Planning Ahead   

               and removing a burden   






     The decision to have a loved one start hospice services is often a difficult one.  Doing so is an acknowledgement that there has been a major shift in the life and subsequently the care of that person.  Despite the misconception, starting hospice services does not mean that death is imminent, though sometimes it does, but rather that the care focus for that person has shifted from curing a disease to managing its symptoms and providing comfort and quality of life for as much time is left.  However, while I encourage people to focus on valuing and making the most of the time available, an important decision to make sooner rather than later is mortuary.  Some patients start hospice services with mortuary arrangements already in place.  For them, planning and making arrangements for mortuary was simply a practical thing, like planning for retirement.  It’s not that they were indifferent towards death or unaffected emotionally by their declining health, but rather that making those plans relieved a burden that would be placed on their loved ones if they passed and those grieving had to make those decisions unsure of what the person would have wanted.  There are a few practical reasons for making mortuary arrangements in advance, like it often costs less, you can begin making payments, it allows the person to choose how they’d like her remains to be handled and it prevents unnecessary stress and conflict during a time of immense grief when the person passes.  But, rather than focus on the practical reasons for making arrangements in advance, I want to focus on the emotional roadblocks that often keep a family from making important preparations.      “THERE’S PLENTY OF TIME”    When I bring up the issue of making mortuary arrangements with families of hospice patients, one common response is that there is no rush as their loved one is stable and they have plenty of time to make those decisions and arrangements.  First, for a person to qualify for hospice, that person has to be diagnosed with a terminal illness that the patient and family have accepted is untreatable or have decided not to pursue further treatments to instead focus on quality of life.  This means that while that person may have a time of stability and little decline, there is the possibility of a sudden decline and change in the patient’s quality of life and care.  I say this not to scare anyone, but rather to highlight that now   is   the best time because there is time and space to have calm and meaningful discussions and make plans for what your loved one wants for him or herself at the end of life.      IT’S TOO HARD    For a lot of people thinking about making mortuary arrangements feels like too much emotionally because it forces them to think about the death of their loved one.  As I mentioned before, simply agreeing to hospice services is a big decision that acknowledges that a loved one is not going to get well and that the way forward is focusing on making the most of the time left rather than trying to extend the time left.  Making mortuary arrangements can make that realization and acknowledgement of the reality of the situation feel all the more real and force a person to start confronting the grief and loss before them.  However, while this is certainly true, it is again an opportunity rather than an obstacle.  While realizing that having time is a blessing in that it gives space and opportunity to make important decisions, beginning to discuss and make those decisions is an opportunity to set the groundwork for healthy grieving and ultimately, healing.  In having those difficult discussions and making arrangements one can begin to recognize the loss and grief that one is experiencing.  For though we often think of grief and loss as only after the death of a loved one, grief often begins with the loss of the little things that make life what it is, like the ability to drive and live independently.  It’s not easy or enjoyable to have these discussions but with patience and wisdom you can take care of an important task while beginning to deal with grief.  Moreover, this is not something you have to do alone.  A hospice social worker or spiritual counselor like myself is here to help you discuss, provide resources and think through difficult decisions.    TAKE THE FIRST STEPS    Whatever you may be feeling about making mortuary arrangements for your loved one, the best thing to do is take those first steps.  My sincere hope is that you’ll find there are people more than willing to help you,  and I believe you have the strength to move forward.  Begin not by trying to figure out every aspect of what kind of memorial service you think your loved one would appreciate and every detail or the service or obituary, but by simply making an appointment with a mortuary representative, your hospice social worker or spiritual counselor who can talk with you about different options and provide resources to help you move forward.  Having that conversation does not mean you have to decide everything that day but will help you see the resources and options in front of you.

Planning Ahead . . . There are a few practical reasons for making mortuary arrangements in advance . . . But, rather than focus on the practical reasons for making arrangements in advance, I want to focus on the emotional roadblocks that often keep a family from making important preparations.