The East King Trailhead(tm), the community quarterly for East King County

Your life, your terms: Plan ahead to make the end of life as blissful as the beginning

Writing the perfect ending

Admit it, you proud baby-boomer: Nothing in your life has been “your father’s anything,” right? He swung to Benny Goodman, you grooved to the Beatles. He worked 9-to-5 for wages, towed a trailer to Yellowstone for family vacations, and was handed a gold watch after thirty years with the same employer. You worked from home, coached your kids’ soccer teams, and hiked to Machu Picchu. He came home from work to a martini, cigarette, and steak-and-potato dinner. For you, an evening of racquetball followed by a finely-crafted microbrew hits the spot.

But now when you look in the mirror, you see that the hands of time are beating on you every second. Dad may be long gone. Perhaps those sedentary evenings and didn’t-seem-harmful-at-the-time vices sped up his departure from mortal life.

But that won’t happen to you, no sirree. You are going to live forever—at least to 100, right?

In the end, the bottom line is, unromantically, the same: Someday you too will be a memory. But the end of your life, that can be different, right? Better? Less conformist and more about what you want?

End-of-life care: modern, comfortable, peaceful

Unless you are lucky (or unlucky) enough to move on in the blink of an eye, you can contemplate not only your mortal existence, but how you will spend your final days.

“When my father was diagnosed with terminal cancer before he died in 1977, he took it stoically,” says Rob Luck, social service supervisor with Providence Hospice of Seattle. “He was grateful for the life he had and just wanted to be comfortable. He figured that was the way life was.”

Hospice care is a relatively new approach to end-of-life treatment. It gives the dying an alternative to being warehoused in hospitals or being isolated at home awaiting the end. Hospice care was developed in England in the late 1960’s, and the hospice movement began to take hold in the United States some ten years later. According to the American Cancer Society, “hospice care provides humane and compassionate care for people in the last phases of incurable disease so that they may live as fully and comfortably as possible.”

“People now are seeking a quality of life in their final days,” says Luck. “They may have always wanted that, but now they are more open to expressing the desire.”

While Luck’s father may not have had that option a generation ago, people today are seeking out hospice care. “We now have more than 500 people on our service most days,” says Lyn Miletich, Director of Public and Community Relations at Providence Hospice of Seattle. “That is up from 125 just a few years ago.”

Hospice workers provide a variety of services, including palliative care (pain management), social support, chaplain services, and medical assistance.

While staying at home is usually the most comfortable way for most to live out their lives, that is not always possible. Facilities such as Marianwood, located on the Sammamish Plateau, are now beginning to cater to those needing inpatient-type hospice care.

“We have converted some of our private rooms to hospice services,” says Jerry Hoganson, administrator at Marianwood. “There is a growing demand for them not only because of demographics or a wider acceptance of hospice, but because of lifestyles. Many people with an ill parent or spouse also work outside the home and are unable to sufficiently care for their loved one. Here, they know that they are being well cared for and that they can visit in pleasant surroundings. If something does happen and the person’s condition worsens, there is someone here to let them know immediately.”

Marianwood’s hospice rooms are contemporary suites appointed with quality décor and modern amenities like flat-panel televisions, cable, and wireless Internet access.

“[Hospice modernization] mimics the development of the birthing suites that became common in hospitals a generation ago when people waned a more comfortable, less sterile place for the start of a life,” says Hoganson. “Now it has been added to the other end of life.”

Fin: What do you want when the end comes?

Much to your chagrin, you have come to the end of your days. When you contemplated your demise, you recalled the stiff, formal funeral of a long-ago deceased relative. Big hearse, huge casket, everyone dressed in black. Ugh! Not you. Not your life. Time to be different. Time to be more personal and less cookie-cutter. Time to take control.

“This is a generation that has always dictated its desires and I am not seeing any change in that,” says James Noel, executive director of the Washington State Funeral Directors Association. Noel was a practicing funeral director for forty years before taking his current position seven years ago.

“I have seen a dramatic change,” he says. “There are still those who have a traditional funeral with a viewing, a chapel service and a graveside service, but those are becoming more and more rare.”

Noel says that people want to personalize their memorial and that he has seen that desire manifested in many ways.

“People want to hold a potluck in the backyard or even broadcast the service on the Internet,” he notes. “In the end, funeral directors now are here to serve the desires and needs of the decedent and the family.”

Want an earth-friendly interment? Consider a rapid-decomposition casket made from recycled cardboard. According to funeral director Noel, so-called “green” burials make up a small percentage of the funeral business, but are growing in popularity. He notes that the current trend in funerals is away from large caskets—Nearly two-thirds of Washington State burials involve cremation.

“With the cremated remains,” explains Noel, “you can take them and put them almost anywhere. People like that because it is a personal expression of the person.”

Document your end-of-life plans

Whether you choose a non-traditional memorial (perhaps cremation and a lakeside chili-feed accompanied by a Hendrix cover band) or prefer the classic viewing/chapel/hearse approach, Noel notes that you need to fill out an important piece of paper, even if your demise is by no means imminent. In addition to a will, a directive stating your posthumous plans—in as explicit detail as possible—will help your friends and family celebrate your life in the way that you choose.

“By putting your desires in writing, and having the document legally witnessed, you get to decide what you want,” says Noel. “By law, that document overrides what your spouse, children or siblings think you might want. And in an age when most people have had multiple marriages and maybe kids from each relationship, each child has an equal say, no matter where in your life they came along. It can be messy.”

Equally important he says, is to let people know the document exists. File it with a funeral director or an attorney, but discuss your plan first with your family.

“Remains get taken to a different funeral home than you might have chosen, and attorneys are not always immediately contacted,” Noel says. “People often only discuss their plans as they are driving away from the service of a friend or relative, and only long enough to say something like, ‘I don’t want a service like that, just wrap me in a sheet...’. They need to be more open and complete about what they want.”

Noel notes that he cannot begin to imagine what future end-of-life ceremonies will look like.

“All I can say is that there will always be a need to remember and be remembered,” he observes. ■

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