SPEAKER_02 0:00

Hey, welcome back to part two of our series on advanced care directives. We are going to finish up with the rest of the wishes from the Five Wishes document and some ideas about how to make sure this document is legally binding and is kept up to date.

SPEAKER_00 0:16

That's right. As we mentioned last time, these tools won't solve every emotional challenge around death. It's not going to make it easy peasy, but they will remove the uncertainty and they'll help ensure that your values and the relationships you have with friends and family, they will know what your wishes are. And that way they can help make the decision that matters most to you if the time comes.

SPEAKER_02 0:42

Yeah. So thank you so much. Stay tuned.

SPEAKER_00 0:45

Yes. Stay tuned. Ciao.

SPEAKER_02 0:48

Welcome back, everybody. We are so glad to see you again. And Ana Luisa and I are really happy to be able to do part two of Advanced Care Directives working with the Five Wishes. So in part one, we talk mostly about kind of the more legal kind of things, the um important things to make sure you have a healthcare agent, etc. So please do watch part one if you haven't already. But now we're going to get into the last three wishes of the five three uh five wishes document. And we will have it uh here behind us so you can see and really recommend that you go to fivewishes.org to learn more about it. There's a ton of really good information there. Um, the next three wishes really deal with more personal, spiritual, and emotional things. Um, so you know what are you what's important to you and the way you uh are treated. So the first one is how comfortable do you want to be?

SPEAKER_00 1:42

That's right. And it's really hard to think about that in terms of um how will I feel? What what's gonna be happening? And you can't plan for every single possibility, but you can plan for there's a possibility that I won't be able to speak and have my needs heard. So this is why we just want to think about it ahead of time and just decide, you know, I'm okay with like the first one. I don't want to be in pain. I want my doctor to give me enough medicine to relieve my pain. Some of you may not want that, some of you may think that, you know, what's coming is coming and I'm good with that. But again, it's really important to just kind of check in with yourself, decide in this moment, this is how I feel, and then, you know, choose what are these wishes.

SPEAKER_02 2:32

Yeah, and and this is meant to um give you ideas.

SPEAKER_00 2:35

That's right.

SPEAKER_02 2:36

Um, and of course, it says you can cross out anything you don't agree with. Um so you know, different things around here. And I and you know, since everyone watching probably is a pretty good reader, and we won't don't necessarily want to read through them, but I liked some of them, like you know, uh having a cloth on your forehead and and keeping your mouth uh moist, those kind of things. Yeah, those are those can be really important. And so really think about it, and especially if you've had experience with it in the past with other people, think about what you know what they made of might have put down here and make sure you put in whatever you think of. Um I I think uh the other one I really like here, which some seems to sometimes, I think Ana Luisa, you were talking about one time going in and there's a person who just you know need just wanted their hair brushed, you know, just wanted to look good, wanted their makeup, you know, right? That that comes up.

SPEAKER_00 3:25

And um well, and and I you know, we don't know what people are experiencing when they're unconscious. Yeah uh we suspect that they're able to hear us. They just I suspect they're able to feel discomfort. And so some of these, you may think, of course, people are going to actually keep my my mouth moist and you know, clean my linens if they're dirtied. But you know, family members sometimes just get so overwrought and kind of become arrested in just this kind of in their head space around, you know, this is happening and I'm really scared. Uh, they may not do this. And I have walked into hospital situations with friends and and clients who I notice, you know, nobody's tending to the physical body because everybody's up around and thinking about it and talking about it and planning for stuff. And so, you know, oftentimes without really asking too too much, I, you know, go get a little warm washcloth, just like get the face done. I sometimes just put it on their hair too, because being in bed for a few days, your hair gets kind of hard and owy. And then, you know, is there a brush nearby? Do they have a favorite brush? Um, clean the lips. Sometime with some medical conditions, and I just experienced this for the first time. Uh, doctors don't want people using toothbrushes or anything near the mouth. And so the swabs are there for that purpose. Yes, because you know, people could begin to bleed out, but but you still want to make sure like the lips and everything are moistened and a really good dollop of of lip stuff. Um and I, you know, again, I you may forget to do this, but if you're with somebody who's going through this, but if you know that you think you're gonna want this, this is a great place to have that conversation. Yeah, because people will love a thing to do.

SPEAKER_02 5:20

Yes, that's right. Yeah. And and one of the things you just said, which I think is important to notice too, is um talk to the healthcare people who are there. You know, make sure that what you're gonna do is is called for, right? Not or not called for. So yeah, and and that's again, it's just a wonderful way to have a conversation about this. So and that's what we over and over again. The most important thing is having this conversation.

SPEAKER_00 5:41

Having these conversations, and you know, it's scary if uh let's let's say that it's at the end of your life, you are actually in the transition mode and you're actually dying, and maybe you're in a hospital, actually, or maybe you're not. It doesn't matter, but you're still in a bed, not reacting too much. And, you know, it's really lovely to if you're a very modest person and you don't want a lot of this stuff happening, you don't want people, you know, trying to make sure that your skin is taking care of everything. Be very specific. Like, you know, I was with another patient recently and I had friends come in and do foot massages and with some oils because they I could tell like people would need it as something to do, right? So um, but if you would never in a million years ever want somebody touching your feet in a moment that you feel vulnerable, yeah, you know, I don't want any of those things, you know. Maybe like keep me moist but in my face, but please don't touch any other part of my body. Yeah, and it's great to just have that idea and already and you know, can convince commit to discussing this with someone.

SPEAKER_02 6:53

Yep, so important. Yeah, and and there's also um, you know, after these wishes, there's also places you can write in other ideas, other thoughts that you might have. And um, so you know, as you've experienced things or if you talk, it really helps to talk to somebody who's done this work and can say, well, what about that? You know? So it's a really good conversation to have. Um, the the next wish really talks about how you want people to treat you, and it's similar, but again, it's more like um do you want them to be, you know, sitting around praying or singing or uh or chatting? Chatting, yeah, yeah. Who and this is another place you might want to put here um who you don't want to have.

SPEAKER_00 7:31

That's right.

SPEAKER_02 7:32

By your bedside, right? That comes up.

SPEAKER_00 7:34

Um yeah, and you know, I just noticed like I wish to be visited by a chaplain or clergy, and I want to just really quickly um chaplains don't necessarily equate to Christianity. So a lot of chaplains in medical settings are trained to be interfaith, and so you're not just signing up for somebody to come and you know, use the Holy Bible or anything else.

SPEAKER_01 8:00

Yeah.

SPEAKER_00 8:00

Um they if you are an atheist or spiritual but not religious, this is where you could put it too. And that person would come in and know this about you and not be creating a very different religious setting for you that is uncalled for.

SPEAKER_02 8:16

Yeah, it's so important, especially if you have yeah, if you're Islam, Islamic, um that's right.

SPEAKER_00 8:21

Maybe you want your Imam to visit you.

SPEAKER_02 8:24

Yeah, or you want to do uh Kirtan, you know. Um this is where you write it down. This is where you ask for that, you know. Um, and so this gives you again ideas that you can cross out if you don't like it, and places you can put other things. The last one, you know, what do you want to be called? Um in a lot of cases, people have changed their name or have different names that they'd like to be called.

SPEAKER_00 8:45

Right.

SPEAKER_02 8:46

So this is a good place to write that down, too. So it's just again a place to really think about what's what is your wish, what are your wishes and what do you want people to know?

SPEAKER_00 8:55

So and remember, sometimes this will be going on in a hospital, and sometimes it could be going on at home. So, you know, really kind of give a a good kind of foresight to the potential for like, will it be a bunch of neighbors at my house, you know, and do I want them all in there? So yeah, yeah.

SPEAKER_02 9:13

Or just yeah, or or what part of your family would you rather not to have show up?

SPEAKER_00 9:18

That's right. Or maybe you just literally want quiet and just to be doing this.

SPEAKER_02 9:22

Just by yourself.

SPEAKER_00 9:23

One person. You know, again, everybody's different. Everybody will do it exactly as they want to do it. No, but there's no right or wrongs for any of this.

SPEAKER_02 9:31

Yeah, exactly. But you do want people to know your wishes, and and they may or not, may or may not follow them. But the more you can talk about this, the more likely this is gonna actually happen. So that's right. Yeah. So wish number five gets into what you want them to know. And this is such a sweet thought. I think, you know, we we talk about this in uh podcasts, and we've had to we had somebody come in and talk about the two envelopes where you write down things or love letters to your family, you know. Um, so it's that kind of thing, you know. Just what would you like them to know about you? I uh forgiveness, you know, reconciliation. This is a place to kind of put those things down. Um, and just to, you know, let them know that you're not afraid of this, or maybe you are, maybe you want them to know that, you know, please re uh console me or comfort me because this is hard for me, or but whatever, you know, let them know what what you feel, how you feel about them. And I think that's a really sweet thing to do. And they call that uh legacy will. I don't know, there's a living will, I forget what they call it. There's a a name for it in Judaism where they um they actually specifically say, you know, you should write these love letters to your family. But I I think anybody anywhere could do that.

SPEAKER_00 10:39

And you know, I want to also it just occurs to me that not everybody has family, yeah, not everybody has close friends. And I mean, imagine being 99 and having outlived your whole community.

SPEAKER_01 10:53

Yeah.

SPEAKER_00 10:54

And if you have a five wishes and you get to this part and it feels a little uncomfortable or sad, I would say in spite of not having a physical person to write to, consider writing to yourself or consider writing to, you know, your favorite trees or anything you want. There is something to be said. You are not alone, even if you have no humans around you. There will be someone, something who will acknowledge and see you pass. So uh don't let this be a barrier to finishing this because you feel like there's really nobody and I'm I'm alone.

SPEAKER_02 11:37

Yeah, that's so true. And and and there's also, you know, you can write letters to the loved ones who have gone before you too, or the loved ones that might come after you. There's there's option, there's other opportunities. The other thing it says at the end here is uh what you want to have done with your body. Um, and there are a lot of other choices now besides very old recreation. I notice that so that's really what it says here. But um, you can uh put in the other choices, and and if you're interested in any of those, we'll probably have a podcast sometime about what other choices there are. Um and that the choices, even though they're not available in every state, pretty much we're finding, as we've done podcast episodes about this, that if even if it's not available in your state, the people who are uh making it available in the states where it's legal uh are often um quite open to having people come from other states. So if you have that if you have the capacity or the ability to um to go to that state, you know, those those are those things like uh natural organic reduction, which is composting or aquamics.

SPEAKER_00 12:40

Or I was gonna say funeral pyres in some states.

SPEAKER_02 12:43

Natural burials, yeah, yeah, green burials, burial at sea. Um those are those are all things that are out there and are available. So this is a thing to know. So yeah, that's the five wishes. Um again, at the bottom here, you've got things you can add. It's kind of like where you'd write your own obituary, right? Um you can write about what you'd like for your memorial, um, what you want your healthcare uh providers to know. And then there's a space for more if you want. Um yeah. And at the end, you know, there's the the signatures, um, witness statements. Most uh in different jurisdictions have different rules around what you need, whether you need one or two witnesses if you need to have a notary. Um, so make sure you check your own. And actually, um fivewishes.org will give you information on different states, different jurisdictions, and what their rules are. So make sure you get it done. And if you want to change it, it is a legal document, so you need to destroy the old one and make a new one.

SPEAKER_00 13:43

That's right. And it's also a living document in that as you change your mind, it can also be changed. It's you just have to go through this little signature process again. But it it is not forever, you know, chiseled into stone.

SPEAKER_02 13:57

Right, exactly. That's important, actually. It's important to go back and look at it. We my wife and I just went back and did ours again because you know, life changes, you know, you gotta you gotta keep up. And and also the people that you've, you know, as we talked about last time, or in part one, we talked about the people who you are asking to be your house agents. Um and to do this work, you you really want to make sure they're still thinking they'd like to do it. Still around. Yeah, right. Yeah. And still want to do it. You know, maybe they change their mind.

SPEAKER_00 14:24

So and I also want to quick note that uh five wishes can be done by anybody, as you can see, anybody over 18.

SPEAKER_01 14:31

Yeah.

SPEAKER_00 14:32

Uh you know, I always talk to families who have teenagers who are soon to leave high school. Generally, their senior year, they'll turn 18. At that point, if anything happens to them, they are legal adults and parents will not have the outright ability to just choose for them.

SPEAKER_01 14:50

Right.

SPEAKER_00 14:51

And so going through something like this together with your kiddo could really be beneficial to not only start the conversation for them, but also just, you know, have a conversation so that you could talk about yourself too.

SPEAKER_02 15:04

Yeah, you can get both done at once and keep them going. And then that's again, that's the reason to have the little um party at the end of the year or whatever, you know, have a setup party every year to get sit down and say, let's look at our advanced care directives and our and our other things that we're gonna our wishes for the end of life and make sure things are the ducks are all lined up, right? That's right. It does have a note here at the end what to do afterward. And again, you know, it's just like make sure everybody has a copy, including your healthcare people and your loved ones.

SPEAKER_00 15:33

So that's right. I want to just have you scroll back down to um the little statement about doctors, uh, your medical people. Um it was like, I guess it's up. Up okay, back up. Um there's a little part that says, what else would you like your um doctor, your healthcare provider to know about this? And you know, you might be thinking, well, if I'm in the hospital, they must know everything about me. Uh but I have to say, um, I have a friend who I worked with to finish hers, and she wanted to know that in no way, shape, or form could she have certain medications because it really affected her really poorly.

SPEAKER_01 16:12

Yeah.

SPEAKER_00 16:12

And so she's like, I don't know if like they'll know this, if like it's an emergency situation and I'm in the hospital and unable to like tell them. But she wrote down the list of the medications that are really, really bad for her. So, you know, if you have some information like that that may not easily be included in your health documents, uh if it's an emergency situation, it would be good to note that here.

SPEAKER_02 16:38

Yeah, yeah, good, good point. Yeah. Or or other treatments that you wouldn't want to have for whatever reasons. Yeah.

SPEAKER_00 16:43

That's right.

SPEAKER_02 16:44

Yeah. Great. Well, and and you know, hopefully, as we, you know, your doctor has seen this and that and that they all know this ahead of time, like you said, but it's never never hurts to reinforce that this is what you want. This is your your your wishes. So anyway, so um we hope that you will all go ahead and do this. And um, well, I just noticed you have to be 19 in Alabama.

SPEAKER_01 17:08

Yeah, I know.

SPEAKER_02 17:10

Yeah, but check check out what's it's what's true in your jurisdiction. Uh, make sure that you get it all taken care of and have your loved ones take care of it, your kids. Uh, and you know, this is really kind of a great way to get a conversation like this started, which can be difficult in with anyone, you know, with all of your girlfriends in your care. Um, there is a little card here we've talked about, you know, making sure people can notice this when they come in and if there is an emergency, the EMTs. And one way to do that is to um post it, you know, post a physician's orders for life-saving treatment, which probably will be uh another um podcast.

SPEAKER_01 17:45

That's right.

SPEAKER_02 17:46

You can talk about that and other things. But um, the other way is to have this kind of a card in your wallet and uh or you know, we even had people tattoo it on their chest, do not resuscitate.

SPEAKER_00 17:56

Yeah, although that's its own kind of issue if somebody calls 911. But I was gonna say, you know, you could also I I'm not sure how easy it is for people to uh for medical folks to open up our phones, but um you could also photograph this some of the or or you know, put this on your phone somewhere. I I know that I've heard people talk about there's a part on the phones that nobody actually needs to get into, but it's listed right on on the top part. So that is actually really cool.

SPEAKER_02 18:25

Yeah, that's a good idea. We should look into that further and you maybe let us know if you find out how that works.

SPEAKER_01 18:30

That's right.

SPEAKER_02 18:31

Yeah. Well, thank you so much for joining us this time around. Um it's always a pleasure, and we really appreciate you and glad that you're doing this work.

SPEAKER_01 18:40

That's right.

SPEAKER_02 18:41

Please watch the podcast, subscribe, and um spread the word and let us know how we can be a better service to you.

SPEAKER_00 18:49

Yes. Enjoy.

SPEAKER_02 18:50

Take care. Adios.

SPEAKER_00 18:52

Adios.

SPEAKER_01 18:54

Good for last conversation about the end of life.

SPEAKER_02 19:01

Thank you for joining us today. Thank you to Charles Heastan, the composer of the original music you are listening to now.

SPEAKER_00 19:08

And of course, thanks to you, our audience, and all of our amazing guests. Please come back next week for another great episode. Share this with your friends, family, and community. We hope you will subscribe and follow us on YouTube, Facebook, Instagram, Blue Sky, and TubTech. Each guest additional information will be found in the podcast notes. And of course, if you have a good end of life story to share, please reach out. We're always eager to hear from you.