We are pleased to welcome Susan Lieberman, Ph.D. to our blog for the third time – a real hat trick. Today she’ll be answering questions about her new book, Death, Dying & Dessert: Reflections on 20 Questions About Dying. As Susan has said, with more humor than you would expect in a book about death, Most of us believe we will die. We just don’t expect it in our lifetimes.
Her book, written in an easy and accessible voice, is for healthy adults of all ages. In 20 chapters, Susan takes you through organizational, emotional and spiritual issues to reduce anxiety about end-of-life, inviting you to think, talk and act in ways to make dying less frightening.
Susan, You’ve said you believe that talking about death is not dangerous but, in fact, life-giving. So let’s get started.
HMC: Why are people so reluctant to talk about death?
SL: It seems we human being are wired have death as our destiny but life as our deepest desire. It’s normal to want to deny death, to find it impossible to believe that our spirit, our soul, our essential self could just end – and, in fact, many of us don’t believe that will happen. Whatever we believe about what happens after our bodies give way, they will stop working.
I can’t promise an easy death, but if we can step out of denial for just a bit and put the right paperwork in place, learn enough factual information to help us make informed decisions and have conversations with those we love, it will reduce the chaos, anxiety, stress and even expense that often comes with dying.
I know some people are afraid that if they acknowledge the possibility of death, if they make a will, it will invite bad luck. I think if that were true the 30% of Americans who do have wills would have a disproportionate share of death…and they don’t.
HMC: What if you already have a will? Aren’t you done?
SL: I was one of those people who had a will. My husband and I had been to see an estate attorney and all the paperwork was completed. I just had no idea what it said or what it meant. My husband and I both stipulated in our advance directive that if we were dying, we didn’t want heroic measures…but we had never talked about just what and when constituted dying and what we meant by “no heroic measure.” We had never talked with our adult children about this. So, maybe you are done…but maybe you have just begun.
HMC: If you don’t own much, do you really need a will?
SL: There are a few situations in which people do not need wills, but it often not as clear and straightforward as you think. Here is what experienced estate attorneys tell us: Those situations are far less frequent than people think and avoiding a will all too often makes settling your estate far more expensive than if you had paid an estate attorney to draw up a simple will.
If your affairs are complicated, you will can address tax matters, succession agreements and the creation of trusts, but if your affairs are simple, it’s safer to put in place a simple will executed by someone who can make sure you meet the laws of your state. Different states have different rules.
HMC: Why worry about what happens after death…after all, we are dead?
SL: If one day we are fine and the next, life is over, then there is not much for us to worry about…unless we care about the family members we have left behind who are not dead and have to deal with a funeral, emotions, paperwork, disagreements. Really, do you want you family fighting, quite literally, over your dead body?
And if you don’t just go out like a light, then having thought about how to deal with difficult decisions can make dying much less stressful and chaotic.
HMC: How do you start a conversation with your family?
SL: Death, Dying & Dessert talks about half a dozen ways to begin but the very first place to start is with yourself, with what you think and feel, you hope for and hope to avoid. We don’t need to have all the answers…I’m not sure we can…but we can help the people who love us know what our thought processes might be.
HMC: What if you have parents who simply don’t want to discuss anything related to death or dying?
SL: Each of us gets to choose how to live and how to die. If a parent simply refuses to talk with you, that’s a choice you must respect…but you might try this: Dad, you have always done whatever you could for me, helped me in so many ways. It would help me now if we could talk just for 20 minutes about some end-of-life issues. I know you trust me, but it would quiet my anxieties a great deal if we could talk. How can I make this easy for you?
HMC: Is it possible to prepare for death?
SL: Are we ever fully prepared to die? I think for most of us there is a tension between our desire for life, always, and our biologic destiny, which is death. It is normal to favor desire over destiny, but if we can understand that, ultimately, destiny will win and spend just a little time dealing with all the stuff that life has put in place around dying, like proxies and wills, we can be more and better prepared and make things easier for ourselves and those who love us.
HMC: What’s an advance directive or living will?
SL: An advance directive is a document you sign that says if my doctors think I have six months or less to live, here is what I want them to do. You can say DO EVERYTHING or MAKE ME COMFORTABLE BUT NOTHING MORE or you can suggest something in between. Without your instructions, odds are good that the doctors will DO EVERYTHING.
There is a new document, called a POLST (except in NY where it’s called a MOLST). This is a patient directive. It is a doctor’s order signed by the doctor. It is for the frail elderly or people who are facing death soon and it explains in greater detail what you want. It carries even more weight than an advance directive because it is from your doctor and part of your medical record.
HMC: What’s a health care proxy?
SL: A health care proxy is something you absolutely want. It is a legal document that says if I can’t speak for myself in a healthcare crisis, this is the person who will speak for me. Perhaps, you assume it will be your spouse but you don’t know that he or she will be able to do this when you need it. Fill out the form. You can find it online and download it for free. Appoint your first choice and then at least one other backup.
But don’t just write the person’s name in. You really need to talk with that person about how you want to think on your behalf. The American Bar Association has a wonderful questionnaire in its healthcare toolkit regarding the proxy. It’s a series of questions you can answer and your appointed proxy can answer and then you can compare.
You want to choose someone who will speak as if they think you would speak, not as they want to speak and who understands you well.
HMC: Do you believe in afterlife?
SL: I don’t know. I have no experience with that. There are others better able to speak to this than I. My focus in not after death but long before death, right now. I want to encourage healthy men and women to put in place the structures that can make dying less stressful and chaotic.
HMC: Susan, thank you for opening up this important topic. It’s given us a lot to think about, both for our own planning and how we want to initiate a discussion with our parents. Readers, you can ask Susan your own questions through the Leave a Reply button below. And copies of Death, Dying & Dessert are available from Susan’s website, www.SusanLieberman.com or from Amazon.