How to make end-of-life plans now

12:00 a.m. Friday, Sept. 9, 2016 Lifestyle

Debbie Pearson and Margie Jenkins want you to think about death — your own death and the death of your loved ones. They also want you to think about life — the quality of life you will have if you can no longer make your own decisions.

Pearson, a 68-year-old nurse who has lived in Austin her whole life, has written the new book “Age Your Way.” It makes the case that you need a plan for your medical care, your death and what will happen after your death. The book comes after years of working as a nurse and after starting Nurses Case Management in 2000. The company manages the medical care for clients who cannot make their wishes known or for people who need an advocate in Austin when their families live elsewhere.

“Age Your Way” is the first step to helping people think about their mortality. The next step will be “The Blueprint to Age Your Way,” which will be a three-ring binder where you can gather all of your important paperwork and write down your wishes and keep everything in one place. “The Blueprint” will be out early next year. Pearson will talk about “Age Your Way” Sept. 25 at BookPeople.

Jenkins has been a psychotherapist for more than 35 years and has specialized in helping people talk about end-of-life issues. The 93-year-old Houstonian has a book called “You Only Die Once” and created a six-session course on managing your end-of-life affairs by the same name. The course, which includes video instructions with some Jenkins humor thrown in, is being given at Riverbend Church beginning Sept. 18.

The time to think about your death is now, Jenkins says.

Jenkins reminds us that dying is not just for “old people.” “Every day in the paper are people who die — from infants to 100 years old,” she says. She likens it to talking to kids about sex. “When would be a good time to talk to kids about sex? I don’t think you should wait until the kid goes out on the first date. I don’t think you should wait until you’re on your deathbed to talk about death.”

Her course, Jenkins jokes, is “only for someone who will die someday or knows someone who will.”

Think of your end-of-life plan, funeral arrangements, how you want your personal property handled and what your legacy will be as the things that make a lasting impression on those you leave behind.

“To write a written plan for what you want at the end of life is one of the most loving and unselfish things you can do for someone you love,” Jenkins says. “It reduces a lot of that trauma and stress. We all know we’re going to die, but it’s treated like a secret.”

Putting it all in writing makes your descendants not have to debate your wishes based on their own recollections. “People have different memories,” Jenkins says. “You should write things down. This is what you want and this is what you like.”

End-of-life care and eventual death can cause family relationships to break down or even be destroyed. “Death can bring out the worst in people,” Jenkins says.

Jenkins has firsthand experience about how plans made in advance can help. She lost husband Bob “Jenks” Jenkins five months ago, suddenly. She was able to say goodbye to him, then her four children helped plan the funeral based on his wishes.

“Because we had talked about it, it was easier for all of us,” she says.

Her next work will be on life after the death of a loved one. “I lost the best friend I’ll ever have,” she says. “I still cry. … We had a wonderful life, and he had a really good death.”

Giving yourself and your loved one “a really good death” is only part of the plan. It should include how you want to live out your life. Pearson says most people don’t make plans and then something happens medically. “Family members are just scrambling. They have no idea what their family member wants. They have not a clue what the resources are.”

As a case manager, she often has to decipher the medical wishes of someone who can’t fully participate in decisions and someone she doesn’t really know well. She also encounters families whose members don’t all agree or are trying to manage a parent’s care long distance.

Pearson thinks of people planning for their care and death as being in three stages.

Stage 1: They are able to make the plans by themselves and let their heirs know their wishes.

Stage 2: They need help making the plans. They might be reluctant to make a plan, but they are still able to express their wishes and provide information.

Stage 3: They are no longer able to make decisions. Someone else has to do it for them, often in a crisis. Because of this, pieces of information are missing and the plan might not reflect what they wanted.

She would like people to start making their plans at Stage 1 or help their loved one make plans at Stage 2. Stage 3 is really too late.

The detail of the plans you need to make has changed over the years. When Pearson started nursing school in 1975, she says, doctors made all the decisions regarding your care. Now, “doctors have no idea who you are,” she says, and unless it’s life or death, because of liability, “doctors are not going to make decisions,” she says.

Many people think that if they have an advance directive document and a medical power of attorney, they are all set. Legally, maybe, Pearson says, but the advance directive only talks about life-or-death decisions such as whether they want a respirator or no respirator, CPR or no CPR. The quality of your last years is not in there.

Important decisions, such as do you want to stay in your home or at what point would you like to go to a senior center, should be talked about well before the time has come and be put in writing. Even less important preferences also can help. If you’ve always hated banana pudding, wouldn’t you want your caregivers to know that? Imagine your life with chocolate pudding instead.

Pearson and her husband, Hank Pearson, did their own blueprint two years ago in preparation for writing “Age Your Way” and the eventual blueprint. It took them a year to gather all the papers, write down all their wishes and make their plans. Every time they would think they were done, she would think of another consideration.

After that year was up, she sat her three children down with their spouses and went over the blueprint. It was uncomfortable and everyone cried, but now everyone is on the same page. The next year they updated the blueprint, and they again sat down with the children and their spouses to go over what had changed.

Here are some of the things to consider, gather up and put in one place — a place your heirs know about. It could be a safety deposit box or a safe in your house. Make sure they know the safe code or are on the safety deposit box slip. Don’t forget to have the conversation about your wishes and what’s in the documents before locking them up.

Consider these things: