Pieter Hintjens is an author and programmer best known as the founder of the ZeroMQ project. He was recently diagnosed with a rare and aggressive form of cancer. A Protocol for Dying is his latest and final blog post in which he reflects on how to interact with the terminally ill.
Palliative care practitioner BJ Miller on redesigning our relationship with death. BJ Miller and the Zen Hospice Project previously.
Over these last two years, I've come to suspect that my cat has gotten better, more comprehensive planning around her eventual death than most people do.
For most of US history, our relationship with death was more intimate than it is today. Americans often died at home and remained there until burial, where they were washed, wrapped in shrouds, and laid out on boards while the family made preparations for a funeral feast and an at-home funeral. In addition to family, women known as “Layers Out of the Dead,” helped take care of the immediate tasks following a death. This homespun approach to death largely persisted until the Civil War, when embalming, hospitals and eventually funeral directors changed the way we dealt with our deceased. But now, with home funerals and even green burials slowly regaining acceptance, a new generation of “Layers Out of the Dead,” are emerging.
End of life planning is hard. There are checklists, like this set from Get Your Shit Together. There are practical tips for making things easier for whoever's dealing with your estate after you're gone, like the tech tips in this previously from MeFi's own Jessamyn. But in the murky middle between living completely independently and being incapable of managing everyday tasks lies a subtler and more difficult question: how to organize and manage your money when financial competence is one of the first areas to decline on the slide from mild cognitive impairment to dementia. SeekingAlpha contributor PsychoAnalyst has a surprisingly nuanced analysis of the steps self-directed investors can take to protect their finances from the underestimated risk of their own declining ability to make good financial decisions, and raises some points worth thinking about for folks beyond the site's investor wonk audience.
A legendary design firm, a corporate executive, and a Buddhist-hospice director take on the end of life.
She was determined to fulfill her father’s dearest wish, the wish so common among frail, elderly people: to die at home. But it seemed as if all the forces of the health care system were against her — hospitals, nursing homes, home health agencies, insurance companies, and the shifting crosscurrents of public health care spending. The NYT reports in depth on a single case, a snapshot of the typical end-of-life care situation in the United States. A worthwhile but disturbing long read, potentially very upsetting if you've lost a loved one in a similar managed care setting. [more inside]
The Ultimate End of Life Plan. "...Torn, I called my mother's internist. 'I know your mother well enough, and I respect her,' he said. 'She doesn't want to risk a surgery that could leave her debilitated or bound for a nursing home. I think I would advise the same decision if it was my Mom.' I called my mother and said, 'Are you sure? The surgeon said you could live to be 90.' 'I don't want to live to be 90,' she said. 'I'm going to miss you,' I said, weeping. 'You are not only my mother. You are my friend.' That day I stopped pressuring my mother to live forever and began urging her doctors to do less rather than more. A generation of middle-aged sons and daughters are facing this dilemma, in an era when advanced medical technologies hold out the illusion that death can be perfectly controlled and timed."
"You will not find a group less in favor of automatically aggressive, invasive medical care than intensive care nurses, because we see the pointless suffering it often causes in patients and families. Intensive care is at best a temporary detour during which a patient’s instability is monitored, analyzed, and corrected, but it is at worst a high tech torture chamber, a taste of hell during a person’s last days on earth."
Last operational flight of the F-14s Speaking of gravity-defying cats... Remember the F-14, Tom Cruise's favorite ride? It's the end of an era for the venerable warbird. The variable-geometry Tomcat was the last carrier aircraft built specifically for fleet defense and long-range interception -- in fact, it grew up with a dedicated weapon system just for the job. Like any cat with nine lives, it showed up doingnew and different things. In its later years it found a new role as a precision-strike aircraft (the "BombCat") and nearly lived to be the bridge to the new F-35 multirole Joint Strike Fighter. Excuse the warmongering. What can I say...I was bored with the lousy NFL early games on TV this afternoon..
Dutch Legalize Euthanasia "The Netherlands has become the first country in the world to legalise mercy killing after a controversial law on euthanasia came into force on Monday." While tolerated for nearly two decades, opponents are comparing the practice to Nazi Geramny. Is this a step forward for those living with severe pain and no hope in sight?