I feel the sting of my mother’s absence most acutely at the milestones. In some ways, the milestones, no matter how many years separate them from her death in 2010, make me feel like I’ve just lost her. But in other ways, the milestones that I’ve experienced without my mother bring a new richness, too—just because my mother is gone doesn’t mean that a joyous milestone must be tragic.

Before my mother died, her terminal illness made me think about future milestones that would come without her. I remember the day my mother and I were driving back from a chemo appointment and talking about my boyfriend at the time. I knew I wanted to marry him, but marriage was far off for us. My mother started crying. She would never hear a man ask for my hand in marriage, and she would never walk me down the aisle. I took hold of her hand as I pulled the car into our garage and was silent. Any words of comfort felt false at the time. So we sat in silence together, acknowledging the pain of it. And then we let it go. Because we both knew that my mother wouldn’t be there for one of the most important days of my life, and there was nothing either of us could do about it.

My mother wasn’t around last year when I planned my wedding. I remember standing in a bridal salon looking at myself in the mirror and aching for my mother’s opinion on a wedding dress. She wasn’t at my bridal shower, she didn’t walk me down the aisle, and she didn’t give a toast at the reception.

After I got married, I heard that a family friend had referred to my wedding as “heartbreaking” because my mother wasn’t there. My knee-jerk reaction was to chastise her. I wanted to tell her that though my mother’s death was heartbreaking, there was nothing heartbreaking about my wedding. In fact, on May 19, 2012, there wasn’t a single drop of sadness as I held back tears of pure joy and married my husband. I celebrated our marriage, my new loving in-laws, and my utter elation at winning the brother and sister-in-law lottery.

Not once on my wedding day did I mourn for my mother—not because I didn’t miss her, but because my loss does not define my gains.

When the trauma of my mother’s impending death hit me, I felt like my world was collapsing. I had trouble breathing, unable to imagine my life (or any hopeful, rosy version of it) without her. I believed that this cataclysmic loss would forever define my life; I couldn’t see another way. But then my life continued, without my mother. I began to learn what it felt like to have experiences without her, and I began to understand that my achievements are not solely defined by my loss, just as I am not solely defined by it.

And in a very real way, I’ve been able to feel my mother’s presence at my milestones. At my wedding, I felt her through her family and friends who watched me walked down the aisle and marry my husband. Seeing the delight on their faces was just a small window into what might have been, the overflowing joy that would have radiated from my mother, watching me on my wedding day.

Last month Slate re-ran a story from 2011 about a man named Harry, his dog Duke, and the Perfect Day they spent together before Duke died.

"[Harry had] gotten an idea, one he thought would pay tribute to his life with Duke and give him something to feel besides sadness and loss...'Tomorrow, I'm going to give you a Perfect Day,' he said quietly to Duke as they left the vet's office. He would take the day off from work and create a sweet memory with his dog. It would be a special day, filled with all the things Duke loved most, as close to perfect as Harry could make it."

If you've lost a beloved pet, what have you done to grieve the loss and remember your friend?

via Slate

This week the Alzheimer's Association released a report stating that 1 in 3 seniors dies with Alzheimer's disease or another type of demetia, a staggering statistic that has the potential to change the way we think about end-of-life planning.

Though dementia can cause death, Alzheimer's and other forms of dementia can also add to a rapid decline in physical (not just mental) health, compounding and intesifying existing health conditions such as heart disease, kidney disease, cancer, and other health problems.

There are currently 5.2 million Americans living with Alzheimer's disease or another form of dementia; by 2050, that number is estimated to increase to 13.8 million people. So what can we do to prepare ourselves for end-of-life, given this new information?

1. Talk to your family about your end-of-life wishes. By communicating with your family about how you want to be treated at the end of your life and what your priorities are (comfort, longevity, staying in your home, etc.), your family can feel more comfortable making care decisions on your behalf when the time comes.

2. Create an advance directive. By putting your health care wishes in writing in the form of a living will, you can save your family the stress of trying to determine what you would have wanted. By naming a health care power of attorney, you can choose someone to make decisions on your behalf for a time when you may not be able to speak for yourself or make decisions for yourself. By both creating a living will and naming a health care power of attorney you can give your family the legal tools to take care of you the way you want. To find your state's advance directive forms, use our list of State-by-State Advance Directive Forms.

3. Share your decisions with your doctors. Once you have an idea of the type of medical care you'd like, sit down with your doctors to let them know about the decisions you've made. You may want to give them copies of your advance directive, let them know who your health care power of attorney is, and discuss the reasons behind your choices. By communicating your decisions with your doctors, you can be sure that the people managing your care know the choices you've made and will be able to work with your family to follow your wishes.

via Yahoo! News

One of the first things my mother did when she was diagnosed with pancreatic cancer was contact an estate attorney. She was always good at planning ahead, and she treated death no differently. On came a slew of paperwork, an advance health care directive, a living will, and executor and power of attorney appointments. My mother selected a funeral home, the cemetery and her own gravesite next to my father’s. The fact that she had done all this end-of-life prep didn’t make burying my mother any easier. But her planning made it possible for me to carry out her wishes, and that did bring me comfort.

There’s something called an ethical will that’s designed to pass on guiding principles, values and hopes for a family’s future. My mother never formally assembled an ethical will, but growing up in a household where my mother was always imparting a lesson—from compassion for others to table manners to how to cook asparagus—my mother’s ethical will (which was really more like an encyclopedia) had been ingrained in me. 

The most valuable lesson from my mother’s ethical encyclopedia is her insistence that I trust myself. She taught me to trust myself during times of indecision and to go against the grain of a group decision if my gut was telling me otherwise. “Always trust your feelings,” she’d say. This guiding principle has helped me find my way through several big financial decisions, professional challenges, and conflicts with friends. Of course I still struggle in moments of doubt, but I have my mother’s voice and faith urging me to follow her advice…which is to follow my own advice, and that gives me strength.

I miss my mom a lot, but I’ve been able to move forward without too much grief. I’m convinced that the main reason for this is because of the legacy of values and teachings my mother passed on to me. I don’t get paralyzed by obstacles (big or small) because I’m wondering what my mother would do—I know what she would do and how she would advise me. Her opinions on things that have transpired since her death have always been, and continue to be, crystal clear to me. 

I believe that the lessons my mother taught me were ways for her to prepare me for life without her. As grateful as I am for her fastidious attention to the administrative side of her end-of-life planning, it’s her ethical encyclopedia that is most valuable to me. She taught me that I would be okay without her and that I can be my own sounding board, my own advisor and my own moral compass. And that’s something that will extend her life and lessons far into my future.

In Issue 11 of The Magazine (a subscription-based online and iPhone/iPad app that features fascinating short articles on a range of often-tech-related topics), Jane Hodges writes about the death of her father. The essay is a moving portrait of her father and of her experience after his death, as she threw away his things. But what struck me as most profound in the piece was Hodges' description of her father's quality of life in the months before he died, and his isolation and withering sense of self that she believes ultimately caused his death. Though her father suffered from chronic heart problems and died of a heart attack, "in this daughter’s heart," she writes, "he died because his final freedom—the freedom to use technology and the identity he got from it—was abruptly struck from his life."

"Up until the hospitalization that put him into rehab," Hodges writes, "my father had succeeded in ignoring his own physical decline because he still had a life of the mind, thanks largely to technology." Though his physical health was dwindling, and he could no longer engage in many of the physical the activities that had brought him real pleasure throughout his life, Hodges' father was able to stay actively connected to the world. Though his body was failing him, his mind was not, and he was able to keep his mind and his self agile, engaged, and well fed.

But the rehab facility where he spent his last weeks did not allow laptops and had no wireless Internet access, anyway. "Without the distractions of laptop and log on, he saw how narrow the tunnel of his life had become." Her father was rarely able to leave the rehab facility because of his fragile health. His isolation from the world was at once physical and mental.

It was, physically, a heart attack that killed Jane Hodges' father. But in a more emotionally minded reality, we can understand his death as the death of his sense of self, with his body merely following. His independence was gone, his access to the things he loved had been taken from him, and he was confined to a space that was not his own. On top of these factors, he was physically unwell. How would any person—sick or well—feel in a situation like this?

In my mind, the question that Hodges is raising is: what do we want end-of-life to look like? When we approach death, what kind of life do we want to be leading? The issues of where we want to be, how we want to be treated, who we want to be with, and what we want to be doing in our final time are not to be taken lightly. Though we will all someday die, and though the cause will ultimately be physical, the quality of our mental, emotional, psychological, and spiritual lives should not be discounted. These are, in the end, the things that make us who we are and give us reason to live.

When someone is dealing with a significant hardship, like death or caring for someone who is dying, the natural inclination may be to give that person space. And sometimes, that’s exactly what the person needs, especially in the beginning when she’s trying to make sense of the emotional avalanche that just landed on her plate. Sometimes, offering space can be a way of offering compassion.

But sometimes, space is not the answer. 

When I was caring for my mother after her diagnosis, some people gave me space when it was the last thing I needed. In an effort to be compassionate, certain friends didn’t come to me when they were experiencing difficulties of their own; they gave me space. Perhaps they thought their pothole-sized problems seemed too trivial compared to my crater of a hardship. Better to wrestle with the issue privately, they must’ve thought, or bring their troubles to someone else. 

And I completely understand this response. Having been on both sides of this dilemma, I know it’s not easy to know what to do. Not only can it seem trivial to bring up your issues with a friend who’s going through a hard time, it can feel selfish, self-centered, or insensitive. Especially when you’re in a small squabble with your parents, and your friend’s parent is battling for her life. 

However, I’m here to tell you that those of us dealing with hardship craters want to hear about your potholes.

Being able to lean on friends, cry to friends and vent to friends helped me soldier on when times were tough. And being able to be there for my friends, to listen to them vent, helped me maintain a certain level of normalcy in my otherwise upside-down world. One of the largest discomforts of dealing with death is adjusting to the new normal: new fears, schedules, unknowns, etc. If the people you love start acting differently as well, that’s just another discomfort to add to a very long list. Being able to rely on business-as-usual friendships can be extremely reassuring.

I think it’s important to remember that our problems don’t add to a friend’s hardship; it’s keeping them a secret that might. Just because someone is struggling with new and potentially overwhelming challenges doesn’t mean the tenor of your relationship with your friend has to change. Allowing her to continue being that friend can be its own form of compassion.

And another thing—it feels good to help someone in need, doesn’t it? When we deal with hardship, it can feel good to console someone else for a change. Takes the heat off us for a while. 

If you’re still feeling hesitant about bringing a personal problem to a friend dealing with death, why not simply ask if she feels up to talking about it? I guarantee she’ll give you an honest answer, and the chances are she’ll be grateful. Occasional distraction is a good thing. Her hardship crater isn’t moving any time soon, but she’ll likely be happy to help you cover up your pothole.

Whether you believe in an afterlife or not, it's safe to say that once you're dead you're not able to do much in the world. There are a few exceptions, of course: you can leave an ethical will, which can pass on your values and experiences; you can leave a Last Will and Testament, which can pass on your property, assets, and belongings; and now, thanks to the power of modern technology, you can tweet from beyond the grave.

Both CNN and PSFK shared stories this week of companies that are enabling users to send messages via Twitter even after they've died. The two companies, LivesOn andDeadSocial (both launching March 2013), have very different approaches, though.

DeadSocial is a tool for setting up scheduled tweets (or Facebook or LinkedIn messages), to be sent out at a date you specify. That means you can send your niece a birthday message when she turns 10, even if she's only 3 years old now. Your words and messages will be received in the future, after you're gone.

LivesOn, on the other hand, does not tweet your words and messages. Instead, they've created an algorithm that will analyze your word choice, syntax, and interests to create tweets that are seemingly coming from you...even though they're not.

The idea of sending messages after death is nothing new. Many people leave letters or notes for friends and family to find, such as parents leaving notes for their children to receive in the future. But the idea of a Twitter feed created by artificial intelligence posing as you? Is that you at all?

As Digiday said, "Twitter could end up being full of a lot of digital ghosts."

Last month we brought you a story via BoingBoing that asked if doctors die differently than the rest of us. (The answer, in a nutshell, was yes: doctors do die differently, often with much fewer end-of-life medical treatments.) The question raises lots of issues—specifically, what do doctors know about dying that we don't?

Radiolab, the brilliant, curious, insightful radio show and podcast produced by WNYC in New York, talked to Dr. Ken Murray (who we spoke about in our previous post on this topic). Dr. Murray lays out the reasons why doctors overwhelmingly choose NOT to be resuscitated if their breathing or heart should stop, NOT to receive ventilation (machine breathing) or dialysis, NOT to receive surgery or invasive testing...in fact, why doctors overwhelmingly choose NOT to receive almost all life-support treatments at the end of life. One thing the doctors in the study overwhelmingly DO want? Pain management.

The piece offers insight into the treatments doctors want least, and why there's such a huge chasm between what doctors want and what patients want. Looking that the effects that CPR has on terminally ill patients, the show cites evidence that CPR is ineffective as a means of restoring a patient to full health. The producer of the show looks at a study that examines the success rate of CPR on TV medical dramas ("ER," "Chicago Hope," "Rescue 911") versus the reality of the efficacy of CPR on terminal patients. On television, nearly 75% of patients who receive CPR have a full recovery; in real life, the number is closer to 8%.

Though there's not yet a full transcript of the piece available online yet, I'd encourage you to take 20 minutes to listen to the podcast here. Whatever end-of-life medical decisions you choose, Radiolab offers an interesting perspective to consider. And be sure to check out the comments; there are lots of people who disagree with the piece, who have fascinating and worthwhile perspectives to offer, as well.

via Radiolab

Today's blog post is by our Editorial Intern, Ariana Dindiyal. We're so happy to have her on the Everplans team, and look forward to more blog posts from her in the coming weeks.

Hallmark, the largest distributor of greeting cards, was recently faced with a unique and compelling request from thousands of petitioners: greeting cards for the dying.

Regina Holliday, whose husband died of cancer, discovered the need for such a product after experiencing hospice while her husband was dying. She and her husband received many inappropriate cards, such as cards wishing him a speedy recovery. But Regina and her husband both knew that he was going to die. There were no cards for people in their situation.

Regina began a Twitter campaign along with a petition on Change.org, where she requested that Hallmark create hospice cards and add them to their grand selection. The petition has so far gained 3400 supporters. Regina’s story has been covered by Forbes and ABC News.

Hallmark responded to Regina’s campaign with acquiescence in a post on their website, and they have reorganized their selection to make the 100 cards for “tough times” more readily available in stores.

Thanks to Regina’s efforts, it is easier for people to send more appropriate cards to family members and friends facing death. We know that talking about and confronting death is hard, but Regina’s work here has taken a small step towards opening difficult conversations. We greatly admire her for that.

The folks over at iMortuary put together this Valentine's Day infographic, featuring some truly odd facts and stories of love and death. Happy Valentine's Day!

Loved 2 Death