Have You Attended a Death Cafe?

Death CafeAt a Death Cafe people, often strangers, gather to eat cake, drink tea and discuss death.

Their objective is ‘to increase awareness of death with a view to helping people make the most of their (finite) lives’.

A Death Cafe is a group directed discussion of death with no agenda, objectives or themes. It is a discussion group rather than a grief support or counseling session.

Death Cafes are always offered:

– On a not for profit basis
– In an accessible, respectful and confidential space
– With no intention of leading people to any conclusion, product or course of action
– Alongside refreshing drinks and nourishing food – and cake!

Death Cafe is a ‘social franchise’. This means that people who sign up to the guide and principles can use the name Death Cafe, post events to the Death Café Website (www.deathcafe.com) and talk to the press as an affiliate of Death Cafe.

Death Cafes have spread quickly across Europe, North America and Australia. As of today, 803 Death Cafes have been offered since September 2011.

The Death Cafe model was developed by Jon Underwood and Sue Barsky Reid, based on the ideas of Bernard Crettaz.

Death Cafe has no staff and is run on a voluntary basis by Jon Underwood in Hackney, East London. Also Lizzy Miles who ran the first Death Cafe in the U.S. and Megan Mooney who runs the Death Cafe Facebook page have played a significant role in Death Cafe’s development.

People often ask why the Death Cafes are so popular. Everyone has their own reasons for getting involved in Death Cafe. – See more at: http://deathcafe.com/what/#sthash.eYN3ZxOa.dpuf


Do You and Your Aging Parents Have a Digital Estate Plan?

ImageYou may be comfortable that your have your estate plan in order. You have a will, a durable power of attorney, a living will and a health care proxy. But do you have a digital estate plan?

In the past, we kept albums full of snapshots, vinyl records and shoeboxes full of correspondence. Now our photos are all on Flickr and IPhoto, our music is downloaded from ITunes and our correspondence is email via Yahoo or Google. Naomi Cahn, a law professor at George Washington University, stated that most adults have 20-25 accounts on the internet. And many of those accounts are for banking or investments.

Have you given instructions to your family on what to do with your internet accounts if you should die? And do they even know how to access those accounts? User names, passwords, internet addresses?

The family of Ricky Rash, a 15 year old who committed suicide in 2011, discovered how difficult it was to recover information from their deceased son’s internet account. In an effort to understand why he had taken his own life, they requested but were refused access to his Facebook account.

Facebook claimed that according to the Stored Communications Act of 1986 – the federal law that governs the protection of a person’s electronic data – even the account of a minor is protected from access by his parents or anyone else.  Other sites and providers interpret the legislation this way, making access all but impossible.

There are only five states that have taken any steps to help recover the internet data of a deceased person—Indiana, Idaho and Oklahoma legislation covers social media and blogging accounts, while Connecticut and Rhode Island legislation covers only email.

What does this mean for you? It is critical that you create a digital estate plan. The listing of internet accounts needs to be comprehensive. Information must include:

  • the name of the account
  • the contents of the account
  • the URL address
  • username
  • password
  • instructions for the disposition of the account including the person to oversee such disposition.

I have created a new spreadsheet to gather this information. Email me at rmauterstock@gmail.com and I will send it to you.

There is a whole new industry that has been created to service your digital estate including legacylocker.com, a new digital estate planning service. You can create an account and then enter your user names, passwords and wishes for each of your digital assets. You can specify an heir for each account; Legacy Locker will provide heirs with information after the account holder’s death is verified.

There are also online memorial services to celebrate your client’s life, including www.Bcelebrated.com, and www.MyWonderfulLife.com. These services enable your clients to create their own memorials before they pass away. Facebook and Twitter also offer these services for family members.

The importance of having a digital estate plan will increase as more and more of our assets (and access to assets) are online. Gradually laws will evolve to give family members access to deceased loved ones’ accounts. It is important to prepare your clients for the disposition of their digital assets now so that family members will not be unpleasantly surprised when they attempt to uncover them.

If you want to explore digital estate planning in more detail read Evan Carroll’s excellent book Your Digital Afterlife.  This book was the source of many of the sites I mention in this article.

Important Information You Must Save for Your Elderly Parents

Every time I speak before groups of babyboomers and their elderly parents I remind them of the importance of getting all their critical information down on paper or in a computer file that can be accessed by the family if there is an emergency.

What kind of information do you need close at hand? Copies of wills and trusts, durable powers of attorney, health care proxies and living wills should all be readily available. In addition the names and contact information for any family advisers(attorney, doctor, minister, banker etc.) should also be accessible.

Financial information such as the name and account numbers for bank and investment accounts should be listed. In addition the beneficiary statements for IRA’s, annuities and life insurance policies should be close at hand. Make sure these are up to date, and the beneficiary has not already passed on. Also make sure there are contingent beneficiaries listed if the primary beneficiary is deceased when the funds are released.

Last and perhaps more important than ever before. Make sure the internet addresses, usernames and passwords for any online financial accounts are readily available. When one of my clients passed away, his wife did not know the internet accounts he had utilized to manage his investments. The institutions would not give her any information about the accounts. She eventually had to hire an IT specialist to hack into his accounts and it took months!

A Guide for Babyboomers helping their elderly parents

A Guide for Babyboomers helping their elderly parents

Save info on important documents for your parents.There are a few ways to store all this information. One is a simple three ring binder. If you purchase my book “Can We Talk, A Financial Guide for Babyboomers Assisting Their Elderly Parents.” there is a section at the end of the book called the Lifefolio that has forms available for everything I have mentioned above. You can either tear those pages out or copy them and put them in the binder.

Another approach is to copy all the information digitally into a cloud system such as Dropbox or Google Documents. Then all family members who are authorized can access the information from any computer or tablet connected to the internet.

Whichever way you do it, do it now. You never know when there might be an emergency and you will need to access critical information for your parents.

It’s Time to Talk Turkey With Your Aging Parents!

Mom's 90th BirthdayHave you had a conversation with your parents regarding what they want to do if one of them needs extended care? Will they stay at home? Who will take care of them? I know it may be difficult to ask these difficult questions but the holidays may be good time to begin the conversation. You don’t want to wait until they have a medical crisis before you start planning. No one makes good decisions when they are under a lot of stress.

So how do you begin the process? Here are my suggestions to get the ball rolling:

Go to the website www.agingwithdignity.org

Download a copy of the Five Wishes Document.

Complete the document for yourself. It will force you to make a lot of decisions regarding how you want to be treated if you become critically ill.

Sign the Five Wishes document and have two witnesses sign it. If you are in one of 42 states this now becomes a legal health care proxy and living will. (Check the website for those states where the form is not legal.)

Make several copies of the document and save the original in a protected place.

Share the document with your spouse and children and make sure they know where the original is.

When you visit with your parents over the holidays share your completed Five Wishes document with them. Tell them what the experience was like filling it out.

Leave blank copies of the Five Wishes for each of your parents and suggest that they might want to complete them.

Check in with you parent a few weeks later to see if they have completed the forms. If not set up a time to review the forms with them and help them fill it out.

This process is a painless way to open up the conversation regarding your parents’ wishes for their care. You don’t have to ask them the questions directly. The form provides you with the tools to gather the important information. You just ask your parents to read the questions on their own and answer them privately when they are ready. And the process of planning their future care has begun!

Time to talk Turkey

Many families gather together during the holiday season. This is the perfect time to have a meaningful conversation with your elderly parents. But many of us have difficulty opening up a serious conversation with them. Let me give you some suggestions that will help to get the ball rolling.

The experts have told us that there are two things that dominate the thoughts of our elder parents. The first is the desire to maintain control over their lives, to be able to stay in their home, to continue to drive, to do what they want to do when they want to do it. But as their health deteriorates this is often hard to do. That’s when the second most important thought takes over.  “What will be my legacy? How will my family remember me?”

2600 families with elderly parents were interviewed by the Allianz Insurance Company. 70% of them responded that discussing how the parents would want to be remembered by their children was a conversation important to them. But when polled, only 30% of the families had made the effort to do so.

When was the last time that you asked your parents, “How do you want to be remembered by your grandchildren and great grandchildren? If you are willing to ask that question, close your mouth and just listen. And remember to listen carefully. Drop all your preconceptions of what they will say and how they will say it. Listen with an open heart.

But if you are not willing to open with that question, I suggest you start with a question that everyone is willing to answer, “How did the two of you meet?” That one was a shocker for me. When my mom was moving into assisted living I reviewed with her the important documents  that she held in a metal box. Amongst her legal papers, was an envelope marked “ Letter from Bob while overseas” This was a seven page poem that my father had written on his way across the Atlantic to fight at Normandy in the D-Day invasion. It was in perfect condition. It described how my parents met and their courtship and marriage. I was surprised to learn that my mother, at age 15, ( in 1930) had called my dad to take her to a party after they had met skating that afternoon. (She still denies it to this day).

Once the conversation starts to flow, it’s important discus other areas. Things such as, “ Have you thought about what you want to do if one of you becomes sick? Do you want to stay in the house? Who do you want to take care of you? You might mention what happened in other families when these issues were not discussed. The crisis and confusion that followed.

I’d suggest that you then share with them, a very valuable three page form, “Five Wishes”, a well organized and sensitive questionnaire that gives them the opportunity to write down their health care preferences in many different situations. It can be found at www.agingwithdignity.org. Don’t try to have them fill it out then. Leave it with them and check in with them at another time to discuss their answers. You can also read my book, “Can We Talk?” where I have a created a series of more that 20 forms to gather important information from your parents. You can find it at www.parentcareplanning.com

Do Not Resuscitate?

Many of us mistakenly believe that if we have gone to the trouble of having our parents complete a living will and have had an attorney prepare an advance directive identifying a health care proxy for them we have covered all the bases. But this is not the case!

Advance Directives and living wills are not accepted by Emergency Medical Services (EMS) as legally valid forms. If a patient has a living will that states that they do not wish to be resuscitated but does not have an appropriately filled out state sponsored form that is co-signed by a physician, the Emergency Medical Technician (EMT) will attempt resuscitation. This is a little known fact to many patients and primary care physicians that can cause patients to be resuscitated even if their family has given instructions not to do so. Although this law is currently being evaluated for a constitutional challenge it is still in place.

A do not resuscitate document is a binding legal document that states resuscitation should not be attempted if a person suffers cardiac or respiratory arrest. A DNR does not affect any treatment other than that which would require intubation or CPR. Patients who are DNR can continue to get chemotherapy, antibiotics, dialysis, or any other appropriate treatment.

The DNR documentation is especially complicated since each state has its own specific approved form. The DNR form for residents of the State of Arizona is required to be printed on orange paper or it is not valid.  The Massachusetts form can be obtained from the Department of Emergency Services and can be downloaded from the site: www.mass.gov/Eeohhs2/docs/dph/emergency_services/comfort_care_bracelet.pdf  It provides for a bracelet to be applied to the patient’s wrist.

It is imperative that you contact your state health and human services department to determine what form is approved in your state. The form must be signed by the health care proxy ( sometimes called the health care agent) or a durable power of attorney and cosigned by a physician. It is recommended that the original DNR form be kept in safe place, and that copies be kept in places that will be readily available to EMS personnel

Are you a good health care agent?

One of the most important jobs you may ever have is to be designated a health care agent or health care proxy for another person, possibly your parent. In this role you will make heath care decisions for them if they cannot make them themselves. One of the best sources I know of for the forms to designate a health care proxy is provided by www.agingwithdignity.org Their forms are approved in more than 40 states.

Aging With Dignity recommends that you do the following things to be a good health care agent/proxy:

1. Know your loved one’s wishes ahead of time. Ask questions when discussing their wishes with them so that you understand what they want.
2. Introduce yourself to the doctors and nurses caring for your loved one. Make sure that they know you and know how to reach you. Make sure that they have a copy of the document naming you as the health care agent/proxy.
3. Ask questions of the doctors and nurses and follow through with them as they are treating your loved one so you know that your loved one’s wishes are being followed.
4. If you run into problems, ask to speak to the social worker, patient representative or chaplain of the hospital or institution your loved one is in. If a doctor or nurse does not want to follow their wishes, contact the ethics committee of the hospital, hospice, or nursing home.
5. Be courteous but be firm. Sometimes doctors or their staff ignore a patient’s wishes if the health care agent/proxy doesn’t push for them.
6. Obtain a HIPPA release form and have your loved one sign it giving you authority to see their medical records. Without it you will be often be denied any information about their condition or health.

Aging With Dignity provides a document called “The Five Wishes” which allows your loved one to specify in detail exactly how they want to be taken care of. It also has a place for them to name their health care proxy/agent. It combines both a living will and health care proxy into one form. Once it is witnessed by two people and signed by the person it becomes a legal document in more than 40 states. Call 1-888-594-7437 or go to the website www.agingwithdignity.org to order the form.