Author Archives: admin1

Christmas in Space

As I write this, two astronauts of the six man crew on the International Space Station are outside the safety of their spacecraft, replacing a malfunctioning pump that’s part of the station’s cooling system. This is the real thing, in real time, not a Hollywood movie. The space station is traveling 17,227 miles per hour, completing over 15 orbits around the earth daily.

While they work to repair their craft at 250 miles above the earth, down below, millions of shoppers are orbiting parking lots at malls, racing against the clock to have gifts ready by Christmas. The pressure and frenzy that surrounds the holiday is a marketing marvel, perpetuated generation after generation, by retailers whose annual profits depend on those minions believing that gift wrapped stuff, delivered on time, is an act of love.

No matter what their spiritual beliefs were before they launched into space, the astronauts experience a transformation upon seeing Earth from that vantage point. They use words like awe, wonder, vastness, spirit, humility, infinity to describe their recognition that we are a tiny, fragile blue dot in a vast sea of black.

I can’t imagine anyone who relates to their experience feeling pressure to beat the Christmas deadline.

What the astronauts saw: http://vimeo.com/55073825. Share their awe and share it with your children. What an awesome gift that would be.

Sharing the Passage into Dying

Whether you think tweeting from a hospital bed is an invasion of privacy or not, this journey of a son holding his mother’s hand during her final journey is heartfelt and moving.

NPR’s Scott Simon Tweets From His Mother’s Hospital Bedside

ByDavid Wessel

: Will O’Leary; NPR’s Scott Simon

Scott Simon, host of NPR’s Weekend Edition, is tweeting from the hospital bedside of his mother, Patricia Lyons Simon Newman Gilband, as she approaches death — and has drawn 1.2 million followers to a moving, occasionally funny and very 21st century chronicle of one of life’s universal experiences, the death of a parent.

One Tweet posted on his feed reads “I am getting a life’s lesson about grace from my mother in the ICU. We never stop learning from our mothers, do we?”

I just realized: she once had to let me go into the big wide world. Now I have to let her go the same way.

— Scott Simon (@nprscottsimon) July 28, 2013

ICU seems to be staffed by good, smart young docs who think they know everything, and wise RN’s who really do.
— Scott Simon (@nprscottsimon) July 28, 2013

When my mother woke briefly I sang her My Best Girl. She replied w/ You Are the Sunshine of My Life. Broadway in the ICU.

— Scott Simon (@nprscottsimon) July 28, 2013

If we only truly realized how little time we have..,
— Scott Simon (@nprscottsimon) July 28, 2013

Mother asks, “Will this go on forever?” She means pain, dread. “No.” She says, “But we’ll go on forever. You & me.” Yes.

— Scott Simon (@nprscottsimon) July 28, 2013

Tried to buy coffee for family w/ a mother in ICU too. Barista overheard, refused my card. “Your money’s no good here.”
— Scott Simon (@nprscottsimon) July 27, 2013

What is the idea behind deep fried onion rings in a hospital cafeteria?

— Scott Simon (@nprscottsimon) July 26, 2013

I am getting a life’s lesson about grace from my mother in the ICU. We never stop learning from our mothers, do we?

— Scott Simon (@nprscottsimon) July 25, 2013

Married to an Optimist

If you’re married to an optimistic man who is also a procrastinator, beware. He’ll postpone taking action about things he doesn’t like to think about, often until it’s too late. I think of my friend Carol and her husband Ted.

The storm wasn’t supposed to hit until evening. “I’ll only be gone a few hours,” her husband had said. “ I have to meet this client before the weekend. We’ll review the papers when I come back.”

The storm hit early. The bridge held; her husband’s heart didn’t. When she got to the hospital, he was hooked up to life support. His eyes were closed; he couldn’t talk. His sons consulted with the doctor. They ignored her. Even after ten years, the boys still resented their father’s remarriage after their mother died.

Feeling invisible and helpless, his wife sobbed. If her husband survived, he would need heart surgery and extensive rehabilitation. His outdated estate plan, with provisions tailored for his first marriage, appointed his sons as holding durable powers of attorney. She would have no say in the matter. She knew the sons would not include her in their decisions. If her husband died, his previous will, still in effect, would benefit the adult sons from his first marriage.

A few weeks before his heart attack, they had consulted an estate attorney to bring the plan up to date and reflect their ten years of marriage. She had been so relieved when her husband finally acknowledged how frightened she was not to have financial protection in case something happened to him.

He was the optimist in the family, always expecting the best, looking for the silver lining around every dark cloud. She loved that about him; it balanced her own tendency to brood and worry about things she couldn’t control.

You have a choice – Create an estate plan, make sure you’ve signed the durable powers of attorney and know that you’ve done what you need to do about things you can’t control.

The other choice? Hope for the best.

The Problem with Entitlement

The daughter of a friend of mine told her children that they could go to riding camp this summer. Because of unexpected financial setbacks, she can’t afford to send them.

Instead of explaining to her children about her true economic situation, the daughter approached my friend and suggested she provide the money for her grandchildren to go to camp instead of taking her own long planned cruise. When my friend said she wouldn’t cancel her own plans, her daughter accused her of not caring about the welfare of her grandchildren.

This is an example of how entitlement obscures reality. It is a one-way mindset, a pattern of focusing on what we think we are owed in relationship without awareness of our own obligations. Children raised with entitlement, rather than learning a sense of personal responsibility, believe the world revolves around them.

Children and grandchildren need to learn the meaning of the words “We can’t afford it.” When you can’t afford, on your own, to do something, you explain to your children that they can’t have something until you can afford it, or until they earn the money to do it. Children can handle disappointment if you’re straight with them.

How else can you prepare children for the real world? Why should a grandparent give up a planned trip to send her grandchildren to horseback riding camp? Why would a daughter expect her to do so and accuse her of not caring when she refuses to give up her own trip?

“Money” Conversation Not About Money

Psychiatrists have long equated the reluctance to write a will, prepare an advance directive or estate plan, with fear of dying.

Who wants to think about planning for death? We have to confront our mortality. No more illusions that it won’t happen to us. We have to face giving up our possessions and power. We have to deal with uncomfortable subjects like aging, illness, death, inheritance and a host of other things we’ve managed to avoid thinking about.

Having the ‘money conversation’ is rarely ‘just about money’. It’s also about family dynamics, mistakes, regrets, guilt, and a host of other issues. Children feel morbid, greedy and intrusive asking their parents questions about money and death. The parents don’t want to start conversations about ‘touchy’ subjects either. The result – people procrastinate, hoping for the best. Hope is not a strategy. It’s a procrastination tool and most often, it doesn’t work.

Click the buy the book button:

www.moneyloveandlegacy.com/

Check out the guide for opening the conversations that matter between parents and children.Follow the check lists for what parents need to put in place so children aren’t burdened with a financial and legal mess after parents die.

It’s truly an act of love for parents to get their affairs in order.

The Gift of the Ordinary

The poetry of life often lives in the daily rituals, the ordinary activities we often do mindlessly without appreciating how lucky we are to be doing them. Not me, not ever again.

One of my favorite ordinary things is making coffee in the morning. Grinding and inhaling the aroma of the beans, filling the coffee maker with water, emptying the ground beans into the filter, and pushing the brew button. How much more ordinary can you get?

Ever since my husband died suddenly in an accident years ago, I’ve been aware that ordinary events can turn extraordinary in a second. The Boston bombings, 9/11, a plane or car crash, a fatal heart attack, a drive by shooting or the diagnosis of a terminal illness. These sudden events, woven into the tapestry of daily life, are reminders that the ordinary is a gift.

One of my favorite poets celebrates the ordinary. Jane Kenyon, who died of leukemia at the age of forty-seven, understood the importance of celebrating the dailiness of life.

Otherwise

I got out of bed
on two strong legs.
It might have been
otherwise. I ate
cereal, sweet
milk, ripe, flawless
peach. It might
have been otherwise.
I took the dog uphill
to the birch wood.
All morning I did
the work I love.

At noon I lay down
with my mate. It might
have been otherwise.
We ate dinner together
at a table with silver
candlesticks. It might
have been otherwise.
I slept in a bed
in a room with paintings
on the walls, and
planned another day
just like this day.
But one day, I know,
it will be otherwise.

Protecting Seniors from Financial Fraud

Be wary of any financial professional with letters after his or her name, especially those who designate themselves as a ‘senior advisor’.

According to a new report from the Consumer Financial Protection Bureau’s Office of Older Americans, Americans over 60 make up 15 percent of the population, but are estimated to account for 30 percent of investment fraud victims. Older people may have money they have saved for retirement, and cognitive decline may make them more vulnerable. They are also more likely to rely on recommendations from someone with a “senior advisor” credential.

That’s the problem. There are currently more than 50 “senior certification” designations in use. Who can tell the difference between A.R.A., an A.R.P.C., a C.S.A. or a C.R.F.A.?

The Bureau estimates that “tens of thousands” of professionals, including financial advisers, brokers and insurance agents, use some sort of senior credential. That means older adults will continue to be vulnerable to bad advice and even outright fraud.

Initials tell you nothing about a financial advisors training . Some credentials require a specific level of coursework, but others don’t require any.You can find out about the background of thousands of registered investment advisors at http://www.sec.gov/answers/iapd.htm.

John Lennon and Life

John Lennon sang “Life is what happens while you’re busy making other plans.” He wrote the words for ‘Beautiful Boy’, a song he dedicated to his son Sean.

I know another John. Last week, one of his lunch meetings was cancelled. Because he keeps his bicycle and helmet in the office, John is always ready for breaks like this. The sun had finally peeked through the clouds. A leisurely ride and he’d be back in time for his 2 o’clock meeting.

Two miles away, Robert’s wife was insisting on driving him to his doctor’s appointment. Irritated at how she and the kids were ganging up on him about giving up the car keys, Robert, 85 years old, wouldn’t listen to her.

“Stop badgering me. I’m just going two miles,” he said, slamming the front door as he left. Climbing into the Lincoln, he slowly backed out of the driveway.

Ten minutes later, along the tree-lined road that cast shimmering and confusing shadows, John was killed when Robert’s car hit him. John’s cell phone was ringing. His daughter was reminding him that they had a date to go shopping for camping gear that evening.

John’s family has no life insurance because John had delayed paying the premium. His wife, as busy with her company as he was with his, didn’t check if he’d paid it. Both their wills needed to be updated; neither could find the time to consult their attorney.

Robert’s family is in shock. Angry, frightened and remorseful, they’re consulting with their attorney about the legal actions they will face as a result of not being insistent enough with Robert.

We can’t see our own life unfolding. But our families will live with the consequences of how well we handle our responsibilities. Are your insurance premiums paid? Are you being too soft on someone who shouldn’t be driving anymore?

Or, as John Lennon puts it, are you busy making other plans?

Stanford Doctor Stresses Need for Advanced Directive

What is an advanced directive?

An advanced directive is a legally sufficient document that gives health care providers and family members information and guidance regarding care of a patient who does not have the capacity to make decisions for him/herself. The patient can fill out this five-part document on his or her own and is not required to see an attorney. Once the document is completed, a patient can either take it to a notary public or have it signed by two witnesses.

Who should have one?

Advanced directives are for all of us. The document speaks for the patient when they can’t speak for themselves. Even though a younger person may not think it is important to have an advanced directive, one of the most common reasons young people visit emergency rooms is trauma, and in such cases individuals can lose the ability to speak for themselves. Furthermore, a single person living alone may have no one to speak for him/her regarding resuscitative measures.

Most people don’t want to contemplate being in that position. How do you convince them that they should consider an advanced directive?

As a physician, I have seen numerous family members come in distraught because their loved one was not in a position to make decisions on his/her own and hadn’t made their wishes known. An advanced directive really helps family members make sure they are taking care of their loved ones.

How is an advanced directive different from a do not resuscitate order?

A do not resuscitate (or DNR) order specifically states that under certain circumstances the patient does not want to have various resuscitating treatments, such as cardio-pulmonary chest compressions or being placed on a ventilator. An advanced directive may contain these same instructions, but may also add specific additional instructions such as: “I do want pain control” or “I do want to be resuscitated, intubated and I do want to have nutrition.”

The advanced directive also goes further, detailing what is to happen if the patient expires — including whether the patient wants to donate organs or have their body go to research.

How would someone get started?

While state law requires certain provisions to appear in your health care directive, there is no single form in use to document your wishes. For information, see http://oag.ca.gov/consumers/general/adv_hc_dir. An advanced directive form can be downloaded here: California Probate Code Sample Form, pdf.

Notify your doctor, family and close friends about your end-of-life preferences. Keep a copy of your signed and completed advance health care directive safe and accessible. This will help ensure that your wishes will be known at the critical time and carried out. Give a copy of your form to:

The person you appoint as your agent and any alternate designated agents

Your physician

Your health care providers

The health care institution that is providing your care

Family members

Other responsible person who is likely to be called if there is a medical emergency

A person who has executed an advance health care directive may register information regarding the directive with the Secretary of State. This information is made available upon request to the registrant’s health care provider, public guardian, or legal representative. See http://www.sos.ca.gov/ahcdr/forms.htm.

Can you break out the five parts?

The first part names who you want to make the treatment decisions. The second part is the individual instructions you want carried out. The third part asks about organ donation. The fourth and fifth parts are for designating your primary care provider and including your signature, respectively.

Any final thoughts?

I have seen families whose loved one has not taken the opportunity to fill out an advanced directive where one was needed, and the decisions the family members had to make basically tore the family apart. Families are often thrust into situations they don’t expect. An advanced directive avoids much of the strife of very difficult family decisions. As a patient, I would not want my loved ones fighting amongst themselves about how to care for me. With an advanced directive, the medical issues are very clearly outlined.

From an article published in the Be Well @ Stanford News with Dr. Dana Welle, DO, JD, FACOG, FACS, physician risk consultant at Stanford Hospital and Clinics. https://bewell.stanford.edu/advanced-directive-dana-welles

The Ripple Effect

I was walking my dog a few days ago when I saw a tall blonde woman walking towards me with small slow steps. Holding a cane in one hand, and the leash of her large dog in the other, she seemed to be a paradox – a image of fashion, beauty, youth and vigor, yet she was taking small steps with a cane.

“He’s friendly”, she called out reassuringly. I loosened the hold on my dog’s leash. The dogs began their get acquainted ritual and we chatted a bit. Her name is Lois. I learned that she was recovering from a broken back injury, sustained when she fell down a flight of hardwood stairs. I asked how it happened. “There was some mud on my husband’s shoe after he walked the dog. It blended into the dark wood. He didn’t see it, I didn’t see it, and I slipped,” she explained.

“It’s no one’s fault. It just happened. I feel so lucky that it wasn’t worse,” Lois continued with a wide smile. “I used to run with the dog, but he’s learned to walk slowly with me. After two years of surgeries and rehab, I’m walking again. How great is that?”

We exchanged names and I said I’d look forward to seeing her again on the walking path. I haven’t seen her again, but I hope I do. I want to thank her for reminding me of something I know, but to which I pay too little attention.

It’s not what happens to us, but what we tell ourselves about what happens to us, that makes all the difference. I’ll try to remember that the next time I get irritated about something that wouldn’t even register on Lois’ scale.