Saturday, May 18, 2013

Archive for June, 2009

The Talk of Life: Organic Legacy, Out Loud

“What’s so important about saying it out load?” I was asked a few months ago during a Q&A session at the end of one of my presentations that talked about ?creating an organic legacy.? Good question I replied. What is so important about trying to get our aging parents to speak openly to us about the story of their lives? The short answer is “in the nick of time” insights.

It is easy to think of life review as simply a reconsideration by our aging parents of the important relationships and events in their lives. Certainly that is a big part of it, but certainly not all of it. There are unexpected discoveries, things you never saw coming, to be had in the actual telling of stories out load. The emotional and spiritual surprises that are not revealed through “private brain chatter.” They are the product of the telling out loud.

In this way, the telling out loud uniquely facilitates the legacy process. It helps our aging parents discover among other things hidden truths and forgotten strengths. It doesn’t matter how well they know the details of familiar stories or how often they have been repeated in the past, at some point the retelling reveals a new insight that catches everyone by surprise. But these are “aha moments” only occur in the actual telling of the story to someone who is empathetic to occasion. Older adults need a safe opportunity to hear themselves and then to ultimately use the raw material of these exchanges in the ultimate crafting of an “organic legacy.”

By way of background, organic legacy is a concept I created in my work on the developmental tasks on the last phase of life and is discussed at length in my book How To Say It To Seniors.

How To Say It To Seniors by David Solie

How To Say It To Seniors by David Solie

For those of you who are not familiar with organic legacy, below is a summary of some the key points of the concept.

Legacy is not optional.

When understood as a developmental need, legacy insists on being addressed, either consciously or unconsciously. It’s the end product of life review, a developmental mandate of those privileged to survive into old age. Once we enter this stage, we constantly reconsider our lives to determine how we want to be remembered.

Returning to the past is not pathology.

Life review and the creation of a legacy are a natural evolution of where we need to be developmentally at the end of our lives. Legacy surfaces when control issues abate. If control issues are not resolved, they dominate our developmental mandate, and we never get to focus on legacy.

In searching for an organic legacy, events that may have been misinterpreted, misunderstood, or unrepaired in the past are reexamined.

This process reinterprets events and, if necessary, invites us to make amends. This process is difficult because of many factors:

The number of experiences we have stored up over a lifetime;
The tremendous mental focus needed to do it right;
The physical energy required to remain highly involved at a time when physical strength is ebbing each day;
Unfacilitated control issues.

Creation of an organic legacy offers the potential for healing.

Forming an organic legacy means that we have dedicated considerable time, energy and insight into what has happened in our lives, and tried to determine what everything means. Packaging the essence of that journey provides future generations with a perspective that fosters understanding, forgiveness, acceptance and resolution of values that may or may not have been appreciated during our lifetimes.

Legacy is not simply a summary of what we’ve experienced.

Part of our legacy is what we lived and part of it is what we may not have lived, but what we admired. Both parts of legacy contain values for which we would like to be remembered. Legacy coaches facilitate the articulation of these values.

Legacy gives us a chance to play an active role in the future.

Through organic legacy, we are able to create a vehicle that has the potential to influence people beyond those we encountered during our lifetime. The goal is to be part of a conversation 100 years from now, even though we are not physically present, because we set in motion a series of events or memories that live on after us.

End of Life Conversations: From A Doctor’s Perspective

My wife Janet shared with me a very moving article about end of life conversations from a doctor’s perspective entitled: Talking Frankly at the End of Life. Here is the link.

One of the most important aspects of the article is the issue of telling the patient the truth about their medical condition. “Am I doing more harm than good?” the author asks from her physician point of view. She cites a recent study in JAMA that asked 300 terminal patients “if their doctors had ever discussed care at the end of life.” As important, after the patients died, the researchers looked at the type of care the patients received prior to death and then interviewed the caregivers six months after the death to see how they were adjusting.

The results indicated that the patients who discussed care at the end of life were more likely to have a better quality of life at the end of their lives. They were not more depressed. They had less aggressive medical interventions. They went to hospice earlier. As important, their caregivers fared better.

What we want to know at the end our life is a personal choice. We all want some version of the truth but in different degrees and different doses. The key is being offered, more than once, the opportunity to hear it from the person who holds so much sway over our lives: the doctor. It is a natural part of our leaving, the slow dance we all take to step away from this life, preserving our dignity and saying our final goodbyes. Ironically, to do this we may need to remind the doctors who take care of our aging parents as well as ourselves, it’s okay to talk about the end, more than once…

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No Money: No Comment

I was recently asked what to do about aging parents who had little or no savings but refused to discuss any aspect of their “money issue.” It reminded me that our role as adult children is not necessarily about problem solving; it is about compassionate containment. So many of the issues we feel compelled to “fix” have no clear answers. The best we can do is sort out what to accept from what we can actually change. Here was the advice I offered:

The issue of money, like so many other issues in the last phase of life, is about control. The best way to approach it is to reframe money as means of maintaining control. Lack of money takes away control. This link will take you to an article I authored on “communicating touch choices” that offers a practical strategy for how to do this:http://www.aging.org/i4a/pages/index.cfm?pageid=2103&textonly=1

You may also want to consider three strategies that will help you “hedge” your parent’s financial risk:

1. Buy a long term care policy with a two years home care/two years nursing home benefit. This assumes they will cooperative with the process (i.e. signing the applications and answering questions).

2. Start funding a dedicated “side fund” for expenses that a long term care policy will not cover.

3. If you parents own their home, become familiar with how “reverse mortgages work and when they make sense.

Lastly, you need to began discussions with local area agencies on aging to determine what, if any, community resources can assist your parents if they run out of money.

This is a tough end-game, especially if you parents don’t want to talk about. The article will help you frame your conversations. Be patient but persistent in your discussions about control and your desire to help them maintain it.