what's your end of life strategy?

[Riggerjack]

Yeah, people say that, but drug OD is an ugly way to die.
This was introduced to pop culture with the death of Marilyn Monroe. The idea that you could down some pulls, and go out quietly, and clean.
I would recommend doing some research, if this is part of your exit strategy.

[IlliniDave]

I really don't have one. An attorney friend of mine refused to put any instructions regarding a stack of pillows and my face in the event of a prognosis of a long semi-vegetative state (Alzheimer's, dementia, etc.) into my living will. What I don't want to do is what was alluded to at the start--piss away a ton of money on a worthless existence in a "home". I may try the old native American trick based out of my cabin in the Northwoods--pick an extraordinarily cold night and walk into the woods, sit down, and let hypothermia do it's thing. But that presupposes I'll have a period where the outcome is certain, known to me, and I have the wherewithal to do something about it.

What I might do is start gifting to my heirs early. The gov't will go back 5 or 7 years or something if you become destitute and take back any gifts you've made in that timeframe--so if I am able to do it for 15-20 years prior to going into long-term care, presumably my kids will at least get to keep some of it.

Otherwise, I'll be downsizing to a small 1-story bungalow, and I plan to stay physically active, not too heavy, and eat reasonably well to extend my ambulatory years as much as possible. I'm single-again without any real prospects of that changing, which typically shaves some years off a guy's life. Maybe the nursing home years is what that will shave off.

[steveo73]

Yeah, people say that, but drug OD is an ugly way to die.
This was introduced to pop culture with the death of Marilyn Monroe. The idea that you could down some pulls, and go out quietly, and clean.
I would recommend doing some research, if this is part of your exit strategy.

I'm pretty sure that this is what my Auntie did and it ended pretty easily. My grandad just got sick and ended up in hospital but he was dead in say 2 weeks time. It was the right way to end it.

I just don't want to end up losing my mind and spending a whole bunch of money for no reason.

[George the original one]

> I just don't want to end up losing my mind and spending a whole bunch of money for no reason.

Do you have something else to do with your money in the end?

[steveo73]

Do you have something else to do with your money in the end?

Fair enough if I don't go into debt but what if the kids have to pick up the bill. I'm not cool with that. I'm also not cool with going batty and continuing to live. I don't want to do that.

I'd like to die somewhat gracefully.

[Ego]

There is a temptation to believe that we can do something to prepare for each and every eventuality. We want to believe it and there are plenty who profit from the belief. That is one of the solaces that religion offers the believer. By being good and following the rules today, religious people believe they are somehow lessening the suffering they will experience in the afterlife. Some believe that they earn a sort of premium status with regard to answered prayers and the relief of suffering as a result of their goodness.

In this life, rich people with unlimited funds suffer in the same ways that poor people suffer. In fact, it could be argued that those with less wealth suffer less in that they are unable to prolong illnesses in the way rich people can.

There is a popular confusion between preparing for old age and believing that that preparation somehow makes death less likely. Ask someone in the grips of fear what they are trying to accomplish with their preparation and they will tell you, of course, they cannot eliminate death or the sadness their survivors will feel. But when you look at the bottom what they are trying trying to do is just that. They are doing it because doing something feels better than doing nothing.

I will die. Those I leave behind will be sad. Not much I do today can make that go away.

Other than the few ideas rigger offered in the original post, what are some of the other options available to prepare for what will eventually come?

[Chad]

Move to a state that allows euthanasia.

Make sure all assets have clear beneficiaries and your will covers all assets reaffirming where they go. Making your loved ones jump through extra hoops, because you failed to properly prepare for death is a miserable experience for them. You also don't want to surprise them too much or have them hunting for that old brokerage account you opened 20 years ago.

Some how become comfortable or as comfortable as is possible, with the inevitability of your death. This would be different for everyone.

I would suggest living in an easily walkable neighborhood (not a terrible idea for any age). Your age will limit your social possibilities enough. No need to be stuck in a house in the middle of nowhere. I realize this might not seem like an issue for us introverts, but even we need a little social interaction.

[steveo73]

In this life, rich people with unlimited funds suffer in the same ways that poor people suffer. In fact, it could be argued that those with less wealth suffer less in that they are unable to prolong illnesses in the way rich people can.

My uncle is rich and my auntie was poor. My Auntie died well whereas my Uncle is having a bad ending to his life.

what are some of the other options available to prepare for what will eventually come?

Honestly I think take care of yourself now and be ready to take you own life.

[NPV]

http://www.theatlantic.com/features/arc ... 75/379329/

tldr; Doctor says "Seventy-five years is all I want to live. I want to celebrate my life while I am still in my prime."

“Pneumonia may well be called the friend of the aged. Taken off by it in an acute, short, not often painful illness, the old man escapes those ‘cold gradations of decay’ so distressing to himself and to his friends.”

I'm not sure I agree with him but there is much to think about in that article.

The article puts forth many valid arguments for not aiming to prolong life beyond the threshold of high functionality.

The concluding "recommendation" (at least the one author gives to himself, as he reiterates the article is not a recommendation) is less clear to me, as it seems to neither optimize for high functioning longevity nor for lowest probability of survival in not high functioning state.

Instead, it gives a big role to chance - by declining all screenings and medical help, how do you know that you are not missing early stage of a disease which is easily curable at that point in time, but either fatal (thus losing years which you could still live as a high functioning adult) or worse, terminal severely reducing your functionality but not leading to a quick death?

This might be the control freak in me talking, of course, but relying on statistical probability for only 1 case (yourself) is risky - e.g.. It seems to me that mathematical expectation is actually not a great gauge for one-off decisions, because even if mathematical expectation of 100% probability of 1M USD and 10% probability of 10M USD are the same, the risk of the second one is much higher. Similarly, hoping for a particular outcome, even if statistically probable (e.g., that pneumonia or something similar takes you out before something like Alzheimer), would not necessarily be a decision with a comfortable risk profile compared to planned euthanasia in case of mental or severe and terminal physical illness, if something like the latter could be put in a will in a legally enforceable manner.

[mango]

I just saw this interesting article in the NYTimes - http://mobile.nytimes.com/2015/01/20/he ... entia.html

Basically, some people are writing advanced directives (which normally restrict procedures like CPR, etc.) to include restricting hydration and nutrition.

Also, read the comments - some interesting viewpoints there.

[Tom Young]

Strategy - An elaborate and systematic plan of action
As we near age 80, we're in the latter stages, but by no means do we look on it as an "end of life" plan. Not something we set up in our 50's or 60's or 70's, but adjusting to age as we go along.

So, yes, we have a will, power of attorney and advanced directives, but the process of aging for us, is just a work in progress, adjusting as we go along.
From being snowbirds, and then in 2004, moving to a home in a CCRC... from travelling, camping and higher levels of activity, to a slowing down, being content to stay home more, and looking ahead to the options for the coming years.
Aware of the onset of memory loss, dementia, Alzheimers or whatever, we begin adapting our lifestyle to ease into... to hopefully ease into the coming years.

This is not a big deal...not a structured five tier plan for what could/might happen, but a simple "as it happens" adjustment.
Some parts of the informal process:
Living in a regular home which is part of an extented care community. We can go from here, to apartments (one price for everything, meals, utilities, transportation etc) or if necessary assisted living, a rehab facility, or the nursing home or Alzheimer unit.
The family knows of our plans, and approve.
Simplify - everything, from organizing the closets and kitchen cabinets, to the shopping lists, schedules/calendar, money plans, paperwork filing, bill paying, and (beginning to be necessary) notes to ourselves.
Driving much less... very little night driving, and no more long journeys.
Increased health planning... food, sleep, exercise.

While I can appreciate that planning for death can be comforting for some, it's not in our plans. Not having been there, it's hard to predict what I (we) might do under different circumstances. Filling out the directives was an involved exercise, and while most look at the DNR as being "pulling the plug"... it wasn't that easy for me, and there are some 'what if's' there.

Our lives change every day. At this age, about 1/2 of the people who were born when we were born... are still alive. that means that about half of our friends are no longer here. We've had a chance to see this process, and to see how others have handled this part of life. For most, not as traumatic as might be expected.

And so... the later years, just another stage... like going to school, marrying, having kids, working, retiring... and now the later years. No big deal... just another happy adventure.

[jacob]

@Tom Young - What you're saying is really what I would expect.---That it's a matter of perspective. When far away, end-of-life is a matter of grand strategy [and probably not very applicable nor relevant], but when it's close, it's simply a matter of adjusting to the present reality. It's a converging approach/strategy.

The kicker is the black swans ... e.g. getting hit by a bus in an untimely manner(*). I think that might be left to other people too often.

(*) Those bus drivers really drive like crazy don't they?

[BeyondtheWrap]

I agree but at the same time I don't want to be a burden to other people taking care of me. I think my Auntie just saved up her sleeping tablets and popped them all at once. I'd like to die that way. Have a last meal and then state well thats if for me. Thanks for coming and pop the last 2 years worth of sleeping pills that night.

Probably if I was planning on doing that, I would get right to the point of almost taking the pills. Then my heart would start pounding like crazy and I would feel as if I am physically unable to proceed. Then I'd say, "Eh, maybe tomorrow. I have other things I need to do anyway."

Yeah, people say that, but drug OD is an ugly way to die.
This was introduced to pop culture with the death of Marilyn Monroe. The idea that you could down some pulls, and go out quietly, and clean.
I would recommend doing some research, if this is part of your exit strategy.

Do you know of any non-ugly ways to die?

[JasonR]

o

[Veritas]

Honestly, my end of life plan is suicide. Being alive is fairly nice at the moment, but I'm going to die eventually. I'd rather not deal with the downward spiral. I'll try basically every psychadelic drug, experience some major trips and states of altered consciousness for a few months, then off myself. I'll start this process when I start losing mobility, most likely.

[JamesR]

http://www.theatlantic.com/features/arc ... 75/379329/

tldr; Doctor says "Seventy-five years is all I want to live. I want to celebrate my life while I am still in my prime."

The article puts forth many valid arguments for not aiming to prolong life beyond the threshold of high functionality.

Wow, this is a powerful concept. I never really thought about drawing a line based on a threshold of high functionality, which is probably somewhere around 75-80 too. Will have to think on it.

[GandK]

I am in my hometown right now, dealing with this issue firsthand. (Crafting an end of life strategy.)

At 1:00 pm today I will attend a family meeting about whether to encourage my 87yo grandfather to go through rehab for his broken hip (which he dreads), or whether to encourage him to go to a nursing home or hospice instead because, unbeknownst to him, he also has a cancerous mass in his chest. And if he does get mobile and strong again via rehab, he would then move straight on to cancer treatments. How much to tell him, and when, seeing as how his current medical treatment has addled his thoughts, is the question. He had no clear plan. We are all now guessing at what he wants.

Complicating matters is the erratic behavior of his (second, unrelated to any of us) wife, who has been running around the hospital like a chicken with her head cut off, alternating between freaking out about his perhaps impending death and trying like mad to alter their prenup in her own financial favor. And ruining all her (until this very loving) relationships with her entire stepfamily in the process.

I am not looking forward to this in the slightest. It's been a hell of a week.

[J_]

@ GandK: It depends: are you the most appropriate member of your grandfather to discuss this with him? It should be the one how is most close to him in empathy and sympathy I think, who can discuss the situation with him. Who can gauge if it is good or not to let him know about the cancer. So that your grandfather is the person who can decide how to proceed.
And if you are not the closest one to him, let it then to the other, but never discuss it with him with more than one I think unless there is no different approach, that would be too confusing.
(When my father died, my mother was in a state of denial, and other siblings of mine not so close with him. So I choose to stay with him in the hospital, what later appeared to be his last day)

[Riggerjack]

Do you know of any non-ugly ways to die?

I do. This isn't such a difficult thing that with a bit of intent, someone couldn't figure it out with a Google search. But I won't put it out in the open. Suicides tend to be rash, and not be concerned with the consequences of their actions. My plan calls for creating the circumstances of my death, and at least as importantly, resolving those circumstances harmlessly afterward.

Insulin doesn't make for a nice death. The body desperately trying to burn all the sugars is not a peaceful prospect. I'm not sure adding sleeping pills would make it more so, internally. I know percocet gives me very vivid dreams of pain that I can't wake from. I would be afraid insulin and sleeping pills would be worse.

@gandk, I'm sorry about your week. Resolving this beforehand was my reason for starting this thread. Not that it does you any good now. Good luck, and try not to get caught up in any unnecessary drama.

[Dragline]

@gandk, I'm sorry about your week. Resolving this beforehand was my reason for starting this thread. Not that it does you any good now. Good luck, and try not to get caught up in any unnecessary drama.

+1. I think someone needs to tell your father about the cancer. Probably someone who is not a family member. Even if he is not entirely coherent, its better to get it all out there on the table.