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Passages: Caring is preparing

Donating body parts to science
Illustrations by Jasper Rietman

Expert answers to common questions about end-of-life issues

 

How do you avoid family money fights in the wake of a death of a loved one?

The best way to avoid money fights is to have open and honest conversations about it while the loved one is still alive, hopefully with an awareness of his or her wishes.

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Ideally, after death, family members would talk and come to an agreement. A natural leader may arise from within the family or the person appointed as executor of the estate would become the leader. If the group can’t come to a consensus, even with the leader’s help, it may be necessary to bring in an attorney.

It’s important to avoid anything that appears like you’re happy about the person’s death and the resulting benefits. This can trigger resentment or anger with others who are grieving. Try to speak in ways that are not confrontational or antagonistic. Try to acknowledge other family members’ perspectives while at the same time being true to your own.
— Colleen M. Peterson, Director, UNLV Center for Individual, Couple & Family Counseling

 

When are my children old enough to talk honestly about death?

It is important to talk honestly with children about death no matter what their age; however, it’s important to take a child’s developmental stage and understanding of death into account when talking with them. Preschool children have a limited understanding of the permanence and universality of death. They typically see death as reversible, temporary and impersonal. Between the ages of 5 and 9, children are beginning to realize the permanence and universality of death. They often associate death with things that personify it — a skeleton or angel of death. Children between 9 and adolescence begin to have a total comprehension that death is irreversible, a part of living, and that they too will die someday. They may begin to develop philosophical views of death. Teenagers often become intrigued with finding the meaning of life and exercising control over their fears of death through taking unnecessary chances with their lives. Taking these factors into account will help you tailor your conversation to help your children get the most out of what can be a difficult discussion. — Colleen M. Peterson, Director, UNLV Center for Individual, Couple & Family Counseling

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When should I start my estate planning?

You should start now. Begin by thinking about your assets, including investments, retirement accounts, insurance policies, real estate, business interests, as well as sentimental or financially valuable items like cars, jewelry, artwork, and family heirlooms. Then, decide what should happen to these assets upon your death and who should inherit certain items. Estate planning using a Will or Trust ensures your assets will be transferred according to your wishes rather than through intestate succession (state laws dictating who receives assets). Once you make a plan, communicate your intentions to loved ones to reduce the chance of disagreements after your passing. — Michael I. Kling and Ann Mackey Kling, Kling Law Offices

 

When is my loved one eligible for hospice?

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Your loved one is eligible for hospice if he or she has a terminal illness and life prognosis is six months or less, according to a physician. The goal of hospice is to improve the quality of a patient’s last days by offering comfort and dignity, while addressing the physical, emotional, social and spiritual needs of patients and families. Hospice care neither prolongs life nor hastens death.

Hospice care is provided in the location that best meets the needs of the patient, including the home, group homes, assisted-living facilities, and inpatient units. Inpatient hospice facilities are sometimes available to assist with short-term pain and symptom management or to provide respite for caregivers. A team of professionals, including physicians, chaplains, and social workers, provides care and comfort to the hospice patient. Hospice addresses all symptoms of a disease, with an emphasis on controlling a patient’s pain and discomfort. Hospice also offers bereavement and counseling services to families before and after a patient’s death. — Nora Luna, Director of Diversity & Education, Nathan Adelson Hospice

 

What’s the difference between a will, a trust and a living will?

A will is a legal statement that goes into effect upon your death and directs the disposition of your assets. Transferring assets pursuant to a will involves court oversight through the probate process. Provisions of a will apply to property in your own name, not to jointly held or other assets. Trusts are private documents that take effect upon creation. Trusts can be used to distribute property before your death, at death, and afterwards. Assets properly included in a trust pass outside of probate.

A “living will” is a legal document that expresses your desires for medical care and treatment in the event you are incapacitated. — Michael I. Kling and Ann Mackey Kling, Kling Law Offices

 

How hard is it to donate my body to science?

It’s not that hard, but there are a few requirements. Donors have to be Nevada residents, and they can’t weigh more than 230 pounds. It usually starts with a telephone call to my office. I get your name and address, and I send you an enrollment packet, with a vital stats form and some health questions. Once you’re accepted, we do an assessment at the time of death. The condition of the body is important. We cannot accept anyone who has Dementia or Alzheimer’s, or Hepatitis B or C. We also cannot accept anyone who died in a severe car accident, a fire or an explosion.
— Joyce King, Administrator of the Anatomical Donation Program, University of Nevada School of Medicine

 

I seem to be particularly forgetful lately. Is this just harmless forgetfulness or a sign of dementia or Alzheimer’s? How do I find out?

It’s hard to know without an evaluation from a medical provider. Although memory loss was traditionally thought to be a normal part of aging, this is no longer thought to be true. There are a number of causes for memory loss. These include more benign causes like depression, poor sleep, or problems with vitamin or hormone levels to neurological diseases like stroke, Parkinson’s disease, and Alzheimer’s disease.

If a person’s memory or cognitive abilities are so poor that they cannot function independently, the person is considered to have dementia. Dementia is a description of a person’s functioning — saying a person has dementia does not tell us anything about the cause.

Alzheimer’s disease is the most common cause of dementia in people over 65. Alzheimer’s disease is caused by the slow buildup of abnormal proteins in the brain. Although there are no blood tests for Alzheimer’s disease, we can look for Alzheimer’s disease changes on brain scans. The best person to evaluate a memory change is a neurologist. — Aaron Ritter, Resident Fellow at the Cleveland Clinic Lou Ruvo Center for Brain Health

 

How do I write an obituary?

When I sit down with a family, I get all of the basics, and ask them to tell me about their loved one. Was there something they often said or did? How did they interact with others? What were they known for? Think about your favorite memories, experiences, times spent with them. Maybe describe a few things about them that make you smile. Personal details and humor are definitely acceptable. Some of the best obituaries I have read include both.

One other thing: You may want to start your funeral planning by writing your own obituary. It is a great way to be sure the information you want to include is included, and it is also a good way to begin a discussion about death with your family. — Laura Sussman, Licensed Funeral Director, Kraft-Sussman Funeral Services

 

When is it appropriate to start dating after the death of a loved one?

The answer is less about an amount of time and more about personal readiness. Where are you in the grief process? How ready do you feel to start exploring another relationship? The key thing is you’re moving into a new relationship complete and whole, not as a means to fill a void. Also, keep in mind:

Public perception could be a factor. Be aware that others often have opinions about dating after a spouse dies, particularly if they were close to the deceased person.

Be careful about how much you refer to your deceased partner. Talking too much about him/her can be a turn-off and a possible indication that you may not be in a place to be fully present with the current person you are dating.

Feeling guilty might be a sign that you’re not yet ready, but it depends. Feeling guilty because you aren’t being faithful to the deceased person is different from feeling guilty that you’re enjoying being with people again.

Colleen M. Peterson, Director, UNLV Center for Individual, Couple & Family Counseling