Advance Directives - A Guide to Documenting Your Healthcare Wishes

If you are incapable of making medical decisions, who would you want to speak for you? How do you let them know what is important to you in your care?  We discuss the importance of preparation at any age, how to do it, and what resources are available to help. Show notes: https://bit.ly/4iSwqci

In this episode we delve deep into Advance Directives. We often have misconceptions that advance directives are only for older people or people that are dying. But did you know the whole reason they exist were from two young people that had terrible accidents, leaving friends and family members to fight for what they knew they would want? These documents are valid for anyone 18 or older who want to take control of their own bodies.

In this Episode:

• 00:00 - Intro: Five Wishes and Advance Directives
• 01:13 - Ways to Communicate Your Wishes
• 03:44 - Intro: S1E09 Rebroadcast
• 04:41 - St Germain Cocktail
• 06:27 - History of Advance Directives; It Actually Arose from Young People
• 18:43 - How Advance Directives Work
• 24:34 - Healthcare Proxy
• 26:59 - It Doesn't Have to be All or Nothing - Tailor Directives for Situation
• 29:33 - Artificial Food and Fluids - Situations to Think About
• 33:18 - Durable Power of Attorney, Living Will, and Will
• 39:06 - Why Does E1D Have a 3rd Half? 
• 40:08 - Interview-A Daughter's Perspective on an Advance Directive Decision
• 46:45 - How to Protect Yourselves from Scams
• 51:03 - Outro

Bonus: Have you ever wondered why we have a "Third Half" in our episodes? Listen  to the explanation (39:06) and learn its roots in a rugby tradition.

Chapters

• 0:00 Intro: Five Wishes and Advance Directives
• 1:13 Ways to Communicate Your Wishes
• 3:44 Intro: S1E09 Rebroadcast
• 4:41 St Germain Cocktail
• 6:27 History of Advance Directives; It Actually Arose from Young People
• 18:43 How Advance Directives Work
• 24:34 Healthcare Proxy
• 26:59 It Doesn't Have to be All or Nothing - Tailor Directives for Situation
• 29:33 Artificial Food and Fluids - Situations to Think About
• 33:18 Durable Power of Attorney, Living Will, and Will
• 39:06 Why Does E1D Have a 3rd Half?
• 40:08 Interview-A Daughter's Perspective on an Advance Directive Decision
• 46:45 How to Protect Yourselves from Scams
• 51:03 Outro

Transcript

Advance Directives a Guide To Documenting Your Healthcare Wishes

Hello and welcome to Everyone Dies, the podcast where we talk about serious illness, dying, death, and bereavement. I'm Arianne Matzo, a nurse practitioner, and I use my experience from working as a nurse for 46 years to help answer your questions about what happens at the end of life. The staff at Everyone Dies are taking a much-needed holiday break.

Today, we are republishing our podcast about advanced directives. An advanced directive is a legal document that outlines medical care preferences. It includes instructions on treatments you want to accept or refuse, and who you want to make decisions for you if you can't.

There are many different ways to document your medical wishes for the end of life. It doesn't matter if you're young or old. Everyone dies, and we don't know when that will happen.

Therefore, completing an advanced directive is an important gift you can give to those left behind. Having an advanced directive makes the decisions your family has to make so much easier, and they don't have to spend the rest of their lives wondering if they did what you wanted. Tell them they can do it, and one layer of guilt can be removed from their lives.

There are a few ways to communicate these wishes, and the easiest is using an advanced form from your state. Just google advanced directive followed by your state's name, and the form will come up. You can print it out or request one sent to you.

You do not need a lawyer. You can fill it out and have it witnessed by two people who you've not named as your durable power of attorney. Easy peasy.

Another option is a form called Five Wishes. Information as to where to find this is in the show notes. What makes Five Wishes different is that it asks questions about your personal, emotional, and spiritual needs, as well as your medical wishes.

It gives you a chance to write exactly how you wish to be treated if you get seriously ill. It's written in clear, easy to understand language, and it's also easy to use. You just have to check a box, circle a direction, or write a few sentences.

Is it fun to do? Well, not usually. No one likes to think about the fact that life ends, but we are built to one day die, and since this is not an optional event, isn't it time to complete the document to guide your family in the decisions they will face? And don't tell me that your family knows what you want. You may think that to be true, and maybe on some level it is, but let me tell you that when they're in that emotional setting of an urgent situation in an unfamiliar environment of a hospital, people's brains get a bit mushy, and having something on paper is invaluable guidance.

So how about this? Instead of a New Year's resolution to lose weight or start going to the gym, how about a resolution for 2025 to fill out your advance directive? Even better, take a pile of advance directives for your state to your New Year's Eve gathering. Listen to the podcast together and have everyone fill out the form and witness each other's. People say that they know doing this is important, but they just never seem to get around to it.

This December 31st, help your friends and family fulfill their New Year's resolution before the ball even drops. Write us and let us know how it went. Happy New Year! Happy New Year! Happy New Year! This podcast does not provide medical advice.

Please listen to the complete disclosure at the end of the recording. Hello, cats and kittens. It's our homage to Carole Baskin and the Tiger King.

Charlie, have you watched that yet? No. Is it homage or homage? I think it's homage. I don't know.

Yeah, me neither. I didn't go to college. I have not, but in a neighbor's house and I was looking out the window today, I saw a cat in the window.

Does that count? Almost the same, only different. Okay, that's clear. So, hello and welcome everybody to Everyone Dies.

I'm Marianne Matzo. And I'm not. I'm Charlie Navarette.

So, get your beverage of choice. Today I'm drinking fresh grapefruit juice with Saint Germain and gin? Vodka? Vodka. Vodka.

It's the most heavenly drink. And a little bit of lime. It is marvelous, marvelous, marvelous.

So, will that be in the recipe column? You just get fresh grapefruit juice and put in as much vodka and like just a jigger, Saint Germain, and a squeeze of lime. Roll your bobby socks down, put your feet up, and... Go to town. Have a good time.

Very good. Bye. Thank you for spending the next hour with us.

We're going to talk about advanced directives, which is a topic that's near and dear to our own Charles's heart. And then Charlie's going to talk Scammers. We spoke about, in the past, we've spoken about scammers, how, especially when someone is recently widowed, that unscrupulous people will look at obituaries, will find information on Facebook, and wheedle their ways into lonely people's hearts, who are still grieving, and take financial advantage of them.

So, you would think with coronavirus, we would all band together. No. So, we will discuss the way scammers are trying to take advantage of people and institutions during this coronavirus, during the coronavirus.

So, in our second half, in our meaty part of the program, we're going to talk about advanced directives. And I'm going to start with sort of a brief context for why we have advanced directives. And then Charlie's going to talk more about the advanced directives themselves.

And I always apologize for sounding like a teacher at this point. I guess we should just write that into the script. But I think it's important to know, why do we even have advanced directives in the first place? What prompted it to happen? Like, did somebody just one day go to sleep and wake up in the morning and say, you know what, let's make these forms and make people kind of talk to us about what they would want if they're not able to talk for themselves.

But it's not that arbitrary. And there's a reason. And I guess you guys know by now, I like history.

And so what's the history? Why do we even have it? So, let me give you a couple of definitions and a little bit of history. Bear with me. And then Charlie will talk about the advanced directives themselves.

So, an advanced directive are instructions that are given by a patient while they still have decisional capacity. So right this minute, while I'm talking to you, it's assumed that I've only drank half my drink. I still have decisional capacity.

I could make some decisions about what I would or would not want if I was really, really sick. If a person has decisional capacity, they're expected to make their own decisions. The only reason an advanced directive gets quote unquote, invoked or used is if you can't do it for yourself.

So, a formal advanced directive consists typically of a living will or written healthcare proxy. And we'll explain what that is, but just know with advanced directive, you make your decisions unless you can't. And if you can't, they go to the person who you say, I want to make these decisions for you.

There's something called a durable power of attorney for healthcare. Now, this is a legal document that you would sign if you were competent to make your own healthcare decisions and to say, if I become incompetent, here's who I want to have make decisions. Now, people in my experience will typically go to a spouse.

They can go, they'll go to a child. It's like, sometimes treated as here's a gift I'm giving you. I want you to be the one to make decisions.

I really don't agree that it's, it should be used that way. You want to have somebody who can make the decisions, who can listen to what's going on and then say, okay, Charlie wanted me to be the durable power attorney. What would Charlie want? The whole purpose of the durable power of attorney for healthcare is to do what the person would do if they were able to do it themselves.

It's not about, I believe in X, Y, Z. So that's what we're going to do for Charlie. Don't matter what you think. What would Charlie have done if they were there to do it? And a lot of people, oh my God, have I seen a lot of people who, nope, this is what I want.

But, you know, it says in your mom's advanced directive, this is what she would want. I don't care. I'm making the decisions and, you know, I have to be able to live with myself.

And so this is what we're going to do. So those are the two things that make up an advanced directive that Charlie's going to go more into. But why do we even have this? Well, we have this because of two girls.

Two girls? And I often, two girls. I often hear from people saying, I'm not old enough to have an advanced directive, which is why I'd like to kind of give you the history because we don't have advanced directives because of old people. We have advanced directives because of young women who had unfortunate situations and decisions needed to be made.

So the first is a young girl called Karen Ann Quindlen. She was under the age of 21. And she had, it's kind of exactly questionable what it what had happened.

But she ended up with brain damage and was in what was called a persistent vegetative state, meaning that she was not able to respond, her heart was beating. But that was just about it. She was on a ventilator, so that that was breathing for her.

She was on feeding tubes, meaning she wasn't able to eat and swallow on her own. Her family said, you know what, Karen would not want to live like this. You know, she was 20 years old, I want to say.

And he said, she would want to be removed from the ventilator. She doesn't, she wouldn't want to live like this. The hospital where Karen was being cared for said, no, we are not going to consciously kill somebody, even though Karen was no longer there, you know.

So Mr. Quindlen took the case to the New Jersey Supreme Court. And what ended up happening was the New Jersey Supreme Court made Karen Ann, made the father of Karen Ann her guardian, which then made it so that he could make decisions. There was, see, there was nobody to make decisions for her.

I guess she must have been over 21. So they made her the guardian. And this case, the Quindlen case, brought to light issues of what's called ordinary versus extraordinary care.

It had always been thought that no matter what technology could do, and remember, this is 1975. So this is a long time ago. That no matter what technology could do, that that's ordinary care.

If technology can do it, then that's what we should expect to be done. But this case said, no, wait a minute. There's ordinary care, like artificial food and fluids.

He wasn't saying take the feeding tube out. He was saying, take her off that ventilator. So where artificial food and fluids she couldn't eat by herself, were considered ordinary care.

And extraordinary care was the respirator, the ventilator to help her to breathe. Well, as it happened, when they took her off of that ventilator, she didn't die. And she lived for a while afterwards.

But she did it on her own. And with the support of artificial food and fluids. I use that term artificial food and fluids, because anything that we eat and swallow on our own, like my grapefruit drink, is not artificial.

You know, I'm taking it, I'm swallowing it. I'm doing that on my own. I'm able to swallow, I'm able to swallow.

I'm in any control. I'm able to swallow, you don't have to put tube in me, in order to get me hydrated. Okay, you can give me a drink, and I can drink it.

You can drink. All right. Artificial food and fluids is when you have to use a mechanism, a feeding tube, a catheter, you know, in the neck to use artificial nutrition, and IV to give fluids.

Those are artificial, because you're not doing it like the normal way in terms of swallowing. Okay. So that was Kiernan Quinlan, 1975, the difference between ordinary and extraordinary care, and artificial food and fluids was considered ordinary.

Then 1983, Nancy Curzan, another young 20 something year old girl. She'd gone to a party, she ended up, they're not even really quite sure what happened, but ended up in a persistent vegetative state on feeding tubes. She wasn't on a ventilator, she could breathe on her own.

Right. She was non-responsive. So they had a feeding tube in her to give her artificial hydration.

The family said, Nancy would never want to live this way. We want that feeding tube removed, and allow Nancy to die. The rehab center, she was at Missouri Rehab Center said, we're not going to starve her to death.

Because back in 83, that's how it was seen. If you don't, if you don't feed people, quote unquote, feed people, you're going to starve them to death. And that's wrong, especially if you're Italian.

So they said, we're not going to do that. So the father went all the way up through the Supreme Court. And what they said was, we need clear and convincing evidence as to what Nancy would want.

Do you have anything that would have indicated what Nancy would have wanted you to do? Well, finally, there was a friend who said, yeah, we went to a movie together once. And there was somebody who was in a situation like that. Nancy said, she'd never want to live like that.

So they took that as clear and convincing evidence. Yeah. Nancy said, she wouldn't want to live like that.

So that gave them permission to pull that feeding tube, the artificial nutrition and hydration. You know, they didn't like, take the pizza and the beer away from her. They took the artificial nutrition and hydration, turned that off.

And within a short period of time, Nancy died. And so that changed that bar of what was ordinary and what was extraordinary, moving artificial food and fluids into the realm of extraordinary care. The other thing it did is that it resulted in what was called the Patient Self-Determination Act of 1990.

And that's how long this case hung out. The Patient Self-Determination Act determines that all hospitals, nursing facilities, home care agencies, hospices, HMOs, any of those kinds of agency who receive federal reimbursement under Medicare and Medicaid have to give people information on living wills and advanced directives. And so if you go into a hospital nowadays, if you go to see your doctor, you'll have a form to sign.

Yes, I have an advanced directive. No, I don't. I want more information.

I want to fill one out. That's how that came about. It was a result of the Cruzan case and that call for clear and convincing evidence.

That's the standard. And it's no more, oh, we went to a movie and she said she didn't want that. It's more of here's the form.

And here's saying what you do or what you do not want. And who's going to make decisions for you in the event that you're not able to? That you can't, right? So that's the background. That's the background for that.

And then Charlie's going to explain how all of this stuff then works. Eye-opening moments podcasts are real-life stories of adversity, encounters, and perspectives. They are moments that can lift your spirits, give you some food for thought, or move you.

For the introspective mind that likes to reflect, discover, and find solutions or meaning in a life, listen to eye-opening moments podcasts. You know, the great jazz composer, musician Charles Mingus once said that about preparation is making the complicated simple. So before we even start with the documents, remember, you always have to speak for yourself, speak up for yourself.

You have to advocate for yourself. You go to a doctor's office. Before you go to the doctor's office, write down any questions or concerns that you may have.

At the office, ask your questions, and then write down answers too. Take notes. What's also very important is to note the know your patient's rights.

You know, not only for the doctor, but also for the hospital. Treat yourself like you are your own business and you are the CEO of yourself. What you will then have to do is to have the talk.

Discuss your preferences while you can still speak for yourself and make decisions for yourself. Discuss your preferences for end-of-life care with your family, with partners, with friends, whomever. And also, please remember, age is irrelevant.

What Marianne was saying earlier, for example, with caring Quinlan. So say, for example, you're 30 years old. You cross a street and you get hit by a car and you die.

Who knew that at age 15 you were already middle-aged? And the idea that at 60 you are middle-aged suggests you will live to be 120. Middle-aged at 50, you will live to live, you will live to 100. Middle-aged at 45, well, you get the picture.

If you decide not to discuss this with anyone, but you still want to make end-of-life decisions for yourself, you need advanced directive. And like Marianne mentioned, these are documents that let people know the choices you want at the end of your life. So, you know, basically advanced directives are instructions given by a patient while that person still can make decisions about the medical treatment she or he wants or doesn't want.

Generally, and this will vary state to state, there are about four documents you should have. So basically, these documents include a health care proxy, as Marianne mentioned. A health care proxy is also sometimes called a health care power of attorney, an agent, a representative, basically someone who will speak for you when you cannot speak for yourself.

First, of course, you need to find a proxy in advance when you are healthy and clear-headed. Figure out this person for yourself. Pick someone who will say what you want when you are not able to speak for yourself.

For example, do you want to be kept alive by any means necessary? Do you want to stay hooked up to a machine? Do you not want to be kept alive by being hooked up to a machine? Hey, it's your choice. And if you can't speak for yourself, someone has to be able to say this for you. Even though it's written down, someone has to be able to verbalize this and say it.

Do you want a DNR, which is do not resuscitate or not? How much pain are you willing to endure? You have to have this all clear in your head, again, while you still can. Now, most, as I said, this varies state to state. And with some states, I live in New York, there are clear laws to protect someone who fills out a health care proxy.

Other states don't accept a health care proxy. Most states will, but sometimes a doctor can say no. Here, if a doctor says no or wants to try to keep you alive by any means necessary, and that's not your wish.

I've had experiences where then I would suggest to a family that we go talk to a hospital administrator, maybe the hospital's lawyer, and point out that this is going against, you know, that what the doctor wants is going against the patient's wishes. And, you know, legal action will be taken. I've been involved in several conversations with this.

And there's only one time when the hospital did not back the patient. And in that time, the patient was still mobile. Even if the patient had not been mobile, I still would have suggested the same thing.

Find a different hospital, get a different doctor. And that's what happened. So with that, to pick your proxy, it doesn't have to be a family member.

And you really need to think about this. If you, I mean, who best is going to actually do what you want? It might be a It might be a partner, it might be a family member. But you will sit that person down, tell her or him exactly what's needed.

And will they follow through? You need to detail your wishes. And then you need to see if that person is okay with it. And if they're not okay with it, that's fine.

Not a problem. Find someone else. Sometimes, and again, because with this document, it depends on the state.

But if the family, if you choose a friend and your family does not approve of what you wrote down in your healthcare proxy, well, that's too bad. It's your friend who will have the final word. That's why it's always good to also let your family know what you want.

Yeah, that's really important. Yeah. Communication on the web page.

I was gonna say we also have on the web page the resource to look up your own state. Yes. And see what the form is for your state.

So you make sure that you fill out the one that's for your state. And then also, just like Charles Mingus said about preparation, fill out the form. But please speak to your doctor in advance.

Find out that the doctor is also on board. It just can't be your family or friends, the doctor too. Yeah.

And again, if a person can't follow through with your wishes, that's fine. Find someone else. Yeah.

And like, as Maria mentioned, you know, yeah, check with, with the state and, you know, what each individual state requires. The other thing with an advanced directive is it doesn't have to be an all or nothing situation. You don't have to say, I either want everything or I want nothing.

You can say, well, if I get into a situation where I'm not doing well, I want you to put me on a ventilator and go balls to the walls for five days. And after those five days, I want you to reevaluate the situation. Am I getting any better? Am I staying the same? Am I getting worse? And then at that point, say, and then I want to be released from the ventilator.

I want, you know, whatever it is. You don't have to say right from the very beginning. If anything really bad happens, just don't plug me in.

Right. Exactly. Yeah.

Yeah. You don't have to be all or nothing. You can try it for a few days.

You can try it for a week and see if you are able to recover. See if your body has the reserve in it to be able to recover. Exactly.

You can specify that on the, on the proxy and that if, yeah, determine for five days, five weeks, if there's some new medication that's on the horizon, you can leave instructions that, you know, your proxy will make a determination to wait for five days, five weeks to see if some new medication will, you know, could maybe help you. It's, it's up to you. It's up to you.

And each state has different rules. Like in Oklahoma, it's determined by law that everybody wants artificial food and fluids. So the advanced directive form in Oklahoma assumes that you want that.

If you don't want it, you have to fill out the section saying, I don't want it. So if you don't fill it, fill it out, sort of like really look at what you're doing. The assumption is you want artificial food and fluids because that's, you know, specific to our state.

So you have to really look at the form in your state because there's sort of values of the state kind of get written in by law that may not jive with what it is that you want. So when something like that, Marianne, what, I mean, what could people do? Well, the advanced directive form, like if you were to pull up the one for, for Oklahoma, there's a section about artificial food and fluids, and you can say, I don't want it. But you have to initial the part that says that you don't want it.

If you skip that part, if you think, oh, they're talking about pizza and beer, and they're, and you don't think to yourself, they're talking about artificial food and fluids when I can't eat and can't drink for myself. You've got to, you know, this is part of why we're here, right, Charlie, is that people understand what are the issues that are being talked about. Artificial food and fluids is you can't do it yourself.

So if you don't want to be, you know, hooked up to a feeding tube, then you need to say on your advanced directive that you don't want it. Or I only want it for 30 days or two weeks or whatever. When I was, you know, on the ventilator and in a medically induced coma, I had a feeding tube.

I had artificial nutrition and hydration because I was in the ICU for a month. And if I didn't have artificial nutrition and hydration, I would have died. You can't live that long without that stuff.

But if six months or two months had gone by, and I wasn't recovering, then that option would have been removed because I didn't want to spend the rest of my life in a coma on a ventilator with artificial nutrition and hydration. So that I think is a good example of medical interventions are great. The problem may come for you if you say, well, if I'm going to be this way for the rest of my life, I mean, I've seen patients in nursing homes who are bodies in a bed, on a ventilator, on artificial nutrition and hydration.

They didn't have an advanced directive and the family doesn't want to let them go. And the family might not want to let you go for lots of different reasons. And I hate to say it, but a lot of times it's because if that person dies, the source of money dies with it.

Like if the pension or the benefits or whatever, that person, they lose the benefits. So I have more times than I'm comfortable admitting, seen patients kept alive, just not really alive, just a body in a bed because the family refuses to have them released from the artificial nutrition and hydration, refuses to have them released from the ventilator to allow natural death. And that's a concept within all of this is allowing natural death, let nature take its course.

But some people say, well, if you can keep them alive for six months in this way, then financially we're able to stay in the house or financially we're able to have whatever benefit. And I hope that doesn't sound jaded. I'm just merely telling you what I've seen.

Yeah. So in addition to a healthcare proxy, and again, just to repeat, healthcare proxy takes care of medical decisions when you can't. Additionally, you should also have what's called a durable power of attorney, which basically is someone who takes care of legal decisions when you can't.

After that, there is also what's called a living will. And a living will states medical directions and wishes, when again, you can't, but with the living will, you are still able to communicate this. I mean, you are still alive, but you really can't communicate it.

It goes hand in hand with a healthcare proxy. The same idea as, you know, do you want to be kept alive by life support? If yes, how long? So living will in a healthcare proxy pretty much go hand in hand. And then also a will, just a regular plain old will, which of course, you know, directs the distribution of assets after a person dies.

If you die without a will, the state you live in will decide who gets what. This includes your home, bank accounts, assets, and even if you're married and you don't have a will, I mean, still the state will go through just to prove you are who you are and everything is in order. You will have to hire a lawyer just to make sure you're entitled to everything.

If you are not married to your partner, good luck. Laws with unmarried partners, you know, vary significantly from state to state and not every state recognizes a partner. So it's just, a will is just absolutely essential.

And also, isn't it true, Charlie, that what goes in a will is money and assets, and the living will, the durable power of attorney is only about healthcare? Yes. Is that true? Basically, yes, that's the idea. Yeah.

Okay. So you have to have both. Yes.

Yeah, at the minimum, a will, some type of healthcare proxy, like I said, a healthcare proxy, a healthcare, you know, power of attorney, just someone who will speak for you. Really, like a durable, like someone with a durable power of attorney, just those basic things, just basically to protect yourself. And again, so that someone can speak for you when you can't.

Excellent. That was a really good overview of that. There are, oh, I'm sorry, go ahead.

No, no, I was just going to say, just have, and summing up, just have everything in place, you know, before the worst happens. And if you happen to be a fan of Jack Reacher, just remember, hope for the best, but plan for the worst. Yeah.

And put your advance directive somewhere where people can find it. What I always tell people is make like five copies of it, give it to five different people. You can put it in an envelope, sign on the back, if something happens to me, open this.

Yes. Because if you do, if you give it to five people, one person will be able to find it when it's necessary. And not only that, but if you're at home and something happens and you can't speak, you know, the EMTs will come in, will, you know, break the door down.

You're unconscious, you know, you can't hand them your packet. But if you, for example, put something behind the door, or maybe put something on a refrigerator door in a folder, very, very clearly labeled advance directives. Because if EMTs do not see something like that, they will take care of you at their discretion.

And their discretion is not going to be to let you die. They will, they will resuscitate. And I hope no one listening has had to go through that.

Thankfully, I haven't. But I have been told that especially the older you get, the trauma your body goes through is awful. Yeah.

And there are some states that have programs where there's like a little canister that you keep in the door of your freezer that has your advance directive in it. So see if your state has something like that. Because if the EMTs show up and you're in a state that has that program, they'll go to your freezer door and see, is that in there? So check out what is, what are the rules within your state? Because they're all different.

And we have resources on our webpage, everyonedies.org. It's E-V-E-R-Y, the number one dies.org. And that has lots of different resources. So you can look up and see which are the one, what are the rules for within your own state? Well, thank you, Charlie, for that. And as we move on to our third half of the program, I have been getting some comments from some people pointing out that there are not three halves in a whole.

And I want to assure all of you that I'm aware that there are no three halves in a whole. Our third half is sort of a post-education, post-second half piece that we do. And it actually is a rugby term, which is a post-match socialization with the opposing team.

And this often involves songs, drinking, and food. So if you're lucky, we will only be doing the drinking and food and none of the songs, but I can't guarantee anything about the songs. So we do know that we are saying it's a third half and we're doing it for comic effect, not because we really think that.

Our third half is going to involve an interview where we're talking about advanced directives. And I'd like you all to read the blog that we've attached about advanced directives. And I think what's always interesting is people's different perspectives about things.

And there's a film from 1950 called Rashomon. And it is directed by Akira Kusurara. And we have the link for that on the webpage.

So in Rashomon, what they do is they show a kind of a violent scene. And then they go back through that and they show it from different perspectives. So in this film, there's a rape of a bride and the murder of her samurai husband.

And Kusurara goes back and looks at it from the perspective of the bandit, from the perspective of the bride, the perspective of the samurai ghosts, and the perspective of the woodcutter. And if you haven't seen it, it's Japanese and subtitled, but it is really a good film. And it kind of informs how I look at things, that everybody's perspective can tell completely different stories.

Our memories are like this film. Many people don't have an advanced directive because they say they've never really gotten around to it. We encourage people to do it for themselves.

And if not that, to complete one so it makes it easier for the family. So when you read this blog post from this week, it's written by somebody who was suddenly confronted with a very difficult and sudden decision for his wife when she was unable to make decisions for herself. He writes about how he used her advanced directives with his family to make decisions.

But did having an advanced directive really help the family? Today, we're talking about this situation with his daughter, Abby, and about her perception of the use of the advanced directive. Like the movie Rashomon, many people see the same story from their own unique perspective. So Abby, welcome to Everyone Dies.

Thanks for having me. So I just, I realized that, you know, of course, death is always difficult, especially the death of a mom. And I don't want to pick at that wound.

But what I wanted to hear about was, I understand that your dad brought your mom's advanced directive. And do you remember about that? I do. So, you know, you can look at the blog for the details of what we were going through.

I'm assuming I haven't read it yet. But, you know, some of the doctors, you know, we're not medical professionals. And while my mom was in the ICU, we got some very different advice, because the different doctors rolled through after I showed up.

I think we had probably two by the time this came up. And one of the doctors recommended a tracheotomy. And I was, you know, he made it sound okay, right? So I was kind of pushing back pretty hard on dad about what we should do.

And so he brought in mom's advanced directive and asked my brother and I to read it. And the way that their advanced directives were written, I'm assuming dad's is similar. I haven't seen it.

But mom was very clear about not wanting to have any procedures that would dramatically impact her quality of life on the other side. And obviously a tracheotomy would definitely impact her in some significant ways had they done it. So it just brought clarity to the situation.

Us knowing exactly what mom wanted and didn't want made it easier for us to move forward as a family without sort of arguing about what the right path forward was. And so there wasn't long discussions. It was like, oh, this is what she wants.

This is what we'll do. Yes. And so how was that for you? Did that make that extremely difficult situation any easier for you? Yeah.

I mean, knowing what mom wanted kind of, I mean, it belayed any feelings of regrets. Not the right word. Guilt is the word I'm looking for.

We didn't have to feel guilty for making hard decisions when she had made them herself, if that makes sense. It makes a lot of sense. And I often talk with people when they don't have an advanced directive.

They say, well, I don't want to think about that or I don't want to deal with that. And we like to remind people that if it's not for yourself, you do it for your family because they're the ones, if you can't speak for yourself, they're the ones who have to sort through all the information and make a decision. And that advanced directive acts as a guidance, as a way for them to frame the information they're receiving.

Right. And I will tell you that that was important enough to me that as people were asking me about what happened with mom, pretty much the first thing I always say is if you don't have an advanced directive, get one. That was probably the best thing she could have done for her family.

Thank you for that. And I really appreciate you sharing your perspective about what I know was a very difficult time for you and your family. And I'm sorry about the death of your mom.

And thanks for sharing that with our listeners. Of course. Thanks for having me on.

Thank you. Lastly, we offer for your listening pleasure, When Something Has Happened, We'd All Prefer Not by Advanced Directives in Case of a Sudden Life-Threatening Event by Timothy Boone, who's the president and CEO of Good Shepherd Hospice. And we have the web link on our page.

And it's a Dr. Seuss kind of parody on advanced directives. So have a listen to that. So the second part of our third half, Charlie's just going to give us some information about scams that are going on along with in this world of coronavirus.

So what's going on, Charlie? Well, Marianne, you would, as I said before, you think everyone would be, you know, pulling together for the old team. No, there are scammers out there who are attacking computers, attacking smartphones, you know, through robocalls. Just, it's just nuts.

So please don't fall for it. Things to keep a lookout for. You know, somebody may call saying that they have some remedy or some cure.

Have you heard about this? And they are willing to send it to you for, you know, $49.99. Don't fall for it. What happened to $19.95? It's gone up to $49.95 now? It is the 21st century. Yes.

Yes. You know, and people fall for this. They're on TV, actually on TV.

I don't know if he's still doing it. But some fellow selling bottles of some magical elixir for $49.99. Maybe it was $49.95. Was that Jerry Falwell or? Oh, I didn't want to mention Jim Baker, but Jim Baker. Oh, Jim Baker.

Yes. I'm glad you're not mentioning that. No.

No. But he's back. So please be be aware of scam artists like this.

I mean, scammers, you know, may call saying they're from the Social Security. From Social Security and administration. They need they want to facilitate your the arrival of your of your check.

And they just need your Social Security number so they can send that to you directly. If it's Social Security calling, they have your Social Security number. Please don't fall for that.

Maybe someone may call or you receive something on your computer about an upcoming delivery of products. And please click here to show the delivery date. Please don't click.

If it's not if it's something you do not recognize by clicking that, you could literally be opening the door in your computer to let some virus in. Which will then freeze your computer or allow people just to steal your information, you know, bank account information, Social Security number, whatever you have there. People have tried this not only with Social Security, but, for example, with, you know, under the guise of Medicare or Medicaid benefit information.

Again, to expedite something, they need your information. Don't do it. If there are emails, for example, linked to websites claiming to have, again, coronavirus resources, no.

Do not let people in, you know. And even hospitals, hospital administrators, doctors are being scammed. Scammer gets into a system and then freezes all information.

And basically hold the information for ransom. They will unfreeze your information if you pay what they want. If they find something, I mean, it's bad enough, you know, with, you know, medical information, you know, which helps people.

But if they also find any personal information in there as well, well, now they have you two ways. So just be alert. I know these are frightening times, but you have to stand on your toes.

There are a lot of unscrupulous people out there. So in addition to being safe, just be careful. Except for us.

We love you all. Yes. Yes, we do.

Yes. We do. Well, thank you, everybody, for listening.

Please do stay tuned for future episodes of Everyone Dies. Our thanks to our CEO, retired Major General David, our producer, Sandy, John, our technical advisor, and our friends and family who are helping us to make this podcast a reality. And I'm Marian Matzo.

And we're hoping that now that the podcast has dropped, that you will share that, subscribe to this podcast, share it with your friends, suggest it to other people that you think might help them. And let's spread the word so everybody has the information that you have. Charlie and I look forward to talking to you soon.

Thank you for listening. Thank you. Be safe.

are for informational purposes only, and are not a substitute for professional medical advice or treatment. Always seek the advice of your primary care practitioner or other qualified health providers with any questions that you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have heard from this podcast.

If you think you may have a medical emergency, call your doctor or 911 immediately. Everyone dies does not recommend or endorse any specific tests, practitioners, products, procedures, opinions, or other information that may be mentioned in this podcast. Reliance on any information provided in this podcast by persons appearing on this podcast at the invitation of everyone dies or by other members is solely at your own risk.