In that perfect world we would have planned for the 'administrative necessities' of our deaths: Will? Check! Advanced Directive? Check! Living Will? Check!
I hope you have an advanced directive and a living will. People who do not clearly document their wishes and preferences for care at the end of life are often subjected to futile medical treatments that they neither seek nor benefit from. Their families are burdened by the medical bills accrued from the numerous ineffective treatments many patients get at the end of life.
Regret is common at the end. How we wished we had said, or forgiven, or .... It can be difficult to express to loved ones the fact that they actually ARE loved. That one is proud of one's children. That offenses, real or otherwise, may be forgiven. We shouldn't have to bear the burden of regret in our last hours.
But, who wants to think of dying? It can be difficult to actually lay out a concrete plan for the last days. To what extent do you want care? What about your body? We shouldn't require our family members, loved ones, agents and/or medical professionals to guess how we want our end, and after the end, to play out.
We should really deal with these things when we're healthy and not wait until we're at death's door. It can be hard to say these things though. Maybe you simply cannot bring yourself to put your emotions into words, face-to-face. Maybe the person you want to forgive is not nearby or you don't know where he is.
Contemplating one’s own death and doing some basic preparatory work is certainly not an easy task. You can download advanced directive and living will forms, but those emotional issues? Maybe you need some help with that one. For many reasons, it might be easier to write down than to express verbally whatever you really need to say. Now there are tools to help in this difficult job.
With this in mind the Stanford Letter Project was developed. This project provides tools for writing letters that, in addition to advanced care directives, inform medical staff of what you think is important in your care, and that help you to express emotional concerns to friends and family. The tools include templates for letters in several languages, and can be filled out as paper copies or on-line. There is also a tool that can hep to share your letter with others.
Letter Project Tools:
- What Matters Most Letter: This is a letter template that allows anyone to document what matters most to them and what treatments they want in the future. This tool is free and is available in print, as an online fillable form and as an iPhone and Android App in eight different languages.
- Letter Project Advance Directive: This tool allows anyone to answer a few simple questions in English. When they finish and click print, the tool will send them an auto-filled valid advance directive document and a supplemental letter to their doctor describing their preferences for medical care at the end of life. This tool is free and is available in print, as an online fillable form and as an iPhone and Android App.
- Friends and Family Letter: This letter can help all adults complete their seven life review tasks: acknowledging important people in our lives ; remembering treasured moments in our lives; apologizing to those we may have hurt; forgiving those who have hurt us; and saying “thank you,” “I love you” and “goodbye”. Using this template, you can write a letter to your friends and family in one of eight languages using an online form, an iPhone or Android App or a printable form.
Here are some of the comments on a NY Times article about the Stanford Letter Project
"This is such an important project as it brings closure not only to the reader of the letter, but also the writer. There are many topics that are difficult to talk about for many reasons but a letter gives the chance to express feelings that may have otherwise been left unsaid, and also an opportunity for the reader to understand what was really going on in the writer’s head; Or the writer can choose to have a loved-one read the letter with them so they can both appreciate what was touched upon. Either way what was written will last for a long time and can be reread many times. For example, I would have loved to receive a letter from my grandmother, containing stories or important lessons, but unfortunately she now has dementia, and I will never get to hear what she had to say. That is why it is so crucial to write a letter while healthy.
Another reason is because we never know what the future has in store for us. People suffer from the mentality that we can “get to it tomorrow.” But in reality we do not know what is coming tomorrow, or if there will be a tomorrow. Writing a letter now gives the elderly, really anyone a chance to say “I love you,” “ I am sorry” or simply goodbye. These words are actually more difficult to say face-to-face than in a letter. With apologies it can be especially helpful, because pride may get in the way of saying sorry. But through a letter, a person can apologize and get the closure they need. Writing is a great outlet for situations like these."
"I am a senior citizen and have often, especially after being rescued from one heart attack, wondered how I will be remembered. I have come to believe that our day-to-day relationships with all of those around us is imperative for human survival. While I do endorse a written commitment to those we love (that can be a reminder of our caring when they come across it during their busy lives in the future), I think we need to start each day with a commitment to share our apologies and expressions of gratitude and love.:"
"My mother died of breast cancer in 1961 when I was 13. All my life I have wished that she had left me something in writing—something that I could have read when I was older that helped me understand what she felt about me, her disease, her life, her loves, her dying. Something that would have let me know her when I was old enough to understand what in her healthy and then unhealthy life had been important to her. But I've made do with old family snapshots. In one especially when I am a baby in her arms, I can see the look of love on her face. In others, I intuit what was important to her by the snaps she chose to take. Not the same as words but, at least, something.
"-I wish I had a letter from my mom. I'm not sure I could read it on a regular basis- even old birthday cards tear my heart out. But knowing I could read it if I wanted to would be a comfort to me and would fill the void her passing left in my heart."