End-of-Life Planning: 

I am working with a 96 y.o. woman who, from my view, carries dementia graciously.  She's feisty. 

She's intelligent.  She nearly single-handedly raised her three children.  She loves to engage whomever is willing to converse with her.  Problem is, two of her kids live out-state, and the nearby child works full time and is trying to raise her own family--a sandwich generation kid.  I address part of the loneliness issue w/the elder.  I look at the deeper issues when she shares.  When I talk with her about her views on end of life, she becomes very engrossed.  She contemplates what the next life might be like.  She reflects on her own life.  She expresses her own views on her next journey.  She indeed considers deeply her point in the road, knowing she's about to enter another life.  She's fascinated by what might come next.  


To share with another human being such deep reflections is truly a special moment.  It gets to the core of what it is to be alive in this world, given that for some of us now, the journey is winding up.  It is these moments that I relish in working with older adults.  Many cannot approach this territory, especially with their own loved ones.  I did.  After 22 years of sole caregiving for my mother, I often talked with her about her thoughts and my thoughts about the next life, about her life, about her best moments, and her worst.  During the 27 day saga in hospice while she was dying, I especially talked with her about what I thought she might encounter in her journey to the Great Beyond (this is detailed in Birthing Death--a new book I've written where excerpts are posted below, and is now available on Amazon).  


The point is, if the loved one is receptive to exploring this aspect of life, I believe it is crucial to open up this sharing.  If a family member is not able to engage the dying person, Geriatric Care Managers and Hospice Chaplains are especially suited to this sharing.  I began as  Geriatric Care Manager and now that I am an Elder Law Attorney, the care management aspect is inherent in all that I do.  


Give serious consideration to exploring this aspect with your loved one.

 

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

June 18, 2014

LEGACY MOMENTS

The absolute, most favorite part of what I do is when I'm allowed the opportunity to do end-of-life counseling with an elder.  I thrive on asking the deeper questions of life.  "What's most important to you at this time of your life?"  "What's your most favorite memory?...Your most favorite movie or book?...What statement is your life making?"  For those elders that can understand the question and articulate an answer, the depth of the sharing can be profound.  


For those elders that are cognitively impaired, I believe that at some level in their soul, they understand the question.  I then work hard at trying to decipher whatever they may share in response, whether their utterings make sense, or are related to the question.  Oftimes, I am called upon to read between the lines.  


I'm reminded of a book I've read about hospice nurses that made it their mission to understand the seemingly non-sensical utters of their hospice patients.  They ended up writing a fabulous book, Final Gifts that I highly recommend.  A patient said he needed his "travel papers" to "go on a trip."  The nurse, picking up on this asked, "Are you going on a journey?"  George nodded and again said, "I don't have my papers."  The nurse continued, "Are you talking about a different sort of journey...maybe about leaving here?...maybe about dying?"


I talk about some of these vignettes in my book BIRTHING DEATH, about being with my dying mother for 27 days in her final hospice journey, about patient advocacy even when death is imminent, about working through family disputes about end-of-life medical treatment, and most importantly, about helping the dying loved one birth into a new world through their bodily death.


Be bold.  Explore the depths of your loved one in every opening they may offer.  Only step through the door, however, if they give their permission.

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

June 4, 2014

Goods Questions To Ask At End of Life


I met with a 96 year old woman yesterday in my Geriatric Care Management capacity.  She continues to wish me to read to her Birthing Death--the book I've recently written.  It apparently speaks to her about end-of-life issues.  It apparently touches upon what she presently contemplates.  I read a little, then ask her what this brings up in her. She readily replied, "I think heading to the gates (of Heaven) will be a fantastic journey," she shares.  How interesting to be able to access these deep thoughts.  


After a while, she began to tire, so I switched tracks and asked her about the funniest thing she ever did.  She mumbled on about riding a motorcycle w/her sister in the snow and rain.  I didn't know if this actually happened, but she sure had a good time telling the story, and that's the point.  It's important to find ways to access good feelings, whether the memories are accurate or not.  


I then asked if she had any unfulfilled LAST WISH.  After a considerable pause, she said, "I can't think of any."  I replied, "That's the mark of a fulfilled life."  She nodded her head.


Such questions, when well-timed, can be indispensable in helping the older adult feel a sense of meaningful contact with another, and completion of their long lives.  Never underestimate their healing power. 

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

June 29, 2014

Moments of Peace - A Different Mindset

There you are.  Mom or Dad is with you.  Perhaps the TV, radio or computer are on.  Perhaps you are texting or retrieving messages as you check in to see how your parent is.  But have you ever been THERE?  Have you ever really been present?  

Experiment.  Turn off the electronics.  Be PRESENT.  What happens?  Don't know what to say?  What to do?  You may very well feel compelled to turn something back on.  Anything is better than just sitting here with the anxiety of not knowing how to proceed.  But again, I call you to experiment.  Hold his hand.  Look into her eyes.  Just sit in silence together, being present to each other.  It's the best way I know for love to make itself known, to make itself present.  THAT'S the present.  Being present gifts you the present.  

I've done it many times with my mother.  Those are the golden moments I now often reflect on after her passing.  It costs nothing, yet it's the better than anything you can buy.  Experiment!

June 20, 2014

A DYING PERSON GIVES ME THE GREATEST GIFT...

Yesterday, I visited a 96 y.o. client in a hospital, being treated for an acute delusional episode, perhaps due to a urinary tract infection, perhaps due to advancing dementia, perhaps due to a combination.  I noticed a bedside sitter reading an interesting book and happened to think of a book about social justice I was carrying to read in a daily life's interminable "waiting" moments.  When I pulled that out of my bag, it then occurred to me to also show her BIRTHING DEATH--the book I've written about the 27 day hospice journey with my mother.  My client, although somewhat out of it and blind was nevertheless aware of what was happening.  She spontaneously and immediately remarked about my book, as in past weeks, I've been reading it to her at her request.  She shared to the effect that the book has touched her at depth, and is making her transition into the next life more joyfully anticipatory.  But the way she says it is simply the best..."It's a bridge."  Coming from one whose earthly flame is fast fading, it blew me away.  


She then added, "I'm frolicking in the wind."  I immediately picked up on her remembering the lyrics of a song included in the book that apparently touched her in ways I could not have known until that moment.  I've included Jan Garrett's song lyrics to LET HER GO, retold her...


   She's just as pretty as a picture, glowing thru the years.

   Light and shadow, all woven together...

   She send you her love forever,

   and a song to bless your soul...

   Singing in her bight spirit, 

   You can feel it, hear it.


    Let her go...let her dance...Let her run through the willows in the wind...

    Let her fancy sing and take her chances; Let her fancy free her soul.

    Let her go...let her fly...Let her throw back her head with laughter.

    Let her by, don't try to follow after...Let her go.


  She was the sun and the moon in the garden of your heart...

  The lifeline you could always come home to...

  And now it's her turn to venture

  Into new worlds of her own...

  So let your whole life caress her,

  Let heaven bless her.


    Let her go...let her dance...Let her run through the willows in the wind...

    Let her fancy sing and take her chances; Let her fancy free her soul.

    Let her go...let her fly...Let her throw back her head with laughter.

    Let her by, don't try to follow after...Let her go.


 Caught in a body of circumstance, 

 This day is too small for her soul...

 She'll slip out into the silence of a starry night,

 Barefoot all the way home.


​   Let her go, let her fly...say goodbye...Let her go.


 (see http://www.garrett-martin.com/music-store/albums/sypsy-midwife-songs-soul-retrieval to listen to the song and learn more.)  


My client then added that because of the song "I'm no longer afraid of death."


Ya just can't get any better than that!


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

July 7, 2014

End Of Life Discussions

Talking with older adults about the end of life...It's not something most families do.  And yet, I've learned that in doing so with my clients, there are invariably golden nuggets for both my and my client.  Yesterday,  a 97 y.o. shared how her mother visits her every morning to help her out of bed, and every evening to help tuck her in for the night.  She asked me if she were dreaming or this were real.  I suggested it could be either, but it didn't matter.  What was most important was how she felt about these encounters.  She said she felt good.  "Then there's your answer!"


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology