there remains individuals determined to undermine the wishes and efforts of my great uncle. His wishes and efforts that allowed him peace of mind for leaving this earth.

The struggle to protect his wishes emphasized the deep need for end of life planning. Such planning is not age dependent; it is life dependent. I began preparing my own end of life planning during my teenager years and regularly update my documents to reflect any changes and maintain currency throughout the years. Our life journeys may end abruptly and our loved ones who walk alongside us may realize and respect our wish but without legal documents stating and supporting our wishes, there is risk for obstacles in spite our life companions best efforts to honor us.

When discussing advanced directive and durable power of attorney forms with clients, I often am told "my family knows what my wishes are". Unfortunately, verbalizing wishes is not always enough to ensure our wishes our honored. Our doctors do not and are not always allowed to honor our previously verbalized wishes without legal documents stating our wishes.

End of life planning has many caveats for exploration and completion. It is more than simply verbalizing our healthcare wishes in broad generalities. It includes establishing someone to make decisions on our behalf if we're unable to do so ourselves - financially, medically, and physically. It includes directing the distribution of assets, establishing care for dependents, determining medical wishes and service preferences upon our death.

The laws and processes surrounding end of life planning and ability to establish ongoing legal matters, such as guardianship for a dependent, vary from state to state. Thus it is essential to thoroughly obtain and understand what is allowed and required within your area of residence.

Leaving our life companions without legal protection to honor our wishes leaves the door open to not only our wishes being dishonored but also unnecessary stress, legal filings, difficult decisions, potential conflict, and costs that all can be abated by completing end of life care.

When we walk alongside another person we are privy to sharing deeper aspects of ourselves while gaining insight and wisdom not learned elsewhere. This is a mutually shared benefit as the walkee and life companion learn and share their needs, wants, fears, and wishes with one another. It is when we let our egos fall to the wayside and instead listen to what another person needs from life that we are allowed to share one of the greatest gifts we have - respect and honor.

For information on medical end of life planning - Advanced Directive, Durable Power of Attorney, and Do Not Resuscitate Orders - visit here here. For information on estate planning, visit here

Let The Fire Burn

The last seven months have been an incredibly difficult, transformative, and freeing period that is truthfully just starting. For when such a process begins, it can't be confined to a mere few moments in time - not if you submit yourself to the process. For when you submit, the transformation truly begins and it can become a lifelong, marvelous journey.

I fought a new bout of depression this year; that old friend of mine that likes to seep into the depths of my mind and heart and squeeze my very life in its cold, dark claws as it whispers to me, gently bidding me to join its ranks of peace and tranquility. A peace only found in the abyss of death, where there is absolute nothingness. A nothingness that consumes you to the point that there is no pain, worry, or grief. It's a peace that I once was honored to experience briefly and so it calls to me, reminding me of a time long, long ago.

But as I struggled against its calls, strong though they may be, I resurfaced. And not only did I resurface but I found a new appreciation for my life, for my time on this earth. I found a strength within me I never knew was there. A strength that is greater than that which I harness for and through my health battles. A strength that is beyond the physical. All my battles have primarily been against the physical realm. Fighting for my physical life, my physical body against the physical effects of my rare disease and the tolls it takes on me.

I have been pushed past my breaking point yet once again, only this time it wasn't because of my health. I was thrown into a fire and though the flames continue to surround me, I am beginning to see the traces of smoke filtering in amongst the flames. In being pushed to my limit by multiple individuals and situations this year, I'm being transformed and am continually finding new limits, horizons, and restrictions to break. I am by no means done with this personal growth, this new found freedom. The flames continue to do their busy work of burning my outer layers to allow my soul within to shine and to shine brightly. And thanks to these flames, I am happier with myself and more free than I have been in years.

These flames schooled me in dealing with what life and others may throw at you and how to stay afloat. I'm learning to let go and not worry. To take care of myself rather than waste my time and energy on worrying about how others are going to affect me. That is not the same as no longer caring about others. Rather, it's a freedom from the restraints we often allow others to place upon ourselves.  No longer allowing others to control us and our actions and moods.

Instead of trying to figure out what life will be like and what the right direction to take is because of someone else, try setting your own life goals and going after them with tenacity, intensity, and fierceness. No longer letting another control your life's direction will break you of the restraints and life will realign. You will become focused. With that focus, you will discover what is most important to you and establish your own standards for living. Finding yourself, what you deem important, and the satisfaction of independence in your pursuit will lead you to intense happiness and freedom. Levels of which you wouldn't know when you allowed yourself to cower to the standards of others rather than your own.

Realize you can and you will survive on your own without others. I never thought of myself as an independent woman until this revelation was nearly forced upon me. I became overfilled with strength and pride with such a powerful revelation. A lot of us see ourselves as independent solely on our ability to financially provide for ourselves without assistance from another. Although this is a caveat of independence, it doesn't end there. There is so much more to being independent than simply being financially independent. Do you feel able to survive the loss of those dearest to you? I've survived the death of countless individuals I greatly loved and admired but what about the physical loss, the emptiness that can be summoned when we lose someone physically and emotionally though they remain living? My world felt as though it was crashing in around me with such non-death losses. I felt as though I had lost a part of me and perhaps I had in the process of giving a part of me to those I have loved. When forced to the brink though, you will learn you can survive any loss regardless of the severity and difficulty. This doesn't mean you become cold-hearted. Far from it, you simply are able to harness your inner strength rather than solely relying on the strength of others.

No longer care what others think of you. When you lose respect for someone, that person's opinion no longer means anything anyway. Don't waste yourself on those who have already lost your respect. Cherish those who are true to you - those who are supportive, loving, caring, and there with you through the brightest and darkest times of your life - not those who try to create dark times, tear you down, harm you with their malicious intent and manipulations, leave you without explanation. Don't let yourself succumb to the power of others, especially when it is a harmful power. You don't have time for that nor should you.

Don't take the dangerous, personal issues of others on as your own. People will attempt and succeed at betraying, manipulating, deceiving, and harming you. The reasons for others to inflict such pain on another is deep seated within them. Stop trying to decipher the reasons behind their actions. Their reasons don't need to make sense. Their reasons are just that, theirs. Not yours. Do not take on more pain simply because another is engaging in harmful behavior towards you.

Do what you've longed to do but was too scared to commit to previously. There is immense freedom in letting your inhibitions go and doing what you've always wanted to do. Perhaps you refrained yourself because you worried about judgment from others, didn't consider it proper, or didn't think you had it in you to attempt much less complete. Forget that and jump in. I've learned that there are personal challenges our spirit is drawn to for whatever reason. Your spirit gravitates you toward such challenges and won't let you forget about it - even if you bury it for years under fear and inhibitions. If you feel that unceasing tug, your spirit is speaking to you. Sometimes it speaks to you softly, the action may be small but it appeals to you at a deep level. Other times it screams at you out of no where, forcing your attention even if you remain refrained. Let your shield down, accept a self challenge, and let yourself be free.

Whatever the source is for your fire, it will be a long process of adjustment and coping as your outer layers become scorched and the pain sears your soul. Turmoil presents itself with a variety of emotions and stages, often sending you bouncing back and forth amongst them all repeatedly before you are finally able to find your footing enough to begin to walk a more level path through the flames. As the outer layers begin to crack, forcing you to think your mind will crack as well you will want to speed along the process and jump to the end simply to lessen your pain. It's okay that this is a lengthy process for it is through this lengthy process that you are provided the opportunities to discover more about yourself, healing and freeing yourself from the captivity of the world. The pain will be unbearable at times but the rewards of true independence and freedom are vast. Let yourself fully feel all your emotions. Surrender to them as you claim the strength that lies deep within your being. Strength you had yet to harness before and burst from the flames as the warrior you were destined to become.

Not On Faith Alone

Life is a beautiful creature that ebbs and flows between the joyous moments and those of darkness and difficulty. All moments of life have the potential to become a positive, transformative experience as we navigate our way through each moment learning lessons, gaining wisdom and insight, and strengthening our minds and souls. Our successful navigation through life's most difficult times aren't contingent upon faith alone that we will resurface. Rather it is the combination of faith and action that brings us forth from the ashes and sets us free. The speed at which we break forth from the shrouds of darkness is dependent upon our own level of involvement in our life's path and recovery from life's struggles.

I have been coping with periodic bouts of depression since my first surgery 20 years ago and I have been struggling with a particularly long episode of depression for the majority of this year. Although I feel uncomfortable proclaiming that I have successfully found my way through this episode at this point, I am noticing improvements albeit small at times and greater at others. Depression is a roller coaster, taking us on great highs on our good days and great depths on our bad days. The better days are increasing in number and I have been able to start tapering off of my anti-depressant medication. I am in the process of scheduling counseling sessions as well. My process this year has been backwards as the combination of counseling and a regiment of anti-depressant medication is actually clinically shown to be more effective than one method by itself. Sometimes though the darkness is overwhelming and we are only able to handle and function so much before we are overcome with the heaviness of it all. To protect ourselves, sometimes we must tackle one issue or treatment at a time as we obtain a greater grasp on ourselves and the difficult situation we are facing before we are able take additional action. Making the effort though to tackle our struggles is a necessary action.

It is with this action that we are able to see how the pieces of life may fit together even when individually the pieces don't appear to fit or ever will fit. Often the pieces of life require our action to alter individual pieces or moments so that each may find its connecting piece, without our intervention and effort we merely prolong or halt the process of connecting together moments to allow for change within a situation. Looks can be deceiving until a combination of time and action help guide more pieces together, allowing us a clearer glimpse of the larger picture of life. With each glimpse our faith is renewed and our action gains momentum, furthering the cycle of recovery. Yet without this action, our recovery remains stagnant as we passively wait for the darkness to lessen and life to improve itself. We cannot idly sit by waiting for life's greater days without our own participation in the process and our life. Passivity allows life to happen to us, not us happen to life. Action with the faith that there will be better days empowers us to live life zealously and actively.

Stop waiting for a situation to change, for life to improve, for that one day. Your faith for those better future moments is screaming out for your action to join and help make that change. Life is ever altering the course; in order to succeed at our dreams and goals we must change with the course. Find new footing, modify our goals and efforts as needed, and play on.

Appreciating Death

Through my own near death experiences and years of losing loved ones, death has become a far too familiar part of my life. Others view me as having a death orientation and perhaps this is true. My own health scares have left me unafraid of the passage of this life into the next realm and I've become skilled at saying goodbye to those I love. One can't help but gain this skill when the majority of your friends and acquaintances are those with chronic illness - groups I've come to surround myself with personally and professionally. I can't count the number of family, friends, and patients I have lost over the years since I was almost 2 years old.

I traveled across country with my parents to say our final goodbyes to one of my great uncles. We resumed our yearly visits 6 years ago and as my great uncle's health began to decline and he transitioned from his own home to a nursing home, we began preparing with him. He was becoming closer and closer to his 100th birthday. He was tired and he was ready. Each year we wondered if he would live to see his next birthday and each year he continued to surprise us as well as himself with his longevity. The time was finally nearing. We surrounded him and attempted to comfort him during his bouts of pain. We voiced our love and understanding to him, letting him know that it was time to let go. As we parted with him on the second night, I told him that I hoped he would find peace that night. He turned his head and looked up at me with a knowing look in his eyes. I smiled, fighting back tears, and told him how I loved him and lightly kissed his forehead one last time. That night he passed into the other realm. At age 99, four months shy of his 100th birthday, he finally gained the peace he desired for so many years.

Death is a learning process for those preparing to enter the other realm as well as for those left behind. Someone facing impending death over a period time is given a gift of self understanding - learning the depths of one's fears, hopes, regrets, personal beliefs, and gaining wisdom and insight into the meaning of life and what is truly to be held sacred and important in life, rather than the fluff. This can be a time for intense self reflection that doesn't necessarily come easily to everyone until forced to consider one's inner depths.
No matter how many times we go through the process of losing a loved one -  saying our goodbyes or worse yet the inability to say goodbye due to no forewarning and contributing or participating in the funeral services - it never becomes an easy process, simply a familiar process. We know what to expect, we learn how we obtain closure and grieve, and we learn tricks to make the process and funeral arranging easier and smoother. We learn our own preferences for our own services and what is needed for arrangements. We learn about ourselves just as much as we do about others during such proceedings. Individual personality traits become transparent - whether good or bad traits.

Through death, we are able to appreciate life. I gain closure as I grieve through the sharing of life stories of my loved one. Through this process, I'm reminded of the wondrous times of my loved one's life and fond memories together. When I think of my loved one, I don't think about their death instead I think of the stories shared.
When one of my aunts who helped raise me unexpectedly passed away, I don't remember her death and service so much as I do the weeks and months following her death as I spent multiple evenings throughout the week with my parents, aunts, and uncles sharing family stories as we sorted through her belongings. As my grandfather's body gave way to stomach and esophageal cancer, I spent as many days as possible with him. When I recall his passing, I'm not reminded of his death but of being near him, falling asleep next to him watching television in his big over sized bed like I did so many times throughout my childhood.

Death and the events following one's death are not occasions for overwhelming sadness but rather a time to celebrate and honor our loved one. A time for family and friends to come together and honor the individual's life with stories so that the individual may live on in the hearts and memories of those remaining.

Travel Stress

I thoroughly enjoy traveling, learning about the local culture and exploring the sights. I long to travel the world, whether it be state, country, or continents and I have my own travel bucket list I'm completing. Yet the tolls of travel are becoming more evident over the years.  Driving 1200 miles over the course of two days was once tiresome but manageable. Now I plead for 3 days travel to reduce travel stress. Traveling 3 hours via vehicle to arrive at a destination for a single night has become an event I dread as I'm left requiring a day of recovery to feel rested again from such a relatively short distance.

My parents and I traveled to visit my great uncles and tend to the beginning of the last days of my eldest great uncle. We decided to fly due to the stress upon us from our 1200 mile drive. Even with less than a 5 hour flight, the day was proving stressful enough. Our plane arrived at nearly midnight, our one checked baggage hadn't made it on our plane but was following behind us on the next flight. A flare up was starting from my lack of sleep and rest and sharp pains began stabbing at the back of my knee each time I took a step. We decided to hold out during the hour wait to obtain our luggage and then was tasked waiting for a rental car and determining if we would be able to check into our hotel a night early while correcting the hotel's error for multiple reservations. After all was said and done we entered our hotel room around 2:30 am to sleep 4 hours before heading to visit my great uncles. Needless to say, we were all exhausted and requiring rest before too long.

What's the best ways to combat travel stress?

Firstly, starting your trip rested and energized makes a difference. Completing necessary planning and preparations for your trip beforehand allows for a more organized, less stressful start to your day. We need this energy and let's face it, most of us are already struggling with energy levels so we don't need to start off further drained than usual.

Know how travel and food will affect you. I know I do better with reduced fluids and food intake during periods that provide limited restroom access. Struggling to avoid restroom necessity when I'm unable to access a restroom is physically and mentally hard on me as my body becomes sore and my anxiety and frustration levels increase. Correctly timing my fluid and food intake provides increased freedom when I need it most.

Schedule your travel to allow for departure and arrival times that are optimal for your well-being. Do you function better early or late in the day? When do you usually start to run out of steam? Allow time for rest breaks to regroup, stretch, and walk to prevent blood clots, achy joints, or lodging for sleep to prevent exhaustion and decreased immunity. Make arrangements ahead of time if you fare better with handicap accessibility or assistive devices. 

Eat healthy during your travel and stay at your destination. It's easier to fall into the fast food traps while traveling but your body and mind will thank you for avoiding such traps. Fast food and other unhealthy foods leave us feeling sluggish. 

Take your medications to help keep you on track. It's easy to skip or forgo medications when our typical routines are altered. Consider adding immunity boosting supplements to your medication regiment after discussing it with your doctor. Zinc and Vitamin C are great immunity boosters. 

Plan activities that fit your activity level. Jam packing your days with various activities can give you great memories but leave you exhausted, wanting a vacation from your travel and time away. Give yourself some relaxation opportunities. 

Travel is a wonderful privilege and we are able to enjoy our travel experiences to the fullest when we take care of ourselves. So get out there and see the world, it'll change you!

Travel changes you. As you move through this life and this world you change things slightly, you leave marks behind, however small. And in return, life and travel leaves marks on you. Most of the time, those marks - on your body or on your heart - are beautiful. - Anthony Bourdain