OLLI

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OLLI Funeral Consumers Alliance of the
TriangleGoalclear away the clouds and myths
surrounding current end-of-life practices
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Living for TodayPlanning for Tomorrow

• Making Informed ChoicesAboutEnd of Life Care
• Body Disposition
• Reaching Them with Conversations

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Just for perspective...
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Overview

• Meeting Death on Our Terms
• Health Care Issues
• Advance Directives
• Preferences
• Conversations
• Agents
• Signed, Sealed, Delivered
• Body Disposition Choices
• Remembering and Grieving

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Who am I?Preparation for Death personal,
spiritual - 1

• What has been important in my life?
• What to preserve, explain, or remark on,
• Who and what influenced me?
• For me?
• For those near to me?
• Challenges faced in our journey
• Memories of family, events
• How do these affect your views about
• Health Care
• Body Disposition

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Who am I?Preparation for Death personal,
spiritual - 2

• What does my obituary say?
• Do I even have one?
• For whom is it intended?
• Have I thoughts to leave for others?
• Ethical Wills or Other Statements

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Four Things

• 4 things that matter most
• "Please forgive me," 
• "I forgive you,"
• "Thank you,"
• "I love you."

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Five Wishes

• Five Wishes lets your family and doctors know
• Who you want to make health care decisions for
  you when you can't make them.
• What kind of medical treatment do you want or not
  want.
• How comfortable you want to be.
• How you want people to treat you.
• What you want your loved ones to know.

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Health Care Quality of Life Your Values

• Is chronic decline foreseeable?
• Unexpected acute crisis or accident
• Use and Non-use of 911/EMS
• Role of prognosis/expectations
• Possible or likely complications
• Treatment goal or expected outcome
• What to die from?
• DNA Lifestyle
• When to seek what kind of care?
• At what point might you lose the ability to
  choose?

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Health Care - Crisis

• Critical Care
• Curative (Hospital) vs.
• Trial Periods for treatment options
• Palliative (Comfort Care - Hospice)
• The control of pain and/or other symptoms using
  one or a combination of interventions to create
  the desired levels of comfort and alertness

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Intermission

• Heres one of the galaxies pictured, UDF 423.
  This galaxy is 10 BILLION light years away. When
  you look at this picture, you are looking
  billions of years into the past.

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Advance Directives

• Purpose
• Allow you to give instructions about the health
  care you desire in the event you become unable to
  communicate
• Types of documents
• 1. Health Care Power
• of Attorney
• 2. Desire for a Natural Death
• 3. Medical Directive or Order

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Durable Power of Attorney for Health Care

• Choosing your agent
• Talking with your agent
• Powers - to grant your agent
• Powers Durable beyond inability to
  communicate
• Powers Revocation can be revoked by maker
• Powers Registration can be registered by
  agent if principal is incapacitated
• Choices you make in your power of attorney
  document (DPOAHC)

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DPOAHC - Agents

• How many agents 2-4
• Any agent may refuse or be unable to serve at a
  particular time
• Always have someone ready to serve
• Which Agents Serve?
• One at a time (only one ship captain at a time)
• In the order you list them in a DPOAHC
• When Is Power of Attorney Effective?
• Can be immediate for some purposes
• Can include a HIPPA release

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DPOAHC Qualities of Agents

• SWAAPP
• Strong character say NO
• Willing to do
• Able learns as needed
• Adaptable adjusts to reality
• Persistent keeps at it
• Present physically if possible

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Health Care Medical Orders

• Medical Orders
• Do Not Resuscitate - (DNR - yellow),
• Medical Order for Scope of Treatment (MOST
  pink) or
• Physicians Orders for Life Sustaining Treatment
  (POLST colored)

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Conversations and Trends

• Role of family/stakeholders
• Conversations about your wishes are important
  for everyone
• You hope for agreement
• At least you learn about disagreement and plan
  accordingly
• Death may bring out the best or worst in a
  family
• Consumer movement trends (Going Up)
• Cremations
• Home Funerals
• Green Burials What shade of green?

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Documents - Signed, Sealed, Delivered

• Documents
• Durable Power of Attorney for Health Care
• Desire for a Natural Death (Living Will)
• Advance Directives for Health Care
• Testamentary Wills and General Powers of
  Attorney
• Witnessing Notarizing MANDATORY!
• Distributing IMPORTANT !!
• Health Care Agent(s)
• Health Care Providers (Docs and Facilities)
• !! - Family and Your Community (varies)

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Intermission 2
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Body Disposition Tree of Choices

• What should be done with my body?
• Tree of choices
• donation
• organs for transplant may preclude whole body
  donation
• eyes corneas for transplant with organs or
  whole body,
• tissues for research, training, restoration,
• enhancement
• cremation
• burial

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Anatomical Donation Options

• Organ donation - minutes
• save lives
• Eye or tissue donation - hours
• enhance lives
• Whole body or tissue donation - hours
• medical education, research, training and
  cosmetic surgery
• You can decide what you want to donate and for
  what purpose
• You must make your wishes known!

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Everyone should consider donation

• Educate yourself about options
• Make an informed decision
• Specify type of donation you wish to make
• Organ/eye/tissue/whole body
• Specify uses
• save or enhance lives, education, research
• Know the organization you are donating to
• Specify your donation in writing
• Share your wishes with your family

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Whole Body Donation to Medical School

• Each medical school has its own requirements and
  needs.
• Start by contacting school closest to the donors
  residence
• Some will accept with organs removed
• Prefer paperwork to be completed in advance of
  death
• Certain conditions may cause body to be
  unacceptable
• Too heavy or light
• Unacceptable damage from violence or accident
• Temporary oversupply
• Back-up plan is a must
• donation may not be accepted at time of death

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Ensure your donation decision

• Indicate your decision on your drivers license
  or state ID card
• Register at www.donatelifenc.org
• (you can specify your donation)
• Put it in your DPOA for Health Care
• Share your decision
• with your family and health care providers
• If donated organs or tissues are determined to be
  unsuitable for transplant, they are used for
  research and education

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The Gift of Life Organ Donation

• One donor can save up to 8 lives through organ
  donation
• What can you donate?
• Heart (1), lungs (2), liver (1), kidneys (2),
  pancreas (1), small intestines
• Who can donate?
• Those who die in a hospital
• Body must have a continuous supply of blood
  oxygen
• People of all ages medical histories
• Medical suitability determined at time of death
• Hospitals are required to notify the local Organ
  Procurement Organization (OPO) of impending
  deaths
• Organ Donation The Need is Great
• Over 100,000 on national wait list for organs
• Almost 3,000 on wait list in NC
• 18 people die each day from lack of available
  organs
• National allocation system based on need
• Many checks and balances
• Donation process happens quickly and
  transparently in the Operating Room

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Body Disposition Your Rights

• A family may be its own funeral director
• They are not required to use a FD.
• National Home Funeral Alliance provides help
• Role of
• Funeral home
• Ownership Big chain or independent
• FTC Funeral Rule consumer rights
• GPL General Price List
• Visitation / Viewing
• Embalming
• Crematory
• Independent vs. Captive
• Authorization to cremate self-signing

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Body Disposition Related Services

• Associated Goods and Services
• Body transport, handling can be provided by a
  licensed transport company, w/o a funeral home
• Casket, vault/liner or urn purchase from 3rd
  party
• Additional Details
• Death Certificates can be done by family after
  doctor signs
• (3-5 certified copies sometimes simple
  photocopies are accepted)
• Obituary (ies) can be done by family
• Audio/Video/Internet Streaming Records
• beware an emotional purchase
• Internet Presence retain or remove

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Body DispositionCemeteries and Money

• Role of cemetery
• Earth Burial, Mausoleum, Crypt,
• Vault vs. liner
• Terms and conditions
• Costs and payment options (All firms)
• Cash for at need,
• Prepaying
• Preneed (trust and insurance) Inflation-proofing
• Prefunding
• Insurance
• Bank Account, CD, POD

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Remembrances

• Why have services?
• Purpose, benefiting whom?
• Who participates and leads
• Religious, secular
• When and where may they occur?
• Obituary(ies)
• Why have an obituary?
• What will it cost?
• Role of audio or video records

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Grief Adjustment

• Grief and grief support
• Fog of Death go slow on decisions
• Religious institutions,
• Hospices,
• Funeral homes
• Stages of grief process -- back and forth.
• Death and Taxes
• Social Security Notify pronto
• Death Certificates
• Estate and Trust Administration (another session)

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Glossary

• Agent
• Durable
• Registered
• Revocable
• POA Power of Attorney General or Financial
• POAHC Power of Attorney Health Care
• DNR Do Not Resuscitate
• Desire for a Natural Death
• AD Advance Directive

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Links

• FCAT-NChttp//www.fcat-nc.org
• Funeral Consumers Alliance www.funerals.org
• National Home Funeral Alliance -
  NHFAwww.homefuneralalliance.org
• What to Do If Someone Dies At Homewww/eldercarete
  am.com/public/757.cfm

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About FCAT

• FCAT is one of more than 100 affiliates of the
  Funeral Consumers Alliance (FCA)
• Started
• FCA, 1939
• FCAT, 1966
• Most are 501(c) (3) or (4) under the Internal
  Revenue Code.
• Charitable/educational organizations, can receive
  donations
• One of five affiliates in NC
• Asheville (Western), Charlotte (Central),
  Greensboro (Piedmont), Research Triangle (FCAT),
  Wilmington (Coastal Carolina)
• We are an all volunteer group

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FCAT Provides You

• FCAT Membership Benefits
• Documents
• Annual Meeting
• Newsletter
• How Can You Help FCAT?
• Volunteering
• Spreading the word
• Promoting the work
• Donating

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Series Summary

• Who Am I
• Medical Care
• Body Disposition
• Services and Memorials
• Writing it Down
• Evaluation written
• Discussion

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FCAT Advocacy

• Regulation and advocacy
• State agencies
• NC Board of Funeral Service
• NC Cemetery Commission
• General Assembly
• Federal agencies
• Federal Trade Commission (FTC)
• Funeral Rule

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UUFR

• Care Team
• Diann Irwin
• UUFR Foundation
• Tom Atkinson
• Leaflet
• Investible Donations
• UUFR Memorial Garden
• Marge Link
• Leaflet
• Forms sample
• UUFR.org search memorial
• Memorial Fund specific to an individual

Am I
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