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End of Life Planning · Life and How to Live It with Dr Rocco

• 0:00
  SPEAKER_03: Life in How to Live.
• 0:02
  SPEAKER_01: Do you sometimes feel like life is passing you by?
• 0:05
  SPEAKER_01: How would you like to get more out of life?
• 0:08
  SPEAKER_01: We explore all things life on this podcast.
• 0:12
  SPEAKER_01: Welcome to Life and How to Live It podcast with Dr.
• 0:16
  SPEAKER_01: Rocco.
• 0:17
  SPEAKER_03: Life in How to Live It.
• 0:19
  SPEAKER_03: Oh yeah.
• 0:23
  SPEAKER_03: Dream, create, connect, sleep.
• 0:25
  SPEAKER_01: Welcome to another episode of the Life and How to Live It podcast with me, Dr.
• 0:31
  SPEAKER_01: Rocco.
• 0:32
  SPEAKER_01: In today's episode, we are discussing end of life planning.
• 0:36
  SPEAKER_01: Now that is a challenging, difficult, sometimes uncomfortable topic, but a very important one.
• 0:43
  SPEAKER_01: Many of our listeners have had the experience of having to help their elderly and aging loved ones navigate this challenging topic and just help them decide how they want to spend their later years.
• 1:00
  SPEAKER_01: Our guest today, a friend and someone we can learn a lot from on this topic, is Marion Power.
• 1:07
  SPEAKER_01: Marion is a longtime registered nurse who has worked in the operating room, emergency department, and hospice.
• 1:16
  SPEAKER_01: Her experiences working as a nurse in these areas of healthcare led her to her current specialty as a geriatric care manager.
• 1:25
  SPEAKER_01: In this role, Marion helps seniors and their families navigate the challenges of aging, especially making positive, informed decisions about their care, often with the goal of being cared for at home for as long as possible.
• 1:41
  SPEAKER_01: Marion loves long-distance walking in France.
• 1:45
  SPEAKER_01: She teaches yoga and is an avid quilter.
• 1:48
  SPEAKER_01: Marion, welcome to the show.
• 1:50
  SPEAKER_02: Thanks, Dr.
• 1:51
  SPEAKER_02: Rocco.
• 1:53
  SPEAKER_02: I'm very happy to be here.
• 1:55
  SPEAKER_01: It's great to have you here.
• 1:56
  SPEAKER_01: So, as I mentioned in the introduction, this is a topic that has touched many of our listeners.
• 2:03
  SPEAKER_01: Can you share any stories that illustrate the value of working with a geriatric care manager?
• 2:11
  SPEAKER_02: Yes.
• 2:13
  SPEAKER_02: I'll share a story about John, who was one of my very first clients, and he'd had two debilitating strokes a couple years apart, and lived alone, had no children, never married, and wanted to stay at home.
• 2:32
  SPEAKER_02: And his power of attorney contacted me.
• 2:36
  SPEAKER_02: I met John, and we began to get together a team of people that enabled John to stay at home.
• 2:46
  SPEAKER_02: And I had the resources as a care manager in the community to find different kind of members of the team who could fulfill different functions so that he could stay at home.
• 2:57
  SPEAKER_02: A caregiver, someone to do his grocery shopping, someone to take him out, etc.
• 3:03
  SPEAKER_02: And what happened is he stayed home in a familiar setting.
• 3:08
  SPEAKER_02: And he actually, considering his disabilities, he had a pretty good life.
• 3:15
  SPEAKER_02: He lived another seven years with a long, you know, live-in caregiver and this team of people, and he was a pretty cheerful guy.
• 3:24
  SPEAKER_02: It was it was amazing.
• 3:26
  SPEAKER_01: Well, that that's great.
• 3:28
  SPEAKER_01: So there's a place where you really made a big difference for this person.
• 3:32
  SPEAKER_01: And and so, you know, one thing that you mentioned I want to just highlight is uh when we talk about end of life planning, the this was the last seven years of his life.
• 3:43
  SPEAKER_01: This is not like the last two months of his life.
• 3:46
  SPEAKER_01: So for the listeners, you know, this you we can look at it as different um amounts of time that we're planning for.
• 3:54
  SPEAKER_01: Does that sound right?
• 3:56
  SPEAKER_02: Yeah, I think because he had this um these two strokes, he knew that he needed to get some things in order.
• 4:05
  SPEAKER_02: And I think that is the key is that anytime after 60 or 65, you could get your legal paperwork in order because you don't know what's going to happen.
• 4:15
  SPEAKER_02: None of us know.
• 4:16
  SPEAKER_02: And if that's a good start is just to get those things in order.
• 4:20
  SPEAKER_01: Yeah, and we will definitely talk a little bit about the paperwork and what kind of things we should get in order.
• 4:27
  SPEAKER_01: I'm wondering, you know, I don't think a lot of people are familiar with this term, geriatric care manager.
• 4:33
  SPEAKER_01: What does the geriatric care manager do?
• 4:37
  SPEAKER_02: Basically coordinate, assess, oversee the care of a person who, in some either cognitively or medically, has um an issue where they probably can't live alone, or if they are living with a family member, um, that family member, the spouse, the children need support.
• 5:02
  SPEAKER_02: So it allows someone to stay at home or have know their options.
• 5:10
  SPEAKER_02: I think that's one of the things a care manager can provide.
• 5:12
  SPEAKER_02: What are my options once I've had a stroke or I've I'm beginning to get some memory loss?
• 5:18
  SPEAKER_01: Yeah, and and I think that's really a challenge, you know.
• 5:22
  SPEAKER_01: So people are dealing with really difficult conditions, you know, that are are new to them, new to their family, very significant changes in their lives.
• 5:34
  SPEAKER_01: And and the whole healthcare system is quite intimidating and not always easy to navigate.
• 5:40
  SPEAKER_01: Now, is is a geriatric care manager some someone who is assigned to them from their hospital, from their doctor?
• 5:48
  SPEAKER_01: How does that happen?
• 5:50
  SPEAKER_02: No, I I don't think geriatric care managers are assigned through a hospital.
• 5:56
  SPEAKER_02: On occasion, one of the social workers or discharge planners will call me, but you I really have to go into the hospital and make friends with them in order for them to call me.
• 6:05
  SPEAKER_02: I think you can, there's an aging life care association which you can Google and you can find geriatric care managers in your area, and that's very valuable.
• 6:16
  SPEAKER_01: Yeah, so what is that?
• 6:18
  SPEAKER_01: Aging life care?
• 6:20
  SPEAKER_02: Yeah, it's aginglifecare.org.
• 6:23
  SPEAKER_01: Okay.
• 6:24
  SPEAKER_02: And you can go onto that site and find a geriatric care manager in your area.
• 6:30
  SPEAKER_02: It's nationwide, and I think the caliber of those care managers is pretty good.
• 6:36
  SPEAKER_02: There's a lot of um requirements that you have to pass to be a part of it.
• 6:42
  SPEAKER_01: Okay.
• 6:43
  SPEAKER_01: That sounds like a great resource for people.
• 6:46
  SPEAKER_01: And so that would help them find someone in their area.
• 6:49
  SPEAKER_01: So this is a like a nationwide website?
• 6:53
  SPEAKER_02: It's a nationwide website, and people don't really know about geriatric care managers, but I think it does make a difference if you're in a situation where you've been functioning and all of a sudden you have an event, cognitive or or medical, where you it changes things drastically.
• 7:12
  SPEAKER_02: And a care manager can just even at the beginning just come in and consult and help you know your options, what your resources are in the community, and what you can expect.
• 7:23
  SPEAKER_02: It's huge.
• 7:24
  SPEAKER_01: What was that website again?
• 7:26
  SPEAKER_02: It's aging a G I-N-G life care.
• 7:30
  SPEAKER_02: All one word, aginglifecare.org.
• 7:35
  SPEAKER_02: And you go onto that site, and on the upper right-hand corner it says find an expert or something like that.
• 7:42
  SPEAKER_02: And you click on that, and it will it will put in your zip code, it's a national organization, and you'll find a care manager who's in your area.
• 7:54
  SPEAKER_01: Okay, so that sounds like a great resource for people if they need to find someone to help them.
• 8:00
  SPEAKER_01: Now, who are the people who usually reach out to you?
• 8:03
  SPEAKER_01: Is it the is it the aging person themselves or is it a family member?
• 8:09
  SPEAKER_02: It's usually almost always a family member.
• 8:12
  SPEAKER_02: Somebody, you know, somebody over 65 generally with some kind of health issue or some kind of debilitating event, a stroke, a heart attack, um, memory loss, and they don't know what's available to them, or they don't really know what decisions they're gonna have to make.
• 8:32
  SPEAKER_02: And I can help in a consultation with explaining some of those things.
• 8:38
  SPEAKER_01: Yeah, so explain that process a little bit more.
• 8:41
  SPEAKER_01: You have uh an initial consultation with them.
• 8:44
  SPEAKER_02: Yeah, it's usually I usually go to their home and try and get as many family members together as possible.
• 8:52
  SPEAKER_02: So we're all on the same page, and I just I do an assessment, a very thorough assessment.
• 8:57
  SPEAKER_02: I ask them, you know, both cognitive and medical, and what it is does that they want and what is it the family wants, which often are two different things.
• 9:07
  SPEAKER_02: So it's always sorting through what are the options and finding out how you can help them by tuning into where they are at that moment.
• 9:19
  SPEAKER_01: Yeah, that's a good point.
• 9:21
  SPEAKER_01: So I I once had a guest on the show who said, meet people where they are.
• 9:26
  SPEAKER_01: So that's what you're doing as a as a care manager.
• 9:29
  SPEAKER_02: Yeah, and sometimes you come into a situation you don't know what you're walking into, and and it just you just sit and listen and kind of find out what's needed there.
• 9:41
  SPEAKER_02: And um it's a wide variety of things.
• 9:45
  SPEAKER_01: Yeah, a wide variety of things.
• 9:47
  SPEAKER_01: So so what are some of those things that people do need?
• 9:51
  SPEAKER_02: Yeah, so overall, you know, you're looking at the medical.
• 9:54
  SPEAKER_02: What do they need, do they need some more medical assistance?
• 9:59
  SPEAKER_02: Do they need hospice?
• 10:00
  SPEAKER_02: Do they need um a neuropsych evaluation?
• 10:05
  SPEAKER_02: Do they need help at home?
• 10:06
  SPEAKER_02: Do they need their do they even have their power of attorney or their health proxy in place?
• 10:12
  SPEAKER_02: Is their home safe?
• 10:13
  SPEAKER_02: Can they live in their home?
• 10:14
  SPEAKER_02: Do we need to put some adaptive equipment in, grab bars and other possible things?
• 10:21
  SPEAKER_02: Um And again, I think the most important question is what does the client want, the person who's had the event, and what does the family need?
• 10:31
  SPEAKER_02: These are important things, you kind of have to start from there.
• 10:35
  SPEAKER_01: Yeah, so so you do this initial assessment uh in-home, uh, and and then what do you do?
• 10:42
  SPEAKER_01: You generate a uh a report, a list of recommendations, that kind of thing?
• 10:47
  SPEAKER_02: Yeah, I generate a plan of care with each each category.
• 10:52
  SPEAKER_02: You know, sometimes they're on 20 medications, and I'm like, I think you we need to pare down your medications.
• 10:58
  SPEAKER_02: I think some of them are causing a problem or mixing with others.
• 11:01
  SPEAKER_02: I mean, from that level, that up to I need you need to get your health care proxy done, you need to get your power of attorney done.
• 11:08
  SPEAKER_02: I have a a good uh elder law attorney that I really like.
• 11:12
  SPEAKER_02: I make recommendations, resources in the community.
• 11:16
  SPEAKER_02: Um, I try to enlist family members if there's any way they want to help, if they can.
• 11:22
  SPEAKER_02: I yeah, it's a it's a whole report with um all the categories, legal, financial, what are their financial what's their financial situation?
• 11:32
  SPEAKER_02: That's key.
• 11:33
  SPEAKER_02: And then we work on uh my recommendations, and I start with what I think is most important and move down the list and review that with them.
• 11:43
  SPEAKER_01: Yeah, what a what a great service.
• 11:45
  SPEAKER_01: You know, that's really something that would help people.
• 11:48
  SPEAKER_01: You know, in my experience as a rehabilitation doctor, you know, we used to take people who, you know, had just uh unbelievably life-changing kind of occurrence, a stroke, a spinal cord injury, a brain injury, something like that.
• 12:06
  SPEAKER_01: And um, you know, we could keep them in the hospital for anywhere from say two weeks to a month at the most.
• 12:14
  SPEAKER_01: And then they were, they would go home, and a lot of them really felt terrified to go home.
• 12:20
  SPEAKER_01: You know, they didn't know what to expect, or maybe not them, but their family members had that feeling of just like loss of control.
• 12:28
  SPEAKER_01: And we usually did refer them to some sort of case management.
• 12:33
  SPEAKER_01: Um, but I think that there are a lot of issues or a lot of things that can fall through the cracks because, like what you were describing there is like soup to nuts, right?
• 12:44
  SPEAKER_01: Everything from medication changes to home uh modifications to legal to et cetera.
• 12:53
  SPEAKER_01: So, how do you help them to kind of like check off those boxes?
• 12:58
  SPEAKER_01: Um, because there are a lot of boxes that potentially there are.
• 13:03
  SPEAKER_02: I leave it up to them pretty much.
• 13:05
  SPEAKER_02: Like, I can just do an initial consultation and plan of care, and I can pass that off to them.
• 13:11
  SPEAKER_02: And if they have children who are involved and want to be involved, the children can um, the older children can take that on and they can take my plan and they can implement it.
• 13:22
  SPEAKER_02: And I can also offer to help them implement it.
• 13:25
  SPEAKER_02: So we start with what I think is the most important, which is the legal stuff, and we get that started.
• 13:30
  SPEAKER_02: And I just keep checking in, you know, it's like coaching almost, like have have you have we accomplished this?
• 13:36
  SPEAKER_02: What do you need my help with?
• 13:38
  SPEAKER_02: I'm really there to help them with what they need.
• 13:41
  SPEAKER_02: They don't necessarily need my help with everything, and I don't want to smother them, but I do want to make sure that we get the key things accomplished.
• 13:51
  SPEAKER_01: Yeah, yeah, absolutely.
• 13:53
  SPEAKER_01: So does this report I imagine goes to the whoever requested it, the the the patient, the family member.
• 14:02
  SPEAKER_01: Does a copy go to their doctor?
• 14:05
  SPEAKER_02: Sometimes.
• 14:06
  SPEAKER_02: It depends on how involved their doctor is, but it could.
• 14:09
  SPEAKER_02: Probably though, what will happen is I will go to the I often go to the doctor's appointment with them.
• 14:16
  SPEAKER_00: Okay.
• 14:16
  SPEAKER_02: One time.
• 14:17
  SPEAKER_02: I'll go with to their PCP or their neurologist, and I'll accompany them, either them alone or with a family member, and I'll ask questions because family members don't know what questions to ask, and I'll introduce myself.
• 14:29
  SPEAKER_02: And often the doctors, sometimes they're happy that I'm there, and sometimes they're not.
• 14:36
  SPEAKER_01: Yes, they have been allotted 10 minutes for this visit, and here comes Marion with a list of questions.
• 14:43
  SPEAKER_01: Yes.
• 14:44
  SPEAKER_01: You know, there's but that's what I mean, being a patient advocate like that is so important that you know these folks are.
• 14:51
  SPEAKER_01: That's the key role.
• 14:52
  SPEAKER_02: That is the key role.
• 14:53
  SPEAKER_02: We're we want to enable well-being in these circumstances.
• 14:56
  SPEAKER_02: There's always, I think what I try and tell the family is we're moving toward well-being, whatever that looks like.
• 15:03
  SPEAKER_02: And it looks like it looks different in different situations, but to give family the support and the encouragement that that's what we're moving toward.
• 15:12
  SPEAKER_01: Yeah, I I think that the opportunity to have someone who has done that kind of home evaluation, like home visit, uh, generated a report, a list of prioritized things to address, that that person may also go with me to the doctor's visit is like that.
• 15:46
  SPEAKER_02: Yeah.
• 15:46
  SPEAKER_01: Yeah.
• 15:47
  SPEAKER_02: Yeah.
• 15:48
  SPEAKER_02: I it's always a dance, you know, between the care manager, the family, and the medical establishment.
• 15:56
  SPEAKER_01: Yeah, for sure.
• 15:57
  SPEAKER_01: For sure.
• 15:58
  SPEAKER_01: So I imagine you've you've had many um very gratifying moments when you've seen people, you know, get.
• 16:07
  SPEAKER_01: I mean, you mentioned a story at the top of the show about John, but I'm sure you've got a lot of those kinds of experiences.
• 16:15
  SPEAKER_02: Yeah, I think you you have you do get a lot of kinds of experiences.
• 16:19
  SPEAKER_02: Some of them are a little dark and some are lighter than others, you know.
• 16:22
  SPEAKER_02: With with John, it was it became a joyful situation, which was hard to believe considering his disability, no family.
• 16:30
  SPEAKER_02: Um and other people, when I worked for hospice, there were some situations where you just feel you're so glad that you're there to support the family.
• 16:39
  SPEAKER_02: You can see how important it is.
• 16:41
  SPEAKER_02: Um, and other times you can also just see the struggle that people are going through.
• 16:46
  SPEAKER_02: And that that can be difficult, but still you you have something to offer them, and they know that and they want that, and that's the three.
• 16:58
  SPEAKER_01: Yeah, and the struggle, you know, the struggle is there, but at least they have someone to walk that struggle with a little bit, you know.
• 17:05
  SPEAKER_01: I think that's very important.
• 17:08
  SPEAKER_02: Well, that's it.
• 17:08
  SPEAKER_02: I think I'm gonna say, you know, things are gonna be all right, they're not gonna be the way they were, but we're gonna work at creating something that's sustainable.
• 17:19
  SPEAKER_01: Absolutely.
• 17:20
  SPEAKER_01: And so are these kinds of services covered by insurance in any way?
• 17:25
  SPEAKER_02: They are not.
• 17:27
  SPEAKER_02: And that's that's unfortunate.
• 17:30
  SPEAKER_02: Yeah, they're not.
• 17:31
  SPEAKER_02: I I have to bill privately.
• 17:33
  SPEAKER_02: No insurance will cover a care manager.
• 17:35
  SPEAKER_02: Some in some long-term care insurances will cover their own care manager, but I found when that happens, they just send out notes to you about things you can do.
• 17:45
  SPEAKER_02: It really, it really isn't personal.
• 17:48
  SPEAKER_01: Yeah.
• 17:49
  SPEAKER_01: And that and that's very unfortunate, you know, that's uh a service like this, you know, some people are just going to be priced out of it, you know, just not able to avail themselves of it.
• 18:00
  SPEAKER_02: Well, one thing about that is if you hire me as an initial consultation, I'll come over to your house, I'll probably spend two hours, I'll write up my report, three hours, go through it with you.
• 18:13
  SPEAKER_02: Um you might spend six hours with me, six initially, and that might be enough to find out what the issues are, what the resources are from the report, um, what needs to be done.
• 18:25
  SPEAKER_02: And that might be enough just to get the ball rolling.
• 18:29
  SPEAKER_02: You know, in John's case, he didn't have family.
• 18:31
  SPEAKER_02: So I I I stayed with him for seven years till he died.
• 18:34
  SPEAKER_02: So that was different.
• 18:36
  SPEAKER_02: But often it can just be an initial consultation and plan of care, and someone can begin to, and then maybe you check in every couple months or something.
• 18:44
  SPEAKER_01: Yeah, yeah.
• 18:46
  SPEAKER_01: Well that well, that's a good point, you know, for that initial six-hour investment, whatever that costs, that could be worth its weight in gold in in like saving yourself all kinds of heartache and and lost opportunities and and and maybe money, you know, that you're spending by not knowing what's out there for you.
• 19:10
  SPEAKER_02: Exactly.
• 19:10
  SPEAKER_02: Not knowing what's out there, and just to have someone who does know the ropes and can kind of ease your anxieties, I think is worth a lot.
• 19:20
  SPEAKER_00: Yeah.
• 19:21
  SPEAKER_00: Um yeah, I agree.
• 19:23
  SPEAKER_02: Yeah.
• 19:24
  SPEAKER_02: And uh, I will I'll do a sliding scale.
• 19:27
  SPEAKER_02: If somebody can't afford what I'm asking, uh say, what can you afford?
• 19:30
  SPEAKER_02: And that's fine.
• 19:31
  SPEAKER_02: Uh, many care managers will do that.
• 19:34
  SPEAKER_02: You know, I don't think we're gonna just say turn our backs and walk away.
• 19:40
  SPEAKER_01: Yeah, yeah, yeah.
• 19:41
  SPEAKER_01: No, the people who would do this kind of work are are uh, you know, they have that heart for the for service, you know, they want to help people.
• 19:50
  SPEAKER_01: So yeah.
• 19:52
  SPEAKER_01: Um, yeah, so let's switch gears a little bit.
• 19:56
  SPEAKER_01: And you know, I I want to make this personal about myself, okay?
• 20:01
  SPEAKER_01: So I am 60, I'm in good health, knock on wood.
• 20:07
  SPEAKER_01: Um, but I have basically nothing in place, you know.
• 20:11
  SPEAKER_01: I don't have a power of attorney, I don't have a healthcare proxy, I don't have any of these different things.
• 20:19
  SPEAKER_01: So, what would you think a person like me should have or should should begin putting in place?
• 20:26
  SPEAKER_02: Yeah, that's a great question.
• 20:28
  SPEAKER_02: I think many people are in this situation that you you're in.
• 20:32
  SPEAKER_02: And I would say the number one thing is your legal stuff.
• 20:36
  SPEAKER_02: Fine, I have a great elder law attorney that I always recommend, and there's many, um, who would need to do a power of attorney and a will.
• 20:47
  SPEAKER_02: That needs to be done by by a lawyer.
• 20:51
  SPEAKER_02: And then a healthcare proxy and a living will, a living will being what you would and would not want in the case of a medical emergency.
• 21:01
  SPEAKER_02: You know, people have strong feelings about that.
• 21:03
  SPEAKER_02: Do I want CPR?
• 21:04
  SPEAKER_02: Do I want to be intubated?
• 21:05
  SPEAKER_02: All of those things.
• 21:06
  SPEAKER_02: So those two things, the living will and the healthcare proxy, I can do with you, or you can do on your own.
• 21:12
  SPEAKER_02: They're you can download them and and fill them out on your own, and they're they're acceptable.
• 21:18
  SPEAKER_01: Yeah, let me let me stop you there for a second.
• 21:21
  SPEAKER_01: The the you know, online forms and resources you're saying are acceptable, right?
• 21:28
  SPEAKER_02: They're for two things, for the health care proxy and the living will.
• 21:31
  SPEAKER_01: Yeah.
• 21:32
  SPEAKER_02: But no, but for a will, an actual will of where your assets go, or a power of attorney, you need an el elder care law.
• 21:40
  SPEAKER_00: Okay.
• 21:40
  SPEAKER_00: Yeah.
• 21:42
  SPEAKER_02: And I also want to just say if you don't have these things in place, what happens is I mean, the scenario would be a family member, say your father has a stroke, he ends up in the ER, he's unconscious, and one child says, Oh, I know he wants to be on a respirator.
• 22:00
  SPEAKER_02: I know he wants these things.
• 22:01
  SPEAKER_02: He wants to live as long as possible.
• 22:02
  SPEAKER_02: And another child says, no, no, he didn't want any of that.
• 22:06
  SPEAKER_02: And what happens is there's a lot of stress and confusion.
• 22:10
  SPEAKER_02: And nobody really knows what he wanted because he never said what he wanted.
• 22:15
  SPEAKER_02: And it it it makes for just a difficulty on top of difficulty already.
• 22:22
  SPEAKER_01: Yeah.
• 22:23
  SPEAKER_01: Good point.
• 22:24
  SPEAKER_01: Difficulty on top of difficulty, because you're going through a horrible situation, and now you have all this um lack of clarity.
• 22:33
  SPEAKER_02: Exactly, lack of clarity.
• 22:34
  SPEAKER_02: That's it.
• 22:35
  SPEAKER_02: And if you have a healthcare proxy that says what you do and don't want, or a living will that says those things, it's clear.
• 22:43
  SPEAKER_02: So one thing I'd say you should do is after you get those papers together, talk with your children, talk with your family.
• 22:50
  SPEAKER_02: If you have them, tell them, show them these documents and let them know where they are.
• 22:55
  SPEAKER_02: Because one of them might be a power of attorney or healthcare proxy for you, but you want them to know what you want.
• 23:02
  SPEAKER_02: And then they don't have to think about it.
• 23:04
  SPEAKER_02: They can take care of things, which is a wonderful if you're a child and you can help your parent in that way when they need it, it's really nice when you know what they want.
• 23:15
  SPEAKER_01: Yeah.
• 23:16
  SPEAKER_01: So get the paperwork done and then communicate that to your spouse, your children, etc.
• 23:26
  SPEAKER_01: Uh, and all of them, not just your favorite one.
• 23:30
  SPEAKER_01: Tell them all so that they all know what's what.
• 23:34
  SPEAKER_02: Yeah, and know where the paperwork is, have it in a you know, they should have copies, but if they don't, you know, you say, This is where I keep it, it's in this file right at the beginning of this dr file drawer.
• 23:44
  SPEAKER_02: This is where it is.
• 23:46
  SPEAKER_02: Because when you need it, you need it.
• 23:48
  SPEAKER_01: Yeah.
• 23:50
  SPEAKER_01: Yeah, I know.
• 23:51
  SPEAKER_01: I've had that experience as a doctor, you know, where you know, family members have been, you know, they're like, Well, we're still looking for that, you know, healthcare proxy, you know, we know it's in the house somewhere, you know, so just just having done it is not enough.
• 24:07
  SPEAKER_01: People know need to know how to find it.
• 24:09
  SPEAKER_02: Right.
• 24:10
  SPEAKER_02: And and um and what it says.
• 24:12
  SPEAKER_02: And the other thing I'll say, if you have significant assets, I would also talk with the um elder law attorney about a potential trust.
• 24:22
  SPEAKER_02: There's many kinds of trusts.
• 24:23
  SPEAKER_02: I won't certainly won't go into it, but if you have significant assets, you might want to do that.
• 24:28
  SPEAKER_01: Okay.
• 24:28
  SPEAKER_01: All right.
• 24:30
  SPEAKER_02: Yeah.
• 24:31
  SPEAKER_01: Yeah.
• 24:32
  SPEAKER_01: So those are the recommendations for for me or someone in my position.
• 24:37
  SPEAKER_01: Is there anything else that I should be doing?
• 24:39
  SPEAKER_02: Well, I'll say this is more psychological.
• 24:42
  SPEAKER_02: I'll say to begin to think about and realize that sooner or later your independence will become impossible and that asking for help is not a weakness.
• 24:54
  SPEAKER_02: So we're not very good at asking for help.
• 24:56
  SPEAKER_01: I'm gonna need to practice that because I am not good at that at all.
• 25:00
  SPEAKER_01: None of us are.
• 25:01
  SPEAKER_02: We're so independent, we don't want to bother anybody, you know?
• 25:05
  SPEAKER_01: Yeah, yeah.
• 25:06
  SPEAKER_01: Asking for help.
• 25:07
  SPEAKER_01: Um, okay.
• 25:09
  SPEAKER_02: So into the brain to begin to work on you.
• 25:13
  SPEAKER_01: Begin, yes, yes.
• 25:14
  SPEAKER_01: Hopefully, I have many, many years to to work on that concept.
• 25:19
  SPEAKER_01: Yes.
• 25:20
  SPEAKER_01: So, anything else you would recommend about that, like that person in that situation who's got nothing in place?
• 25:27
  SPEAKER_02: Um, no, just get those things done.
• 25:30
  SPEAKER_02: I would put those on the top of your list.
• 25:33
  SPEAKER_00: Okay.
• 25:33
  SPEAKER_00: All right.
• 25:34
  SPEAKER_02: And I do want to say one thing.
• 25:35
  SPEAKER_02: What maybe we're not done, but I have one more comment about dying.
• 25:40
  SPEAKER_01: Please share that because that's a topic no one wants to talk about, but it is part of life.
• 25:48
  SPEAKER_01: So let's hear about it.
• 25:49
  SPEAKER_01: Let's hear your comment.
• 25:51
  SPEAKER_02: Here's what I want to say is that the experience of being with a family member when they're dying is valuable.
• 26:00
  SPEAKER_02: And it's frightening, but it's worth taking the time to accompany them if you can.
• 26:08
  SPEAKER_02: And you know, it's the culmination of a relationship, it might be a chance to heal some of that relationship.
• 26:17
  SPEAKER_02: Um, it goes beyond our rational thinking into some a spiritual space or some kind of space that that is allowing that person to be as they are, and it's a gift for them.
• 26:34
  SPEAKER_02: They're surrounded by things they love or familiar with, and it's a gift for them to have the chance to go through that with someone who is willing to accompany them.
• 26:46
  SPEAKER_02: And it's for you as well as for them.
• 26:49
  SPEAKER_02: I mean, it's an amazing experience that I wouldn't want people to miss, and it could be frightening, so people, you know, avoid it.
• 26:58
  SPEAKER_02: But I just encourage you to consider hospice is an amazing support.
• 27:03
  SPEAKER_02: And between a care manager and hospice, you can have that person at home, your family member.
• 27:10
  SPEAKER_01: Very well said.
• 27:11
  SPEAKER_01: I I think that it's something, you know, that we don't like to think about, talk about.
• 27:16
  SPEAKER_01: But ultimately, when you have that opportunity to be with the with someone that you care deeply about in their final, you know, final hours, final moments.
• 27:26
  SPEAKER_01: Um, there's a lot that as you said so well, you know, there's a lot that happens for the person who is dying.
• 27:33
  SPEAKER_01: You want to give them that gift.
• 27:36
  SPEAKER_01: Uh, but there's a lot that happens for you as well.
• 27:40
  SPEAKER_01: So um, yeah, thank you for sharing that.
• 27:43
  SPEAKER_01: So thanks for sharing a lot of this, all this information about, you know, end of life planning.
• 27:51
  SPEAKER_01: Um, before we close out the program today, I usually ask my guests a question.
• 27:58
  SPEAKER_01: Uh, and it is if if you had the opportunity to put a message on a billboard, and this is a billboard that many people drive by every day, so you know that many people will see what you have to say, what would your message be?
• 28:16
  SPEAKER_02: Stay engaged.
• 28:18
  SPEAKER_01: Okay.
• 28:19
  SPEAKER_01: Stay engaged.
• 28:20
  SPEAKER_02: Yeah, it's worth it.
• 28:24
  SPEAKER_02: That would be the second line.
• 28:25
  SPEAKER_01: Should we do stay engaged?
• 28:27
  SPEAKER_01: Dot dot dot.
• 28:28
  SPEAKER_01: It's worth it.
• 28:29
  SPEAKER_02: Yes, I like that.
• 28:30
  SPEAKER_01: I like that.
• 28:31
  SPEAKER_01: All right.
• 28:33
  SPEAKER_01: Well, Marion Power, thank you so much for being a guest on the show today.
• 28:38
  SPEAKER_02: You're welcome.
• 28:38
  SPEAKER_02: It was really enjoyable, Rocco.
• 28:41
  SPEAKER_02: Thanks.
• 28:43
  SPEAKER_01: Now it's time for Dr.
• 28:44
  SPEAKER_01: Rocco's Ricks.
• 28:46
  SPEAKER_01: Dr.
• 28:46
  SPEAKER_01: Roccozarix.
• 28:50
  SPEAKER_01: Now it's time for Dr.
• 28:52
  SPEAKER_01: Rocco's Rex.
• 28:55
  SPEAKER_01: Make your next vacation a walking or cycling trip.
• 28:59
  SPEAKER_01: There are so many benefits to this kind of a travel.
• 29:03
  SPEAKER_01: You are much better able to see the place that you're visiting.
• 29:07
  SPEAKER_01: You slow down, you know, especially if it's a walking trip, you're slowing down and that you're at that pace of something like two miles an hour instead of 70 miles an hour.
• 29:20
  SPEAKER_01: And you get to really see the countryside, you get to stop and smell the roses, as they say.
• 29:27
  SPEAKER_01: You get the chance to meet people, you know, you meet the people you're walking with, but you also meet the local people, which you may not get the opportunity to do if you take a kind of a standard trip.
• 29:40
  SPEAKER_01: You know, a lot of times when people plan vacations, they it's almost like a checklist, you know, it's like I want to see this site and that site, I want to try this restaurant, etc.
• 29:51
  SPEAKER_01: But if you take a walking or cycling trip, you don't have to really check all those boxes, you're just gonna see a lot of things and you're gonna learn a lot.
• 30:01
  SPEAKER_01: It's also great exercise, and great exercise works up a great appetite.
• 30:08
  SPEAKER_01: So you can enjoy the food without guilt.
• 30:12
  SPEAKER_01: So give this a thought.
• 30:14
  SPEAKER_01: Now, if you're interested in doing that kind of travel, there are you can set you can set up the trip yourself if you like, but there are also many companies around the world that will help you set up an itinerary, uh, they'll help you with logistics like lodging or shuttling your luggage around so you don't have to back like be a true backpacker carrying all of your things from point A to point B.
• 30:40
  SPEAKER_01: So consider that for your next vacation.
• 30:44
  SPEAKER_01: Make it a walking or cycling trip.
• 31:01
  SPEAKER_01: Did you know that Alaska, the biggest state in the United States, is four hundred and twenty-nine times larger than the smallest state, Rhode Island?
• 31:13
  SPEAKER_01: Despite this difference in size, Rhode Island has a bigger population of 1.1 million people, as opposed to Alaska at three-quarters of a million people.
• 31:25
  SPEAKER_01: So I guess if you're trying to get away from it all, Alaska would be the place to choose.
• 31:30
  SPEAKER_01: Well, that's it for today's show.
• 31:32
  SPEAKER_01: Thank you all for listening.
• 31:34
  SPEAKER_01: Until next time, so long.
• 31:37
  SPEAKER_01: That's all for today's show.
• 31:39
  SPEAKER_01: Thanks for listening to the Life and How to Live It podcast with Dr.
• 31:43
  SPEAKER_01: Rocco.
• 31:44
  SPEAKER_01: If you enjoyed today's show, please subscribe and leave a review.
• 31:48
  SPEAKER_01: See my show notes to find out more about the show.
• 31:50
  SPEAKER_01: And remember, life is not a dress rehearsal.
• 31:53
  SPEAKER_01: Until next time.
• 31:55
  SPEAKER_03: Life and How to Live It.
• 31:57
  SPEAKER_03: Oh yeah.
• 31:59
  SPEAKER_03: Dream, create, connect.
• 32:01
  SPEAKER_03: Just live it, live it, live it, live it.