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Preflighting for the Final Flight

WindOnHisNose

BENEFACTOR
Lino Lakes MN (MY18)
The thread I am initiating now is regarding a subject that I have given a great deal of thought...preparing for our final flight. I am wanting to avoid religious overtones, in that we have a very diverse group of people on this website, and I wish to leave the spiritual side of life to others, so in responding or adding to the thread I respectfully ask that you keep this in mind.

You may recall that a dear friend of mine, Ron Barrows, was diagnosed with pancreatic cancer in November of 2009. Ron was an avid proponent of aviation, having built a Glastar, was a private pilot and was well-known at the local airport as the man to talk to when it came time to upgrade or finish your hangar. He was a do-it-all, get ‘er done type and the kind of person who lit up the hangar when he came around. Optimistic, up beat, bright…you know the type.

Ron asked me to accompany him to his chemotherapy sessions, and I have shared with you as to how that went, so I won’t bore you with the details except to say that it was one of the most important things I had ever done in my life. I watched him take his medicine, and I mean that at a number of levels.

As Ron began to fail near Thanksgiving of 2010 he called me one day and asked me to meet him at my hangar (which was really his, in that his handiwork was seen throughout) and I agreed to meet him there. When I arrived he was sitting inside at the workbench and I could tell he had something on his mind. That something sat in front of him, a document which I had given to him months earlier, a living will entitled “Five Wishes”. It is a directive which allows one to think through how one wishes to go through our last days. The idea is to have a legal framework which spells out what our wishes might be for things we face and are unable to respond to verbal or other sensory input. Things like do we want life support, do we want pain medicines, do we want to be given IV fluids, do we want to be cremated or buried, what music might we want…things that are sometimes really difficult to think about and discuss with anyone. It is a fact, though, that many do not take the time to do this, even when faced with a terminal illness. I had completed my Five Wishes a couple of years earlier, when I had just survived a life-threatening complication of a relatively benign medical procedure, so I knew what this document meant to me and to my loved ones. I had gently encouraged Ron to give this some thought, and there we sat, brothers of a sort, thinking thoughts that are difficult, to this day, for me to write about.


Ron began by saying that he had discussed this document and his wishes with Cathy, his beloved bride, but she had felt unable to really think about it because it was really hard for her to imagine that her husband, this strong, tall compassionate man might really be taken away from her. Knowing Cathy, I could appreciate the dilemma she was in, and the dilemma Ron was in. So I took it as an honor and duty to help him fill it out.

We went through the document line by line, and I would ask him questions to clarify anything that wasn’t clear to him, or for things that weren’t clear to me from his responses. I was surprised by how clearly he had visualized his final days, how much detail he was willing to discuss there in the privacy of the hangar, with the sound of airplane engines flying and taxiing about. He knew what he wanted, and he knew what he did not want. He knew how he wanted to be taken care of if he suffered pain, if he wanted the priest around or not, if he wanted life support if it was clear that he wasn’t likely to make it. He looked at me with that mischievous look when he joked about some “funny” funerals he had gone to, how he had attended some that were really great celebrations about the life of the individual who had passed, how he wanted it to be like that for him.

I was amazed at the clarity of his thought process and the extent to which he, the eternal optimist, had planned for the end of his life. No tears were shed. No anger was expressed. No regrets were offered.

When the final page was completed he sat there, looking very tired, but looking very relieved. It was the same kind of satisfied look I had seen when he had completed a modification to his airplane, or after he completed the hangar. Satisfied. At peace.

Ron stood up, gave me a firm handshake, then a big hug right there in the hangar that he built and we both pretty unsuccessfully fought back tears as we wondered what would be in store for him in the months to come. I could sense, though, a peacefulness in his demeanor which I had not seen coming into the hangar.

I write this to you, my friends, as encouragement to you to please take time to sit down with whatever instrument you choose and fill out in detail a living will. There is nothing special about Five Wishes, except that it provides you with a template which lets you focus on the threshold of the final landing strip, the final runway, at a time when you are still at altitude, able to see clearly. Please take time to do this with your spouse, your significant other, with your best friend or someone you trust. It is very important.

Thank you.

Randy

You can download the pdf of Five Wishes at www.agingwithdignity.org/forms/5wishes.pdf. I am sure there are others, but this is the one I filled out for myself, so I decided to share it with you.
 
Thanks for your inspiration Randy. Your friend is blessed to have your friendship in his life. At the end of the day, that's really the most important thing there is. Well done.

Jim
 
http://www.ted.com/talks/peter_saul_let_s_talk_about_dying.html
This a link to a talk given by an Australian doctor outlining the need for planning our exit strategy. Ron was very fortunate to have your friendship during his planning time. My son and his wife are visiting her Dad who is terminally ill right now. After relating over the phone how the week in Wisconsin had gone he said " Dad you have to chose what you want ahead of time". Thank you for starting this thread even though it is a difficult and easily ignored subject.
 
Randy, thatnks for bringing this up. I hope everyone takes the time to prepare a basic will, power of attorney and advanced health care directive. They are absolutely essential and an ounce of preparation wil prevent the ten tons of cure required when you don't have them.
 
Well done Randy. Life is precious and having great friends to share it with, especially in death is a blessing. It is indeed difficult to talk about our own mortality or that of someone so close but it is necessary and cathartic.
Thank you for sharing and being a great friend.

David Childs
 
I am thinking this will be the last contribution I make regarding my friend, Ron Barrows, as it can be looked at as depressing, and sad, which it is. But this friendship has taught me some very valuable lessons, and I want to close this chapter with an update, and a thought.

After a long battle with pancreatic cancer Ron passed away on March 21, 2011. It happened to have been my birthday. I had become the liaison between Ron and his wife, Kathy, in that they needed someone to be a spokesperson, so to speak, with the many, many friends they had, all of whom wanted to know how Ron was doing, how Kathy was doing. I really had never been in this kind of situation in the past, didn't really know what to say but I gave it my best shot. I have shared much of those thoughts with you here on the Aeromedical Forum thread...which has now spawned into the Medical Matters forum.

I received a call at about 5:00 on the 21st of March from Kathy, asking me to come quickly. She felt he was passing on quickly. I immediately drove there and had the privilege of being there with Kathy when he rather quietly passed.

What I am about to share with you is the final email I sent out to all those friends and loved ones the evening after the memorial service Kathy had for Ron. I felt it important to tell them some of the things I had learned in Ron's final days, days in which he narrowed down almost daily the people he wished to allow to visit him. I knew it was difficult for him to discourage his close friends from visiting him and I was at a loss of how to explain this until I read a pamphlet that Hospice had given to Kathy. They pointed out that as we approach the end of our journey it is often part of the process to narrow the people with whom we want to visit, culminating in perhaps only one or two or three people to be there at the very last moments of life. Now, for a gregarious man like Ron that seemed very much out of character, and I felt that some of his friends feelings were being hurt. My personal experience with family and friends who have passed on was quite different, in that their passing was very quick from my perspective. With this information in mind, and considering the fact that most of Ron’s friends were pilots or at least new of his love of aviation I sent out the following message to try to explain why Ron chose to limit his visitors. I know that my family and loved ones will appreciate the analogy I presented in this message, and as aviators yourselves it might be helpful if you find yourself in the same situation as me.



"Dear friends, I would like to offer a few comments regarding this journey, then will sign off.


First, I am so impressed by you and the support you offered Kathy and her family during this most difficult time. The thoughts and prayers were felt by all of us. The ability for you to communicate your feelings of love and support to the Barrows was difficult in the last several weeks as Ron grew weaker. Kathy was provided some very important insight by the Hospice people, and I learned much from it and feel it important to communicate to you. It is their experience that person goes through several stages in preparing ourselves to pass on, a series of isolations. Initially, we begin to become more focused upon our family and extended family, not really being able to focus upon and grant access to everyone. As we progress we then begin to narrow the focus further, granting access to only our family, then narrowing it even further to only one or two of our closest persons, sometimes even narrowing it to the point of being entirely by ourselves. This is difficult for us to understand and accept, particularly when thinking of Ron Barrows, the ultimate extrovert and friend to all. We may think that we have failed him somehow, as we find ourselves feeling isolated from someone who has never put up barriers to us in the past.



When Kathy asked me to read the book from Hospice describing this process it was very comforting to me, and I hope will be comforting to you in reconciling what has transpired in the last several weeks. Put in aviation terms (sorry) it makes perfect sense. As we are travelling cross country, in cruise flight, everything is under control, things are relatively smooth and the whole world is open to our vision. When we hit turbulence we become more focused and our inputs become somewhat limited, we shut out some of the outside world, until things smooth out. As we recognize that we are going to need to descend for our final landing we become focused again, as we prepare for our final approach. The last few minutes are spent becoming keenly aware that we need to focus only on the environment of the landing zone, our eyes are on the numbers of the runway and we begin to block out our passengers, even our copilot, in the moments before we begin our flare, our senses focusing on those final moments that all of us feel, whether we be pilots or passengers on an airliner, as we hold our breath just a bit as we virtually feel the wheels searching for contact with terra firma, just a few moments of suspended animation. We then breath just a little bit easier as we have safely reached our destination. I think we have all felt that as we experience flight, regardless of our perspective.



Ron has been on such a flight and we have joined together to help him make a safe landing. We have fulfilled our commitment to him to support him in any role that he might have chosen for us. For me, I am so proud of how we have all helped him, and his copilot Kathy, and his passengers…his family. He is likely to have given us the big “thumbs up” sign as we completed yesterday’s events, with the final flyby. “Nicely done”, he would be saying.


What do we do now, how do we fill the void? I am struggling with this at the moment, actually, and do not have it figured out for myself, and certainly have no pretense to be able to offer you the solution for you. I do know that we must accept what Ron has given us and to live our lives, enriched as they have been by his presence. I know I will need support as I move on. I know that each of Ron’s Rooters will need to support each other in many ways. Kathy and her family will have days of loneliness, then hours of loneliness, and will need our continued support and friendship. Ron would have wished for our support for Kathy and her family. Ron told me in the hangar that he wanted us all to move on and live full lives, and not to feel sorry for ourselves when he passed on. So I am trying not to feel sorry for myself, or to feel sorry for you, or to feel sorry for Kathy and her family. I just need to keep reminding myself of that.


I feel as though my promise to Ron Barrows has now been fulfilled. I have kept my promise. I welcome communication with all of you, and feel so thankful to have been able to act as Ron and Kathy’s advocate, so to speak. I am humbled by that. What an honor to have been one of Ron’s Rooters. Please let me know if I can be of assistance to you.
With this in mind, I wish you all the very best in health, wealth and friendship.


So, as my favorite cowboys Roy Rogers and Dale Evans sang, "Happy Trails to You, Until We Meet Again."


May God Bless You.

Randy"


I hope this has been helpful or will be helpful to you all in the future, and I hope it hasn't seemed like endless dribble:) I look at so many of you as good friends, and I wanted to share this with good friends. OK, it is finished.

Randy
 
Randy

Thank you for sharing, in a way only you can do. Your wise observations help us all with family and friends. But most of all, they help with "me" thoughts as we prepare for meeting our maker.

Lou
 
Randy,

Thanks for this post! This past weekend I attended services for a very dear friend whose aviation career started with N3N's, post Pearl Harbor, and ended with supersonic fighters as a Marine Aviator. His detailed wishes were a great comfort to his wife and family. My takeaway is to make your wishes as specific as possible to avoid your loved ones having to make decisions that they may question.

David Rice
 
This is really good information. I wish my grandparents had done something like this, it would have made things a lot easier.
 
I am thinking this will be the last contribution I make regarding my friend, Ron Barrows, as it can be looked at as depressing, and sad, which it is. But this friendship has taught me some very valuable lessons, and I want to close this chapter with an update, and a thought.

After a long battle with pancreatic cancer Ron passed away on March 21, 2011. It happened to have been my birthday. I had become the liaison between Ron and his wife, Kathy, in that they needed someone to be a spokesperson, so to speak, with the many, many friends they had, all of whom wanted to know how Ron was doing, how Kathy was doing. I really had never been in this kind of situation in the past, didn't really know what to say but I gave it my best shot. I have shared much of those thoughts with you here on the Aeromedical Forum thread...which has now spawned into the Medical Matters forum.

I received a call at about 5:00 on the 21st of March from Kathy, asking me to come quickly. She felt he was passing on quickly. I immediately drove there and had the privilege of being there with Kathy when he rather quietly passed.

What I am about to share with you is the final email I sent out to all those friends and loved ones the evening after the memorial service Kathy had for Ron. I felt it important to tell them some of the things I had learned in Ron's final days, days in which he narrowed down almost daily the people he wished to allow to visit him. I knew it was difficult for him to discourage his close friends from visiting him and I was at a loss of how to explain this until I read a pamphlet that Hospice had given to Kathy. They pointed out that as we approach the end of our journey it is often part of the process to narrow the people with whom we want to visit, culminating in perhaps only one or two or three people to be there at the very last moments of life. Now, for a gregarious man like Ron that seemed very much out of character, and I felt that some of his friends feelings were being hurt. My personal experience with family and friends who have passed on was quite different, in that their passing was very quick from my perspective. With this information in mind, and considering the fact that most of Ron’s friends were pilots or at least new of his love of aviation I sent out the following message to try to explain why Ron chose to limit his visitors. I know that my family and loved ones will appreciate the analogy I presented in this message, and as aviators yourselves it might be helpful if you find yourself in the same situation as me.



"Dear friends, I would like to offer a few comments regarding this journey, then will sign off.


First, I am so impressed by you and the support you offered Kathy and her family during this most difficult time. The thoughts and prayers were felt by all of us. The ability for you to communicate your feelings of love and support to the Barrows was difficult in the last several weeks as Ron grew weaker. Kathy was provided some very important insight by the Hospice people, and I learned much from it and feel it important to communicate to you. It is their experience that person goes through several stages in preparing ourselves to pass on, a series of isolations. Initially, we begin to become more focused upon our family and extended family, not really being able to focus upon and grant access to everyone. As we progress we then begin to narrow the focus further, granting access to only our family, then narrowing it even further to only one or two of our closest persons, sometimes even narrowing it to the point of being entirely by ourselves. This is difficult for us to understand and accept, particularly when thinking of Ron Barrows, the ultimate extrovert and friend to all. We may think that we have failed him somehow, as we find ourselves feeling isolated from someone who has never put up barriers to us in the past.



When Kathy asked me to read the book from Hospice describing this process it was very comforting to me, and I hope will be comforting to you in reconciling what has transpired in the last several weeks. Put in aviation terms (sorry) it makes perfect sense. As we are travelling cross country, in cruise flight, everything is under control, things are relatively smooth and the whole world is open to our vision. When we hit turbulence we become more focused and our inputs become somewhat limited, we shut out some of the outside world, until things smooth out. As we recognize that we are going to need to descend for our final landing we become focused again, as we prepare for our final approach. The last few minutes are spent becoming keenly aware that we need to focus only on the environment of the landing zone, our eyes are on the numbers of the runway and we begin to block out our passengers, even our copilot, in the moments before we begin our flare, our senses focusing on those final moments that all of us feel, whether we be pilots or passengers on an airliner, as we hold our breath just a bit as we virtually feel the wheels searching for contact with terra firma, just a few moments of suspended animation. We then breath just a little bit easier as we have safely reached our destination. I think we have all felt that as we experience flight, regardless of our perspective.



Ron has been on such a flight and we have joined together to help him make a safe landing. We have fulfilled our commitment to him to support him in any role that he might have chosen for us. For me, I am so proud of how we have all helped him, and his copilot Kathy, and his passengers…his family. He is likely to have given us the big “thumbs up” sign as we completed yesterday’s events, with the final flyby. “Nicely done”, he would be saying.


What do we do now, how do we fill the void? I am struggling with this at the moment, actually, and do not have it figured out for myself, and certainly have no pretense to be able to offer you the solution for you. I do know that we must accept what Ron has given us and to live our lives, enriched as they have been by his presence. I know I will need support as I move on. I know that each of Ron’s Rooters will need to support each other in many ways. Kathy and her family will have days of loneliness, then hours of loneliness, and will need our continued support and friendship. Ron would have wished for our support for Kathy and her family. Ron told me in the hangar that he wanted us all to move on and live full lives, and not to feel sorry for ourselves when he passed on. So I am trying not to feel sorry for myself, or to feel sorry for you, or to feel sorry for Kathy and her family. I just need to keep reminding myself of that.


I feel as though my promise to Ron Barrows has now been fulfilled. I have kept my promise. I welcome communication with all of you, and feel so thankful to have been able to act as Ron and Kathy’s advocate, so to speak. I am humbled by that. What an honor to have been one of Ron’s Rooters. Please let me know if I can be of assistance to you.
With this in mind, I wish you all the very best in health, wealth and friendship.


So, as my favorite cowboys Roy Rogers and Dale Evans sang, "Happy Trails to You, Until We Meet Again."


May God Bless You.

Randy"


I hope this has been helpful or will be helpful to you all in the future, and I hope it hasn't seemed like endless dribble:) I look at so many of you as good friends, and I wanted to share this with good friends. OK, it is finished.

Randy

I had a call from one of our colleagues who had sad news from her closest friend...pancreatic cancer. I sent her this thread and I thought I would repost here to bring this to minds of those of us who may find ourselves dealing with a terminal illness. If the shoe fits, please take a moment to read this thread. If you think it fits other aviation people, pass this on to them, as I have had many, many responses that the shoe fits them, and found this helpful.

Randy
 
I had a call from one of our colleagues who had sad news from her closest friend...pancreatic cancer. I sent her this thread and I thought I would repost here to bring this to minds of those of us who may find ourselves dealing with a terminal illness. If the shoe fits, please take a moment to read this thread. If you think it fits other aviation people, pass this on to them, as I have had many, many responses that the shoe fits them, and found this helpful.

Randy

I am sorry to bring this thread back to life, but today we received word that one of our own is suffering from a cancer from which there is not likely a cure. While we pray for a miracle, I thought it appropriate, as your gynecologist :smile:, to bring this to the forefront, once again. We are blessed to have some very, very dear people here to whom we give thanks for letting us cross paths with them. Many here help us get from one point in our lives to another, and when we know that there is someone who is going through the final phases of flight it is with thanks that I give for letting us cross paths with you special people. Good Lord, this is what this is all about.

Most respectfully submitted,

Randy
 
Every step we take is one step closer to our final one. I have been fortunate to meet many wonderful people, learn from so many of them. I am grateful for each; as each one passes on, I try to dwell on the honor of knowing them. It just seems easier for me.

If there is something I can do to help in the struggle, please let me know. Don't walk alone down the path, you have friends.
 
In keeping with the spirit of Randy's original post I will offer a few observations:

First I will explain that for the almost past twenty years I have been an RN and worked the last eight years in Gerontology ( elderly) and end of life/hospice care. In this capacity I was a nurse manager as well as hands on care so I may be able to share some personal insight.

First and foremost is coordinate and communicate your wishes with the attending physician and your family regarding the best medical/personal/spiritual outcome for you, and your loved ones. Anyone who is the process of closing the final chapter of their live is entitled to do so peacefully, free of pain/discomfort, and with dignity.The process of dying is hardest on those we leave, keep in mind that whatever path you choose will have a lifelong impact on those we leave.

DNR: Do Not Resuscitate. Have a DNR document drawn up and make no less that FIVE copies.All signed with original signatures. One for Rescue, one for hospital ER and possibly the floor if you are hospitalized, your own copy, family copy. I have personally witnessed rescuers who will ignore a photocopy of a DNR as well as a ER.

Advocate: Have a friend, family member, physician, RN care giver who is willing to act as your legal voice if necessary . You may go as far as giving power of attorney regarding your healthcare decision making to remove life support to an individual who is not emotionally involved. My brother has that power. My wife has stated that she is unable to make that decision if the situation requires it. Again, I have been through this when the dying person is unable to communicate, there has been no legal document drawn up, and family members refuse to make the decision. A very unfortunate outcome for all concerned.

Pain meds: No one should be in pain at the end of their life. There are multiple pharmacological interventions that are available that when used appropriately can keep a person alert, and pain free, or can put a person into a deep sleep util they pass. Point being is that pain intervention is available.

Speak up: Never, ever, under any conditions be hesitant to speak up to professional care givers and communicate your wishes and/or have your family do so.
If that does not have the desired results there is an ombudsman that can be notified.

Hospice: A good hospice program is a god send. They anticipate every move and you will never have to worry. If you are diagnosed with a terminal illness or suffer a catastrophic event, make immediate inquiry into hospice programs with your physician and then do an internet search to ascertain/ verify the effectiveness of the service provider ( is it generally felt they do a good job)

Physicians: Keep in mind that doctors don't like dealing with their patients who are dying. It's an overly general statement, but accurate. It's the nursing staff/hospice that are with the dying. Trust me---I had my own issues I had to deal with for years until I formed my own conceptual ideas of life and death and my own mortality. Every healthcare worker who is compassionate must do this to protect themselves emotionally. Doctors are people. Don't be too surprised if you begin to see less and less of the doctor unless it is for prescribing pain meds. The nursing staff/hospice or perhaps an RNP ( nurse practitioner) will have to be incorporated increasingly with the care plan.

Nursing staff/hospice: Voice your concerns if you have any. If you don't like an explanation consult with others or seek out a knowledgeable advocate. It is a very emotional and difficult time and decision making becomes difficult for many people. If you feel as though proper care is not being properly rendered or pain meds not given often enough or in sufficient dosage to alleviate pain/discomfort----say something to MD, supervisors etc.

Medication: There are a whole host of medications for anxiety, depression, pain etc. Hospice should be well acquainted with all available options. I attended many classes on pain management r/t to end of life care and have sat with the dying and their families and explained in detail that there are many options to alleviate almost any and all discomfort. Dying in pain should never be a concern.


If anyone has any questions, please ask and also seek out advice from others who have had the same experience. One of the motivations for me to enter nursing was I wanted to make a difference after I spent eight months with my dad almost thirty years ago when he passed and I was not a happy man .

TC
 
Do any of you know of a site for simple Wills? I just want something simple to divide my assets equally for my three children... no special provisions about age or anything else. Some site like the five wishes? Thanks
 
Dianna

Please---and you can run this by Jeff Russell----consult with an attorney first---it will only cost a few hundred bucks. You may want to consider a trust (s) to avoid probate (all wills are subject to probate) Wills off the internet can put your heirs into a legal nightmare. I put everything I own into trusts years ago for my daughters---essentially I am now a pauper---but it avoids many legal entanglements after my wife and I die. You may also ask about health care proxy and "DNR etc and get everything taken care of at once.
 
My local lawyer wants $1K for will/trust. I thought that was high as I have practically nothing, and all my investments are TOD..I was kinda waiting for my son to turn 18 so I wouldn't need a bunch of extra mumbo jumbo.... So you have to pay the state, or you pay a lawyer up front... seems about the same to me. My Dad and Granddad died it still took a year or more to get it settled even with a trust and the Lawyer fees were ridiculous... they just wanted more $ for stuff they made up. (paper work not in error, spelled my name wrong twice, spelled by brother's name wrong - all done by the lawyer not the trust... other BS stuff) Nobody contested and nobody argued... So I don't trust a trust that much.
 
I failed to mention that a simple will is short money--a complicated trust is a lot more than 1K. I guess it boils down to whatever you are comfortable with as it pertains to whatever state laws you must comply with re probate etc. I wanted to make it as easy for my children etc and to avoid the usual squabbles and lay everything out in black and white when I go on the big ride. I'd still get a reliable and competent attorney to give you an opinion.
 
Inheritance tax threshold is now at $5,250,000 floor since January 1,2013. The days of trusts and such are now gone for the normal person. Either side of the political aisle knew it was time to do this to save the family farm and business from expensive tricky trusts.

Dianna please look at this site http://www.legalzoom.com/ Realize there are state filing fees with most. Do not forget your living trust and your health care power of attorney as they are just as important if you become unable to make your own decisions.
Good Luck
John
 
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