Author Archive

They WILL know what you wanted!

Hot off the press!

Now hear this!   A  travel with you everywhere Advanced Directive.

Talk about having your wishes on hand at all times!  In a situation where you can’t speak for yourself – now your phone can speak for you.

To be honest this might be one of the first aps I purchase.  It could be an inspiration to all those who love new technology to get their directive done.

Bravo to the American Bar Association!


WHY talk about your end of life wishes?

Here are some statistics worth considering:

  • Only one-third of Medicare patients die in the way they had hoped to – at home, surrounded by the people who love them. (Source: Medicare)
  • 17 percent of Medicare’s $550 billion annual budget is spent on patients’ last six months of life. (Source: Dartmouth Atlas Project)
  • 56 percent of seniors have not communicated their end-of-life wishes to family members.
  • Roughly 80 percent of people say that if seriously ill, they would want to talk to their doctor about end-of-life care, yet only 7 percent report having had an end-of-life conversation with their doctor.
  • 82 percent of people say it’s important to put their wishes in writing, but only 23 percent have done it.

Source: The Conversation Project

Ring the bells that still can ring …

A friend just sent me this quote. It’s such a good reminder that one needs to go ahead and do your best.

your perfect offering.
the bells that still can ring.
is a crack in everything.
how the light gets in.”
~Leonard Cohen

I am heading out to LaCrosse, Wisconsin to study the Gundersen Advance Care Planning System called “RESPECTING CHOICES.” Here’s the story about LaCrosse recently on NPR The Town That Loves Death. Sounds grim but you should look at the article as it is anything but!   There was also a commentary  The Town Where Everyone Talks about Death that followed. It  explains WHY this is a good idea.

I hope to return with a lot more data and know how for working toward these amazing benefits here.


A.B.D. (anything but death)

Just now- I was finally sending an email to the lovely woman I met in Vieques, Puerto Rico while we waiting for our ride to Bio-Bay.  She has an art gallery in Sante Fe, New Mexico called the Wonder Institute and gave me a postcard with a stamp on it, her address, and the words, “I WONDER….”   She gives these to people all over the country  asking them to send their response.

The evening I met her I was on my own. I gravitated toward her and her husband during our long wait ; it looked as though we were the only ones in the entire group over the age of 35 or so. Pretty soon I asked my usual question, “I’m wondering, do you two have Advanced Directives?”  I will keep their answers between me and them unless they wish to speak up. Meanwhile, I have been pondering my response to her “I wonder” card. Read the full article…

Rabbit! Tradition and Innovation…

“Rabbit!”  Say it before you say anything else on the first of every month!. That was the recipe for good luck that my Grandmother gave us. Over time I’ve discovered others who grew up with that tradition or something similar- saying BUNNY BUNNY before anything else. Hal, my RI Dad, as it is easiest to call him, took on the tradition with me after Mom died in 1994 and kept it up to almost the end. We either emailed or phoned “RABBIT” every month for years. It was telling perhaps when he finally said he didn’t want to do that anymore and stopped.

Traditions can be fun…some survive generations, others don’t. Sometimes traditions are revived.

This is what I am imagining may happen with end of life. In the “olden days” the place to die (of old age at least) was at home; the family doctor there to provide support to the whole family. Death was a normal part of life – just like birth. And both happened with your loved ones around.

Garden & Hospice 032Over time, both birth and death moved to the jurisdiction of hospitals.

For a while birth meant the father was sent off to pace or get drunk, the mother was drugged to oblivion so she wouldn’t have to feel anything and babies were promptly whisked away to a safe little box. It took the late 60s and 70s to bring birth back as a family event.

And death?   Due to the amazing advances in medicine, deaths generally happen much later on than they used to. There are all kinds of statistics about the new middle age – (60-80s)  when we get to have an additional 20 years or so of vibrant living. Death is largely a hospitalized event even though people say they want to die at home. Despite years of wonderful work by Hospice we have yet to truly turn the tide and bring death back into the family.  You have to know what questions to ask; what support systems to have in place and clarity about your wishes. The statistic from Center for Disease Control is that “70% of people say they prefer to die at home; 70% die in a hospital or nursing home.”

Innovation around death will be figuring out more ways to optimize both life and death: live for as long as it’s good to be alive and die in as comfortable and loving a setting as possible. The attention to this issue is ramping up. You are invited to  join in. Poke around this website and the links provided.  Comments are welcome.

The Serenity Prayer applies here!

“Grant me Serenity to accept the things I cannot change, Courage to change the things I can and, Wisdom to know the difference.”

Puerto Rico 2014 025In returning to active work on this quest of mine: helping people talk about and think about their end of life wishes — long before the end of their lives, the Serenity Prayer resurfaces as key. Clearly I cannot know that my efforts will actually make a difference.

Wonderful people and groups have already been  working on this goal. has superb language, information and resources.  If you find yourself stalling, procrastinating, believing you should get going but not doing so, call me. I would like to help in any way I can.

Read the full article…

Giving Thanks for Death ~

I just discovered a very clear and beautiful article by Alison Lester about her father’s death:

I hope you will have a chance to read it soon. It feels like a gift to anyone who is thinking about and discussing their end of life wishes. A year ago at this time Hilary and I were giving a workshop series.  The third week into the series my Dad went into the hospital and kindly Hilary and the participants decided to postpone the 4th session until after Thanksgiving.    A challenge was offered … to go home for Thanksgiving and talk about death.  I propose the same this year !

Over and over and over I am hearing how much early discussions ease the way for the end-of-life whenever it comes. And you simply don’t know when that will be. You can have one of those families (like Alison’s) who are full of caring and clear together about what their father wanted.  BUT – you have to talk about it or there’s a huge likelihood that the end will look very different.  Your holiday gift can be completed Advanced Directives .. REALLY!

This comes with my thanks to all those who have been thinking and writing about this — over the ages.

Gratefully, Joanna