1128 Final plans

We're going back to the funeral home this morning to finish our "pre-need" plans. We've learned a lot through this process and talked about things that just never came up in 45 years of marriage. For instance, flat, markerless cemeteries that look like prairies with urns of plastic flowers have little appeal, but we both liked the mausoleum, something we'd never considered. Some areas we just never came to an agreement, so we've pledged, "I'll do what you want, if you'll do what I want." No amount of talking was going to budge either of us.

One thing (among many) we didn't know is that you can't buy these services before needed--but you can purchase an insurance policy that covers in detail what you have selected, whether that is next week or in 30 years. Yes, you can designate an account from which all these expenses would be paid, but just make sure your spouse or children have access to it.

We also learned that although no one in our family was too excited about our pre-planning (reactions ranged from "What's wrong, are you sick?" to "No, no, no, don't even talk to me."), our pastoral staff was delighted. They have faced this problem with baffled and grieving parishioners many times, and they believe making the arrangements before you need them is a priceless gift to your family members.

We also don't agree on all the paragraphs in the Durable Power of Attorney for Health Care (Ohioans can download a copy free, so don't pay for one), particularly the hydration/nutrition clauses. Some of the most recent 2004/2005 research from medical journals I've printed out says withdrawing hydration causes unneccesary pain and discomfort and doesn't affect the outcome. The Living Will (included with the DPOA) appears to be a very scary document, and had no appeal to either of us, so we aren't using that.

You don't have to search too far through the medical literature to find that doctors and "experts" disagree on pallative care. Here's how I see it. Dehydration in a non-terminal patient causes immense suffering and complications, so why add that to the burden of the dying patient? There is plenty of research to show that hydration makes the patient more comfortable, and it does not extend the life of the dying.

Both these documents, the DPOA and the Living Will, link "artifically or technologically supplied nutrition or hydration." I think you need to look very carefully at that and read the research. The Journal of Clinical Oncology, April 1, 2005, v. 23, n.10 reported there is a disconnect between what is done in the clinical setting and what is done in hospice, but "studies suggest that hydration can reduce neuropsychiatric symptoms such as sedation, hallucinations, myoclonus, and agitation."

No matter what you select for a funeral, even cremation, or buying your casket from Montana and using it as a bookshelf until needed--it isn't cheap. So you might as well make the decision when you are not traumatized, ill or overwhelmed with grief. Even the death certificates cost $15-25 (depends on the state), and you'll need one for each bank or financial institution.

Oh yes, something else we learned: obituaries are more expensive on the week-ends, so die on Monday if possible.