A Daughter's Intimate Journey with Her Father with Yvonne Caputo on the Power of Advanced Directives

Yvonne Caputo, from Southeastern Pennsylvania, is deliciously semi-retired after a varied career. She began in education, moved to the area, and leveraged her second master's degree in clinical psychology to work in employee assistance. Eventually, she became the vice president of human resources for a retirement community, which was her last full-time job.

Her experience in the retirement community provided deep insights into aging, observing both the grace and struggles of residents and the critical importance of advanced directives. This perspective was invaluable when caring for her parents. 

Her experience informed her own end-of-life planning, including completing an advanced directive and the "Five Wishes" document. She has had thorough discussions with her children and stepchildren about her wishes, emphasizing not wanting them to personally care for her but to find a good place for her when the time comes.

A poignant story she shares involves her father, they went through the document question by question, leading to an intimate and precious moment between them. His wishes were witnessed and shared with his medical team, making his final days more comfortable and aligned with his desires. Yvonne's father passed away in January 2010. This clarity helped Yvonne and her family ensure his final wishes were respected.

Yvonne highlights the importance of these conversations and documents, not only for ensuring one's wishes are respected but also for the peace and clarity they bring to loved ones. She emphasizes that while such discussions might seem daunting, they often lead to profound and intimate connections, as they did with her father.

Through her work and personal experiences, Yvonne advocates for others to engage in end-of-life planning. She believes that these preparations allow individuals to live their lives fully, knowing that their final wishes will be honored. She continues to share her journey and insights, encouraging others to embrace this important aspect of life.

I’m thrilled to share my new line of death-positive apparel and items; a great way to bring meaningful conversation into style and support a small, death-positive business.

These shirts are designed for those of us who believe in open, honest conversations about death, dying, and grief. 

And if you’re a regular listener, I know you’re already death-positive and not afraid to spark these conversations. 

Transcript

[00:00:00] Yvonne: I don't grieve the loss of my father the way I grieve the loss of my brother and my mother and so many others. Because of Dad's trusting me with that information. Because of the intimacy that happened between Dad and I in the collecting of that information. 

[00:00:19] Jill: Welcome back to Seeing Death Clearly. I'm your host, Jill McClennen, a death doula and end-of-life coach.

[00:00:25] Here on my show, I have conversations with guests that explore the topics of death, dying, grief, and life itself. My goal is to create a space where you can challenge the ideas you might already have about these subjects. I want to encourage you to open your mind and consider perspectives beyond what you may currently believe to be true.

[00:00:44] Today I'm joined by Yvonne Caputo, who shares her journey from a varied career in education and clinical psychology, to becoming vice president of human resources for a retirement community. Yvonne's insights into aging and end of life planning, shaped by her personal experience and caring for her parents.

[00:01:04] led her to emphasize the importance of advanced directives. She recounts a touching story about discussing her father's end of life wishes using the five wishes document, resulting in a profound and intimate moment between them. Yvonne's father's peaceful passing at home aligned with his wishes.

[00:01:23] highlighting the clarity and comfort these conversations can bring. Join us as Yvonne advocates for end of life planning, illustrating how it allows individuals to live fully and ensures their final wishes are honored. Thank you for joining us for this conversation. Welcome to the podcast, Yvonne. Thank you so much for coming on.

[00:01:42] I'm looking forward to hearing more about your story. I appreciate you taking the time. And if you want to start us off with just a little background, where you're from, anything that you want to share. 

[00:01:53] Yvonne: Okay. I'm from Southeastern Pennsylvania. I am deliciously semi retired. I've had a varied career. I started out in education, moved to this area, and luckily had a second master's degree in clinical psychology.

[00:02:09] So I worked in employee assistance for a while and then moved into being the vice president of human resources for a retirement community. And that was my last full time job. 

[00:02:23] Jill: Oh, that must have been actually kind of interesting working there. Did you enjoy it?

[00:02:25] Yvonne: I loved it. I loved it. As a matter of fact, it really speaks to your topic.

[00:02:35] And that's end of life. Because working in a retirement community, I was able to see The positive, the negative, the in between, residents who were graceful in their ending years, residents who weren't so much, the problems that arose if people didn't have an advanced directive, so it really gave me a perspective on what it's like to age.

[00:03:01] Jill: Yeah, because I know most of us, we see it, right, we watch our family members and our friends aging, but it is definitely something that I think most of us don't always know how to do it well, and you mentioned the advanced directives, and the people that do it gracefully and are like, sure, I'm going to take whatever comes my way, and then there's the other people that are like, fighting tooth and claw, holding on, not wanting to go through any of it.

[00:03:29] It can really greatly impact how you spend the end of your life, depending on how you're going to approach it. 

[00:03:36] Yvonne: It really does. I'm so grateful because it gave me insight into not only how do I want to age, But when the time came, it was really important in terms of care of my parents as they got older.

[00:03:53] When mom had a surgery and she needed rehab, it was me that went out to look for a nursing home for her or a rehab facility. My brother, is in medicine. My sister is in medicine, but they didn't have that end of the experience. So they sent me out looking for the place where mom would stay until dad could take her home.

[00:04:17] Jill: Yeah. And there's usually that one person that does step up to do that job. Just a lot of us don't have any experience. We don't know the right things to look for. We don't know the right questions to ask. And it can make it really overwhelming and really difficult because even though we know our parents are going to age and die, It's not easy for us to see our parents aging and needing the care that they once provided for us.

[00:04:45] It's already going to be tough on us emotionally because of that, but navigating all these things that most of us have no experience with can make it even harder and even more overwhelming. And again, that's partially why I have this podcast, so that people can get more comfortable. talking about these things with their family members, they can prepare themselves a little bit better.

[00:05:08] So when they need to navigate it themselves, they can, because that's all we can do, right, is the best that we can with what we have. So we need to start now before we need to worry about it. 

[00:05:18] Yvonne: Well, it certainly has informed me. So, my advance directive is complete. I've also gone on and done this wonderful document called, The Five Wishes.

[00:05:28] And that's complete. I've had long conversations with my children and stepchildren. I've been very clear. I don't want them taking care of me. I want them to find me a good place. I've told them what they need to do in order to do that. How to navigate those waters. The other side of it is, not so much for my mom, I have great regrets there, but for my father.

[00:05:52] I was really able to do things for and with him that made all the difference in the world when his time came. Working in a retirement community, we had a position, the National Health Administrator. And this was the woman who made sure we followed all the rules and we documented care and we did all of the things so that when the audits came, we passed with flying colors.

[00:06:19] Well, she came back from a conference and she was so excited. And she was excited about this pamphlet called The Five Wishes. So she said a little bit about it and I asked her if I could borrow it. And She said, sure, just make sure I get it back. Well, it ended up underneath one of the piles on my desk. So one particular weekend I said, okay, I've gotta file stuff, I've gotta put stuff away.

[00:06:42] And out popped the five wishes and I opened it up and for the next hour and a half I read and re-read and read and reread, and decided I've gotta do this with dad. This is absolutely so wonderful. I've got to do it with that. My father was grumpy. I mean, he took grumpiness to the nth degree. He was really good at it.

[00:07:07] So as I'm driving six and a half hours across the state with the five wishes on the passenger seat, I'm thinking, how am I going to do it? When am I going to show it to him? What kind of a mood is he going to be in? And luckily, when I walked into his hospital room, he was hospitalized again. He was a brittle diabetic.

[00:07:27] The look on his face was bright and cheery, and I said, here's my opening. So, I told him what it was all about, and that I'd like to go through it with him. So, sat up in bed, put his legs down on the floor, sitting on the bed, Patted the seat beside him, still warm from where he was sitting, pulled the dinner cart up towards him and we sat and went question, after question, after question, after question.

[00:07:56] It was one of the most intimate things I have ever done with anybody. But in particular, my dad. I had done my research, so I knew it was legal in the state of Pennsylvania. And I went out to the nurse's desk and looked for two people to come in and witness dad's signature, and it was done. And copies went out to all of his medical personnel, anybody that I thought would need to have it.

[00:08:22] It was just done and it made things in the end so much easier, absolutely so much easier. Dad passed away in January of 2010. He was a Roman Catholic. And when my brother and sister finally got to my hometown, we were sitting in the priest's office and my brother said, well, father, I don't know how this works.

[00:08:46] And I said, well, here's what dad wants. He wants a high mass, he wants all the smells and bells, he does not want people to stand up and say things about him. He was very clear about that. He said, if they hadn't said it to his face, then they damn well better not be saying it at his funeral. So the whole funeral was taken care of.

[00:09:07] And he had been in the hospital, and I had been to visit, and the social worker approached me and said, When can we send your dad home? And I said, Well, you can send him when he's ready. My husband and I were back at the house no more than three hours when the phone rang, and my father was livid. He was screaming at me.

[00:09:28] I was holding the phone out because he was that loud. Why did you tell them that I could be released from the hospital? When he calmed down a little bit, I said, Dad, I said, when you were ready, but it doesn't sound like you're ready. And for one of the first times in my life, he apologized to me. He said, honey, I'm sorry I yelled at you.

[00:09:47] I said, you were just venting. It's okay. And then he said, can you come home? I'm scared. So, I got in the car the next morning. Actually, let me backtrack. I made phone calls. That evening, I found a nurse aide who could come and stay overnight with him. I found someone who could plow his driveway because it was snowing like crazy.

[00:10:10] I had everything I needed settled and I drove again six and a half hours across the state. I was there two and a half hours and he was gone, but it went exactly the way he wanted. What he had said over and over was, I want to go feet first out of my own home. And neighbors came over to help me do some work and we heard a thump and we went back and dad was face down on the floor.

[00:10:36] He had fallen out of his bed and he was pretty non responsive. Well, I'm not a nurse, so I called the EMTs, they came to the house, one of them helped me move dad out to an open space so that they could start working on him. And I said, stop. And they said, why? I said, he's got a do not resuscitate order. And so they said, we have to work on him as long as we're here.

[00:10:58] So I picked up the phone, called the department that he was in, said, get the DNR over to the emergency room, and then, smile of all smiles. The ER doctor called and said to the guys, you can stop working on him. So I laid down beside him and put my arm over his chest and told him that I loved him, told him that he was going to be with my mother, which is what he was saying he wanted to do.

[00:11:23] And then I did what we always did, which was the glue in our family, and that's that I said the Lord's Prayer in his ear, and he was gone. And so the EMTs put him on a gurney and took him out feet first of his own home, And if you can imagine Northwestern Pennsylvania, the snow is coming down an inch an hour, the ambulance is parked, the back doors are open, the light is shining, and they put down on the pavement, and the light shone across his face, and there was this soft, sweet smile, and I literally went, The EMTs looked at me like I had lost, you know, any kind of sense or sensibility, and I looked at them and I said, you just gave my father his dying wish, feet first out of his own home.

[00:12:13] And that all happened because I knew what to do. He had told me what he wanted. As hard as it may seem, those conversations were not as hard as I thought they would be. Once we broached the subject, then he was ready and very willing, very, very willing to talk about it. 

[00:12:35] Jill: And I'm so glad you said that because I say it all the time.

[00:12:38] The conversations are not as hard as we fear it's going to be once we get it started. It's like anything else, right? Sometimes the fear and the anxiety leading up to it is so much worse. And then once we start, we're like, oh, this isn't as bad as I thought it was going to be. I'm glad it's not just me now saying it, because I say it all the time.

[00:12:58] Yvonne: You're absolutely right. The first advance directive that we did with Dad was done in an attorney's office. I set that up for him. I said, it's really important, Dad, that you have your wishes legalized so that in the end, you don't get treatment that you don't want. You don't get treated in a way that you don't want.

[00:13:20] So in the attorney's office, she led it. Mike, do you want this? No. Mike, do you want that? No. So that part was all taken care of. He names me his health care agent. However, the Five Wishes takes it so far beyond what an advance directive is. I knew how Dad wanted us kids to think about him. I knew how comfortable he wanted to be.

[00:13:45] I knew what he wanted for his funeral. I knew how he wanted to be remembered. Any of the little nuances about someone's life was captured in The Five Wishes. And when we were sitting there in the hospital room, I just opened up the booklet, and we went question by question by question. Dad, how does that sound to you?

[00:14:07] Okay, that's okay. No, hon, I do not want to give my body to science. It's so old and decrepit, they're not going to find anything in there anyway. And no, I don't want people standing up and speaking at my funeral. I mean, all those little nuances about end of life were there. The beauty that I want to convey to your audience is this.

[00:14:31] I don't grieve the loss of my father the way I grieve the loss of my brother and my mother and so many others. Because of Dad's trusting me with that information. Because of the intimacy that happened between Dad and I in the collecting of that information. His picture is right over here on my desk, he and Mom.

[00:14:53] And I look at that picture and I still experience a sacred joy. It just fills me. Do I miss him? Absolutely. Do I end up sobbing sometimes? I miss him so much. Absolutely. Do I want to cook one more pot roast dinner for him? Absolutely. One of my books is about his experiences in World War II. I have tons of questions I never thought to ask him when we were talking.

[00:15:21] All of that's relevant. All of that's real. But equal to the profound sadness is this sacred joy. I would love other people. To experience that same kind of thing, having the willingness to do the work that makes it possible. Now it could have been that dad's death didn't end in that way, because we don't know, okay.

[00:15:46] But I was very fortunate that it did. The readers of my first book were really the ones who pushed me to write the second book, which is called Dying with Dad. When they had questions, the questions were, how could you do it? Didn't sure want him to stay alive. Where did you find the courage? All of those kinds of things.

[00:16:06] But, the beta readers, the people who read my book, to see how it flowed and that kind of thing, three different experiences came out of that. Let me know I was on a track. And it was the right one. The first one was a young woman in her late thirties. And her parents had tried to talk to her about death and dying.

[00:16:26] And her, response was, no, no, no, no, we don't need to do that now. You're going to be around for a while. I don't want to think about it. So shelving it. She didn't shelve it after she read the book. The second one was an older gentleman that said, Oh, you mean that's something I'm supposed to do? That's a good idea.

[00:16:45] And I said, yes, this would be really, really helpful for your children. So he purchased the five wishes. On his birthday, he said to his daughters, The only thing I want for my birthday is a Zoom meeting where we can talk about my five wishes. So they're doing this. They're going through it. They're talking about it.

[00:17:05] And they get to the spot and his dad's hurt. And the dad said, I want to be cremated. And the daughter said, well, what do you want us to do with your ashes? He said, I don't care. Do whatever's easy. You throw them over the bridge. His wife chimed in and said, you can't do that. So. The girl said to him, wouldn't you like your ashes spread at the farm?

[00:17:25] This man had grown up in a one room house on the prairies of Canada. Wouldn't you like your ashes to be spread at the farm? And his response was, you would do that? And they said, of course we would. We would be happy to do that. So what he did. He wrote his five wishes expressly asking for that to happen.

[00:17:48] The third one is the most powerful. One of the readers was Acute Leo and had been so for ten years. And when she read it, she got the five wishes. and sat down with her family. I learned that she had decided to go on hospice, but that her husband was making an opportunity for us to talk via Zoom. I was on the call with her, and she just kept saying, Thank you for the five wishes.

[00:18:16] I'm so ready to go, Yvonne. I'm so tired of the pain. I am so tired of not feeling like myself. I'm so tired of not being able to do anything. I have completed the five wishes. I've gone over it with my family. They're ready and I'm ready. How does life get any better than that? To know that, being responsible in a way of helping this woman to go out in a way that she wanted to go out.

[00:18:45] Jill: Yeah, you are partially responsible for that. And that's beautiful. And that's why I love the work that I do because I feel like I'm able to help people. End their life in the way that they really want to end it as best as possible. Right. Like you mentioned, even with your father, it could have gone a different way.

[00:19:05] Like anything else in life, if we plan for what we want, we're more likely to get what we want versus just letting things happen. I love five wishes and I'll for sure put a link in the show notes too. For people that want to purchase a copy, you can go online and purchase them yourself. I actually created my own, what I call end of life care plan that I.

[00:19:25] Go through with my clients based off of five wishes. There's a couple other versions plus things that I just wanted to add in because you're right. When you go to a lawyer and you fill out your advanced directives, that's very legal, right? It's got a lot of information that's very important, but the five wishes, any of these end of life care plans, it gets into so much more about how we want to spend.

[00:19:49] the end of our life, the music that we want, the sense, the lighting, where we want to be. I mean, all kinds of stuff, things that most of us maybe think about, we all kind of envision in our head where this is going to be and what it's going to be like. But like the young woman that you talked about, how often I hear that, that somebody tries to talk to their family.

[00:20:12] About what they want and the family shuts down the conversation because we don't need to worry about that now Well, okay, maybe you don't need to worry about it now But if you don't have the conversation now when you need to worry about it, it's too late to have the conversation That's when you need to know this information.

[00:20:30] And so yes, five wishes is amazing having the plan having the Conversations because I think that's part of it too is like you could fill out five wishes all you want to but if you just stick it in a drawer And don't talk to people about it. It's not gonna do you any good. And, you know, I was thinking, too, when you were talking about how you sat with your father at the hospital and you had the conversation, in a way, that in of itself is a gift.

[00:20:56] To have that experience with somebody that you love, to have that conversation, that's something I talk about regularly, is that the end of life is gonna be one of the most intimate times you can spend with somebody that you love. Because so much of our wall comes down, we're vulnerable, we're real. And yes, sometimes it can get messy and sometimes it can get emotionally overwhelming, but also it won't be as emotionally overwhelming if we prepare for it ahead of time.

[00:21:25] And sadness is part of life, right? We don't need to run from it like we all try to do and we can accept it and be present for the joy, the happiness, the sadness, the grief, right? All of it's part of what makes up life. And I feel like we live better, right? We can enjoy all of it more. So I love that you did that with your father and that you wrote the book so that you can share this with people so that more people will feel.

[00:21:55] It's almost like you give them permission to do this work, right? Sometimes we do need somebody to be like, no, for real, like start the conversation with their family. You need to do it. It's a good idea. Go out there and do it. It's beautiful. It's amazing. I love it. 

[00:22:08] Yvonne: And I would love to see your plan. 

[00:22:10] Jill: Oh, sure.

[00:22:11] Yeah, I'll send you a copy of the one that I created. 

[00:22:14] Yvonne: Okay. I would love to see that because things that you've said are not on my five wishes. For example, you will often see me with my ear pods in and depending on my mood, I'm listening to a specific kind of music. So if my family It senses that I'm not doing well.

[00:22:32] Stick the AirPods in and put on Swing, the 1940s Swing, because that'll cheer me up. I have a Pandora station that is relaxing classical. Put my AirPods in for that. So there are things that I need to say that I have yet to say. And I also know that where my five wishes is concerned, I need to go back and look at it again.

[00:22:55] And it's time for me to do that. Have I changed my mind? I'm beginning to hear a lot about green burials. Mm hmm. Yeah. I'm not sure I want to be cremated anymore. I, I don't want to add something to the atmosphere that doesn't necessarily need to be there. So those kinds of things. I did put in my own five wishes that if they were with me, I'd to cry if they felt the need to cry because the five wishes say something about being light and happy and crying because you're thinking about losing me is is a normal thing so go ahead and do it and to know that i am with you and i am holding you through those tears it's beautiful 

[00:23:37] Jill: Yeah.

[00:23:38] Right. We try to not cry because we think it's going to put the person in a place of like feeling bad too, but you're right. There's just this thing of we don't view tears in a healthy way. Tears are natural and letting them out and letting them flow is really going to release this energy. The energy in the room will actually change if we're honoring what we're feeling.

[00:24:04] So yes, I'm with you that I can be as okay with death as I am, but I'm still sad when people I love die, right? I'm not going to be happy and joyous about it, even though Being able to support somebody through that does give me a sense of joy. It does give me a sense of happiness to support somebody I love through it, but I'm still going to be sad and I'm still going to grieve and I'm still going to feel all the feelings.

[00:24:26] So just welcome them all into the room. 

[00:24:28] Yvonne: I'm a psychotherapist. And a long time ago, I was listening to another psychologist and I've used this over and over again. Sound mental health is the ability to contain the paradox. That's a lot to wrap your head around. You know, you can and you can't, you will and you won't, it is and it isn't.

[00:24:48] And yes, there is this sadness when I think of dad and mom and my brother, on one hand, but there's also a place for joy, and they're in the same spot. They're contained in the same spot. And I've looked for a synonym for contained and can't find one. What you're saying is so life affirming, that life brings opportunity for there to be negative as well as positive.

[00:25:12] And both are important to a full rich life. 

[00:25:14] Jill: It's shutting 

[00:25:15] Yvonne: them out. Shutting them out shuts a whole world away from people. 

[00:25:20] Jill: Yeah, I think there's a lot of religions that Speak to this idea of all of it existing, right? The yin and the yang, it's the visual representation across the wall, actually, from me, I have a couple different things posted up.

[00:25:33] And one of them says, I am everything and I am nothing. It's all and it's also nothing. At the same time, I have one that says the entire universe was created just for me. And I am nothing but dust and ashes. Because again, they're both real, right? This universe, this existence that I have right now. Even though sometimes my brain still has a hard time wrapping around it of like how we can all kind of view the world differently so we really all have different experiences, right?

[00:26:01] My universe is created just for me by my experiences, but also this body is nothing but dust and ashes, right? And they both all exist at the same time and I like to remind myself of all of that duality in life and There is pain and suffering. There's also joy and happiness. All of it is just part of this human experience.

[00:26:24] Our problem, quote unquote problem, is we cling to the joy and the happiness and we push away. We have an aversion to the pain and the suffering rather than just being like, all right, I'm going to experience all of it as best as I can without trying to hold on or push it away. 

[00:26:44] Yvonne: And from a therapeutic sense, again, that sound mental health is being able to contain both of them.

[00:26:52] But I also think of negative emotions as internal stop signs. Okay, if I'm angry, if I think about what I do at a stop sign, I stop. I look both ways. I want to see that it's clear. Well, if I'm feeling anger, why am I feeling anger? Stop. Say it out loud. Alright, once I identify, and by the way, when I say it out loud, I'm connecting with the thinking part of the brain.

[00:27:19] the frontal part that's called the cerebral cortex. I'm making myself think about, okay, I'm angry. Why am I angry? Then I can ask myself, what do I want to do with my anger according to my values? What am I going to do with it? Where is it coming from? How do I process it safely? If we don't do that, if we push that anger down or that frustration down or that anxiety down, and by the way, that front part of the brain gets hijacked.

[00:27:48] We're, we're very likely to go careening right through the stop sign, get creamed, and wonder what went wrong. Well, what went wrong was we had this feeling it was there for a purpose. We ignored it. 

[00:28:00] Jill: We, we do a good job of ignoring, and I don't know, sometimes I think people call it like our intuition, our inner knowing, right?

[00:28:08] Like the voice in our head that's trying to guide us, right? You call it whatever you want. But yeah, you're right. So often we'll feel things, whether it's the anger, or if it's just even like going into a space and being like, I'm not comfortable here. And I can speak from experience where I've gone into situations and been like, I don't feel good here.

[00:28:31] But I didn't listen to it because we're taught not to. And then I've ended up in situations where I've been hurt and then going, Oh, why does this happen to me? And then blaming myself. I'm so stupid. Why could I? All the different stuff. When really looking back on it, I'm like, you knew something wasn't right.

[00:28:50] Why didn't you listen? I'm really good at listening now. I shouldn't say really good. Better at listening, but when I was younger, I didn't listen well to it. And I think that's partially because when we teach children, we teach them to listen to the parents, listen to the teachers, listen to the priest or whoever runs our spiritual life.

[00:29:12] We're taught to listen to everybody else, not. Listen to ourselves. And yes, we do need to listen to the elders because they are there to guide us but there's still that part of us that sometimes we need to get better at listening and stopping and looking around and being like something's not right and there's It's part of me that's telling me this.

[00:29:32] What can I do to make sure that I can correct the situation? 

[00:29:37] Yvonne: I need to feel like I'm okay. I mean, the, the feelings were, were created if we go back to caveman, cavewoman, to keep them safe. If the caveman is out there and the mastodon or the saber toothed tiger comes around the corner, that fear that he feels.

[00:29:54] is a really good thing because it's going to help him to create an action, hopefully, to save his own skin. So they're there for a reason, but if we ignore them, it can be to our detriment. 

[00:30:07] Jill: Unfortunately, a lot of the times it does hurts us and it hurts the people around us. That's one thing, too, with my anger in the past.

[00:30:16] It didn't just hurt me, it hurt others, and it really is these cycles that we get ourselves into that. And then I think, again, with like end of life stuff, is so much of our regrets, and our shame, and our guilt. At the end of life is so tied with things that we did that we feel bad about, right? Not listening to ourselves, hurting other people.

[00:30:43] I know there was started off as a blog post and then I believe the woman wrote a book, but it's about the regrets of the dying. And so much of it is not listening to ourselves, even in the sense of like not living our own lives. We lived somebody else's version of our life because again, the people in our lives, they want us to do these different things for careers.

[00:31:03] We need to marry this type of person. We need to do all these things. And then people get to the end of life and they're like, Oh man, now I want to live my life. I need to live my life. I live somebody else's life. And unfortunately it's too late at that point. We can't go back and fix it. So that's why now we have the opportunity to make some changes.

[00:31:23] If we're not living a life that feels like it's our life. And 

[00:31:28] Yvonne: I think that doing something like The Five Wishes is a great opportunity to take a look at, if I'm really concentrating on the fact that I'm going to die, and what I want, and how I would like it to be, then I have to reflect about how am I living right now.

[00:31:46] I have thought for a very long time that when I close my eyes for the final time, I want to be able to say, It was good. It was really good. And simply, when life handed me lemons, I made lemonade. I loved that very kind of overused but simple quote. So that's really true, that the planning that we can do is a way for us to really self evaluate.

[00:32:14] The other thing is, I wouldn't give up those moments that I had with Dad for all the tea in China. Sitting on that bed with him and going over that document. And by the way, when it was signed and all that kind of stuff. I took his hand and we said together the Lord's Prayer. And to backtrack a little bit, my brother Mark died at the age of 26 in an automobile accident.

[00:32:43] And when you talk about regrets, we didn't know what he wanted. Here my mom and I are downstairs and we're picking out a casket, trying to think about what kind of a casket my brother would want to be in. That was the time. That's what you did. We didn't know. There's a regret there. When the last conversation I had with my mother, she was screaming at me.

[00:33:03] She was in the mid stages of dementia, and she was in the hospital. They were trying to medicate her to get her to settle down. That's the last conversation I had with her. I wish that were different. But balanced out with that now is the fact that I had the conversation with my dad. And when my brother passed away, we were in church for the mass.

[00:33:28] When it came time for the Lord's Prayer, we all took hands. And after that, any time we were together as a family, when it came time for the Lord's Prayer, we took hands. And the other thing that happened when Mark died was a commitment from all of us that there would never be a visit or a phone conversation that didn't end with, I love you.

[00:33:52] And that's been consistent with my brother and sister ever since Mark died. And it was the same with my mother. With my dad, it became the hug, and his grandchildren can even still tell you about this all consuming wrapped in this stalking man's arm hug. So, what you're saying is absolutely true. Those are the things that then when we lose somebody, we have the no regrets of saying the prayers, or remembering the hugs, or having the conversations, of diving in deep.

[00:34:26] Because we wanted to face the fear of what we were about to do, knowing what was possible coming out of it. 

[00:34:34] Jill: I'm sorry to hear about your brother. 27 is too young. And that's where, as much as none of us want to think about it, I tell people all the time, you're never too young to do this. You're never too young to think about it, to talk about it with your family.

[00:34:51] Because unfortunately, accidents like that happen to people and we can try our best, right? We could try to drive safe. We could try to wear seatbelts. We can try to do the best we can. But in some cases, no matter what we do, other people are going to do something that we can't control. And at 27, I'm sure nobody thought to have the conversation with him, right?

[00:35:16] Because 

[00:35:17] Yvonne: my granddaughter was diagnosed with leukemia. At the age of 17. She is now 23. She has been in remission for three years. She had to do the five wishes. Children's Hospital in Los Angeles had her do the five wishes. 

[00:35:33] Jill: Yeah. 

[00:35:33] Yvonne: So there really is an age when that document. Or documents like it can be accessed.

[00:35:40] Jill: And I'm 99 percent sure that 5Wishes has a different version even for younger people. Some of the things that they care about are going to be a little bit different than maybe what somebody that's a little bit older cares about. So there is actually two versions of it. My children are still young. It's either 10 and 13 now.

[00:35:59] But I try to tell myself every day to be grateful for them being here, for being happy and healthy. Because it can change at any point. 17, that's young. 

[00:36:12] Yvonne: It was very difficult to do because it was stuff that she was having to think about that she hadn't thought about before. But I found it pretty impressive that the hospital would guide her in that direct direction just in case.

[00:36:29] My personal care physician, my PCP, when I wrote the second book. I also had my five wishes go to him, so I talked to him about it. He went over and opened the cupboard door, and there was a stack of five wishes right in his office. So it's something that his specific hospital chain is advocating. 

[00:36:52] Jill: Yeah, my primary care physician is part of Cooper Hospital Network, and they have their own version.

[00:36:57] And I noticed one day they had a stack of them on the counter for people to take, and it was very similar to Five Wishes, but it's like Cooper Hospital's version. It's wonderful that more and more doctors are also helping to guide people, because I'm sure it makes their job easier as well. If people can fill these out and have the conversations with their family, it's going to make it easier for the doctors as well.

[00:37:20] Yvonne: Well, so many doctors struggle. What they're trained to do is to keep people alive. All of their training is through that. So it is very difficult for them to be able to let someone go. However, if they have that written permission, if they're able to have something in front of them, which basically says, Hey, doc.

[00:37:41] This is what I want. It makes it easier 

[00:37:44] Jill: for them. It does. And it makes it easier for everybody involved in this situation. And the reality is, we're all gonna die at some point. There's no escaping that. And actually going back to when you said how, when your father was being taken out and there was like the smile on his face and you were like, Oh, yay, this is wonderful.

[00:38:03] And they're looking at you like, was she okay? What do you mean this is wonderful? Again, it doesn't mean that we're ever going to be happy that the people that we love died, but allowing them to have the experience that they want. What greater gift could we give to a loved one than it is to really advocate and make sure that, because you're right, the EMTs, they're going to come in and they're going to be like, our job is to.

[00:38:30] To give CPR to resuscitate somebody attempt resuscitation when they're only doing their job But that's why we need our advocates like you that was Saying, hey, he has a DNR, making sure that you reached out to the hospital, that the hospital was able to contact them. In most states, you could get a POLST or a MOLST form, depending on what state you're in.

[00:38:53] It goes by different words. It has to be filled out by a physician. It's not like the five wishes you could just fill out yourself. It does have to be filled out by a physician, but you could put that in your house so that then the EMTs see that and they say, okay, nope, they don't want this. And that gives them the permission to stop.

[00:39:11] Because if not, they're gonna be resuscitated or attempted. They're gonna be taken to the hospital. Next thing you know, people are intubated. They've got feeding tubes. They've got all these things and they're saying, I didn't want this. This is not what I wanted. Well, we need to not only fill out the paperwork, we need to have our advocates that are gonna be there.

[00:39:30] To say, hey, they don't want this, let's make sure that this isn't what happens. 

[00:39:34] Yvonne: The hospital system that we belong to, St. Luke's, they have the blue plastic thing, and in it you put your fibrishes, you put your pulse, you put it in the freezer, and there is something that you put on your window. So that when they came in, they know to go to the freezer, and that in the freezer, there's going to be this envelope, which is going to tell them what they need to know.

[00:39:58] Jill: That's a good idea. It's an easy to find location. Yeah, everyone can find the fridge in the freezer. Yeah. Yeah, that is interesting, actually. I like that. I mean, I know ours are upstairs in an office drawer, and hopefully, Nothing will happen where it would be both my husband and I so we wouldn't be able to find it.

[00:40:16] If somebody was to come into my house, they wouldn't easily be able to find this paperwork because we've had our advanced directives done for many years because of the Terri Schiavo case happened before we were married. And I was like, nope, if anything were to happen to me, you're my person and we're not legally married.

[00:40:36] But I want to make sure that you know that I do not want that. I don't want to live like that. That's not living. Do not let that happen to me. So we did get ours done when we were younger. We were talking about your granddaughter having to go through the five wishes and how filling out the five wishes really does kind of make us assess How we're living now and that's one thing that I do with groups of people or individuals in some ways as I go through this depth bed meditation when you're filling out that paperwork, you're imagining it in your head, right?

[00:41:09] You're picturing it. You're going through this. And then when you get to the end and you're like, Oh, but that wasn't real. That's just paperwork right now. It gives us this feeling of, Oh, I have almost a second chance. Like I went through a little bit of this imaginary death and it wasn't real. Now I get this second chance to actually live life the way that I want, which is what sometimes happens to people when they have near death experiences.

[00:41:37] They go, Oh my gosh, I have a second chance. I'm going to take advantage of it. Well, the rest of us. Thankfully, aren't necessarily going to have the near death experience, so we can go through some of that experience on an intellectual level, right, on an imaginary level, but then still have the opportunity to live our life the way that we really want to once we're done.

[00:41:56] Yvonne: And I'm fortunate in that my mother had a near death experience. When I was born. 

[00:42:01] Jill: Interesting. 

[00:42:02] Yvonne: Yeah. When I was born, my mother was a very private person. She got a doctor's note that she didn't have to take gym. Now this is back in the 1930s because she didn't want to get undressed in front of the other girls.

[00:42:16] When she went into the hospital, when she was in labor with me, she asked for a private room, and there weren't any, and she was ticked. So she was in the room with another woman. In the middle of the night, the other woman woke up and heard this drip, drip. My mother was hemorrhaging. The roommate called the nurses, and my mother said, I was standing over myself.

[00:42:40] I was able to look to see what these folks were doing to me, and she said, I had the white light, I had the tunnel, I knew that your father was going to be okay, I knew that you were going to be okay, and my older brother Michael was going to be okay, and she said, I didn't want to be brought back. It was that bad.

[00:42:57] Wonderful. Yeah. So here I am. I'm not afraid of dying. It's the death experience of, of what that's going to be like. I like to move. I like to exercise. I like having a clear head. So the older that I get, what's that going to look at? That's the scary part for me. Not the death itself. Because, My mother had that 

[00:43:19] Jill: experience.

[00:43:20] I've talked to people about their near death experience. You try to put into words something that really can't be described by words, right? But one of the things that they said to me was kind of like how every day they are really looking forward to going back there. They're trying to appreciate life now, but they also were kind of like, yeah, but I'm really ready to go back there too sometimes.

[00:43:43] So that's gotta be a interesting experience. Being able to see that and be able to feel that it will all be okay is gotta be a really interesting way to live. 

[00:43:58] Yvonne: And now we're circling back to me working in a retirement community. My office was on the third floor. Unless there was a reason not to, my door was open, residents would come in and we would get to know each other and talk.

[00:44:11] And on many an occasion, someone would come in and say, Yvonne, I want to go. And my response was, tell me, tell me, and out would come, I'm tired, I'm in pain all the time, I miss my spouse, all my friends are gone, I'm just so ready. In that case, what I could do was just listen. And that was something that we tried to teach to the nurses and the aides and all of the rest of the, uh, staff.

[00:44:41] was not to say, Oh, don't say that. Oh, we would miss you. What you were negating was an opportunity to let someone say what it was they were thinking and feeling. There was nothing in any of these conversations that made me think that this was a suicidal patient. This was just a patient, or a resident rather, who just wanted to talk about where they were.

[00:45:04] In the late part of their 

[00:45:05] Jill: life. That is the only part that scares me too. It's not the death itself. But that's why having this conversation with your loved ones and thinking about what you want, you're less likely to experience some of those like worst case scenarios that we've all heard of, of the extended pain and suffering and people just really being in positions where they really would rather be dead.

[00:45:32] Then living the way that they're living. So glad that you advocate for this conversation. 

[00:45:38] Yvonne: And the first advanced directive for dad, the legally drawn up one, came because I sat on the ethics committee in this retirement community. And we had a case of a woman with dementia who could no longer speak for herself.

[00:45:52] She had an advanced directive, but it was from another state. And those little intricacies have to be considered as well. In the state where it was written, quality of life was a reason to deny treatment, not in the state of Pennsylvania. So, her case ended up in court, and the court said she will have two surrogates.

[00:46:14] The first surrogate will allow for the treatment that the doctor is recommending. If it doesn't work, then her daughter can come in as surrogate and say, stop. But here's this poor woman who's in limbo because her advance directive was from another state. And I said, I don't want that to happen to dad.

[00:46:34] Jill: Yeah. And that's not something I often think about either that especially nowadays, people move around so much. We might have something filled out and then think we're okay. We really do need to revisit this paperwork every, I think a lot of times they'll recommend on milestones, right? Milestone birthdays.

[00:46:51] If you get married, if you get divorced, if you had children, like those types of big things, if you get a diagnosis, any of those things for sure, but really revisiting it and reading through it and thinking about it again, because as we age, what I want at 45 is going to be very different than what I want at 85.

[00:47:10] So you need to keep revisiting these things. For sure. Well, we are actually about at the end of time. I will put a link to your books. I'll put a link to the Five Wishes so people can find it. Is there any other way that people might want to contact you? I'm on LinkedIn. 

[00:47:28] Yvonne: They can find me there and my email is Yvonne, author 4.

[00:47:34] Jill: at gmail. com. I'll drop it in there so people can easily find it. But I really appreciate you coming on today and having this conversation with me. I enjoyed it. And I know my listeners will as well. Thank you for coming on. 

[00:47:48] Yvonne: Thank you. It was a pleasure. 

[00:47:50] Jill: Thank you for listening to this episode of seeing https: otter.

[00:47:53] ai Death clearly. In my next episode, I talk with Christine Davies, the director of pastoral care at Robert Wood Johnson University Hospital. Christine's journey into hospital chaplaincy began with a deep connection to her Presbyterian church and early work as an EMT. As a seminary professor, she teaches the art of hospital chaplaincy, emphasizing the importance of presence, listening, and holding space for patients and families, especially during end of life situations.

[00:48:25] Christine discusses the challenges chaplains face. the impact of COVID 19 on spiritual care, and the importance of advanced care planning. She also shares her holistic approach to spirituality, offering support to individuals regardless of their beliefs. Join us as we explore Christine's compassionate work and the vital role of hospital chaplains in providing spiritual and emotional support.

[00:48:50] Support during life's most challenging moments. If you enjoyed this episode, please share it with a friend or family member who might find it interesting. Your support in spreading the podcast is greatly appreciated. Please consider subscribing on your favorite podcast platform and leaving a five star review.

[00:49:06] Your positive feedback helps recommend the podcast to others. The podcast also offers a paid subscription feature that allows you to financially support the show. Your contribution will help keep the podcast advertisement free, whether your donation is large or small. Every amount is valuable. I sincerely appreciate all of you for listening to the show and supporting me in any way you can.

[00:49:26] You can find a link in the show notes to subscribe to the paid monthly subscription, as well as a link to my Venmo. If you prefer to make a one time contribution, thank you. And I look forward to seeing you in next week's episode of seeing death clearly.