Finding a way to a kinder, gentler death

FALLS VILLAGE — Mortality: It’s the proverbial elephant in the living room that nobody wants to talk about even as it stares you in the face. For Baby Boomers (ages 55 to 73), however, it’s increasingly a topic they can no longer avoid. Lynn Martorell Gumbert wants to help open the conversation.

“What people don’t realize is how many choices we now have” for how we want to be treated during our last days and after, said Gumbert, who led an adult education session on the topic at Housatonic Valley Regional High School over a series of recent Wednesday evenings. 

Part of the adult and continuing education program of Foothills, “Conversations on Death and Dying” got people talking about subjects ranging from hospice to massage, green burials to powers-of-attorney, and much more. Remarkably, the tone was upbeat, optimistic and occasionally humorous.

Gumbert is a trained and certified death doula. She provides companionship, guidance and resources that help honor and respect the wishes of dying people and their loved ones as the end of life approaches. Just as a birth doula assists with preparing for and easing entry into life, death doulas provide spiritual, emotional and social support before and immediately after death. 

Death doulas do the important work of helping people create death plans that spell out how they want their bodies cared for during and after the dying process.

Compassionate hospice

According to Gumbert, many people wish to die at home among loved ones rather than in a hospital — but their families don’t know what that entails or what resources are available to help from, for example, hospice. 

“People start the hospice process far too late,” she said, explaining that it can take weeks for Medicare to process the paperwork and for hospice services to be set up. 

People also mistakenly equate hospice with “giving up” on someone with a terminal illness rather than standing up for that person’s right to choose treatment that maximizes comfort and minimizes physical intrusion. 

Often families don’t know what their loved ones want, resulting in undesired intubations, resuscitations and prolongation of survival in a permanently vegetative state, she said.

The green burial option

Many don’t want a traditional funeral and burial. Several participants at the recent session asked about environmentally green alternatives to traditional funerary ceremonies, burial and cremation. 

Gumbert explained that there are multiple states now that allow “green burials” in unlined coffins or shrouds, and that embalming isn’t a legal requirement in the U.S. (In fact, embalming is rare outside the U.S. and Canada.) 

Several people said they were surprised to learn that a loved one’s body doesn’t have to be transported from the home for several days if the family wishes and has learned (from a doula or others) how to wash and prepare it for viewing or mourning. 

Gumbert showed how a family can wrap a loved one in a shroud. She advised against calling 911 when an expected death of someone with advance directives occurs at home, because responders are trained to attempt resuscitation. A hospice nurse or a doctor can declare the death and inform the county coroner’s office.

Directives

As for advance directives, you don’t need an attorney to make your desires legally binding. Gumbert shared with the group a document titled “Five Wishes,” that uses simple language and a question-and-answer format to spell out clearly what you want. 

When notarized, the “Five Wishes” document has legal standing in more than 40 U.S. states. Do you want to spend your last hours at home or in a hospital? Do you want people by your side? What music do you want to hear? Would you like massage? Do you want to tell your family and friends that you forgive them for hurts you suffered, and ask for their forgiveness? The Five Wishes process provides a forum for declaring these desires. If you do complete your Five Wishes document, make sure all your loved ones get a copy of the notarized form.

The group also reviewed medical power-of-attorney forms, another avenue for directing a peaceful, comfortable transition free of unwanted resuscitation or invasive measures. Designating a person as your intended agent in these matters can help families avoid the agonizing uncertainty over what you really want when you’re no longer able to speak on your own behalf. 

Baby Boomers are becoming today’s elderly. Increasing numbers are experiencing heart attacks, strokes, incurable tumors, incipient dementia. Yet only about half of them have any kind of recent advance directives in place, according to a recent survey.  

“People so often don’t know what to do,” Gumbert said. She’s determined to help change that. She hopes to offer the discussion sessions again early next year, and possibly set up an ongoing program where people can come in on a drop-in basis to ask, share, and learn about a subject we all must at some point face.