hi i'm tom callahan welcome to all the seniors benjamin franklin is credited with the quote that the only thing certain this life are death and taxes while i'm a fan of neither i do really do realize the reality that both will come true one point  other today's topic unfortunately is not taxes it's death with me today is ethan anderson the new jersey campaign manager for compassion choices you can walk into only senior stage of rap me tom let's get started what adult choice to solve the mystery medication out and their lives in a peaceful and dignified way ok there's a number of things that i want to bring up that you just mentioned course end of life choices does somebody have to be actively dying to be making sure he says well when it comes to  and dying yes so you can't have that written into your advanced directive in any of the states where in dying as a legal medical option you'd undergo the process once you are terminally ill with us and six months to live and assuming you meet all the other criteria such as being mentally competent and eighteen or older but when it comes to say getting an advance directive to get a post order a living well those can come far before you're terminally ill and they should if you're eighteen or older you should have an advance directive and advanced directive for people who don't realize exactly what they are is psychiatric against directive and they do have those and there are steps that someone can take to make sure their foldout go through it with a guardian you don't actually need a lawyer to have your dense try to get filled out you would need a notary but you don't need as doesn't will be as time goes on so as you know i've been struggling with and the wife document that is two sections as a section on figuring out who you would like to bestow your end of life options to so if you become incapacitated if you're not competent who should make decisions for you and the other part of advance directive is talking about what decisions you would like to make at the end of life whether you prefer to say i have more morphine or less morphine to have more autonomy or less on time me and a post order poll stands for physician orders for life sustaining treatment and  because it's no longer to send ideal ideal it's a document but it's no longer saying what you prefer it's saying these are the orders these are what will happen so i'd recommend someone not going to post unless they are terminally ill or chronically seriously ill someone like myself for example directive but i don't need a post ok now you say it's a physician's orders so they would be working with their primary care physician to build this up how would somebody approach their primary care physician to start this when you actually launched into them it's tremendously liberating and whether you're talking about a post order or about an answer active or talking your family members about the end of life the end result is almost inevitably people come away from the situation feeling like they're a little bit closer to having some control and a sense of peace yes so it's vitally important that we jump right into it ok you've said something that i wholeheartedly agree with it's getting these things out in the open and talking about them and giving them down reading it is very liberating it's a part of getting people if it is you know it's ineffable we're all going to die we're not getting out of this alive that's right nobody does and people you know they shy away from talking about  death which is a shame because the fact that you know we don't want it to happen it does happen but there are ways to prepare for it and this is definitely one of the ways you know what how would you hypothetically advise somebody to start this conversation within their family and their family so i suppose the first step was to figure out a conversation with themselves so before i talk to you about what i want i need to first know what i  want and it seems like an extraneous step but it's one that people really need to actually take so you know if i'm not sure whether i'm going to want to have more autonomy at the risk of not having the best treatment if i've decided that i want to for example diet home and out of access to a hospital the end of life these are sessions we have to make for ourselves for we talked our family about it so that's number one number two is to really maybe it's over dinner there's really no situation i feel that is going to be all that much easier than any other  so really you could stand with them over lunch you know we actually had compassion choices at a campaign like having a turkey talking over thanksgiving and talking about it and it seems a bit morbid but really you need to  about the end of life what i want and my mom actually this is me a couple of months ago i was talking to her about compassion choices in the work that i'm doing and she said look i want all the drugs i can get i want all the drugs give them all to me all the morphine and she still needs out of anthrax and he's be accessible but now i know what she wants so it can be approached with a bit of humor if that works for someone and you know get it doesn't have to be a long ten u s conversation take five or ten minutes to talk about what you want now was that have you brought this up with your mom  before yes i have probably one of those things that you know on several occasions like now i don't want to talk about don't talk i took several tries it takes a little while ago yeah that's exactly what i'm trying to get to is because what happens is some people try to bring up this topic and they are met with the think about it if you didn't have any car insurance and you went out driving your car and you know you're like constantly worried about what you know the car if you don't have an accident course it's the same thing with end of life choices we get in our car three days in a potentially dangerous situation imagine how much was a woman who supposedly had made decisions spoken to her husband but nobody else about it right never put anything in writing and as you can see it exploded into a huge national case that when all the way to the supreme court and  definitely things like a advance directive a pulse and a living will could have helped her you are absolutely and if i can just just touch on that you know if it is vitally important to talk to people about this and that's  part of the status trust the most i think that if you if i bring up the topic of end of life decision making to someone the first thing they're going to say is usually what top people about it but the second and really i think the most important step is to get it in writing and make sure it's accessible so if i didn't have an advance directive and it's in a freezer within a locker within a dungeon with spikes over it it's not helpful because you know the ambulance shows up and have a heart attack and any access to it and if they don't know they don't have an automatic registry in their head of what each person a visit now you also touch on the fact that there's legislation working with type of legislation are you working on right now so there's a bill new jersey legislature called eighteen done for the terminally ill and it's only built to four five one you can find it online and it would allow that option that i discussed earlier that allowing a terminally ill mentally competent adult the choice to self minister of life any medication that allowed that option to someone that that so there are similar legislation that's been passed in five states now oregon senator or their assembly person to push this bill through what should they be saying what's with the language we can give to them to say we want this i suppose the best thing you could say to your local representative and i'm glad you brought that up because really something to the effect of you know dear senator blank please support the am dying for the terminally ill and this is a vitally important option for terminally ill people and then people can just insert their own reasons for supporting it because this is a personal issue this is not about paul texas is not about religion this is just about people and those other things fall into play and they're certainly factors when relooking out whether an option like this should be in place we have to be looking at whether this would actually allow someone to have this make this decision for themselves and live up with comes down to when i asked them whether they think they should support us or not i ask them not to decide whether they would want to end their own lives to become terminally ill because most people will not need that option because hospice and other types of palliative care do a fantastic job  asked some are you going to prevent someone else from being on make this decision for themselves you want to show the people of options so really when talking a lot of players best thing you can do is just emphasize a factor this is just an option for people that are actively in the dying process and i think that's a misconception a lot of people have is they just think oh this is you know this is not assisted suicide but it is you know it's opening the door and it's not and i should point out that there has not been an abuse of this correct you know because basically to be able to enact this option people have to have it will be that they are going to be terminally ill they need to be mentally competent they need to talk their doctor about this options that actually says in the law if you're if you want to obtain a prescription of this nature your dog needs to go through all viable and i have options for you know your absolute right i'm glad you brought up that that's a slippery slope and people talk about that you know if we introduce legislation like that's what's going to happen after that and it's rare to have a law like this where you have  from other states that shows that when you pass a dialogue it doesn't change in oregon you know it was first in acted in one thousand nine hundred seven you still have to be terminally ill you still have the mentally competent and eighteen or older and being able to self administered medication so the factors in place in oregon are still exist today so people talk about a slippery slope my first reaction is well you know play the tape look what's actually happened and in terms of assisted suicide you brought up and i'm glad you did this in the suicide is exclusively for people that are actively in the process suicide is not describe the rational end of life decision these people are making if we look at suicide we think about someone that has a full why the head of them that they're choosing to forego because they no longer want to live these are people i mean britney menarche may have heard of her she was living out in california twenty one years old recently married and she was diagnosed with terminal brain cancer she moved out to oregon and she was in unbearable pain she was having seizures on a daily basis shit body swelling and really was quoted as saying i don't have a suicidal bone in my body and that's because if you take away the terminal illness people are not going to take medication only qualify for it they're actively done and actually it says on the death certificate for people who have taken this it shows the cause of death and you know taking this medication that showed the but the fact that you know like you said you know that's the first state so we have a precedent for this absolutely ok so you said there's five states already oregon washington vermont montana and california ok now surrounding that discussion you know you're going to have your pros and your cons and this goes back to legislation as well you know people are always going to be against something that's going to have the ones that are for  it fortunately sometimes we don't hear enough from the people that are for something so are they able to reach out to you or to an organization to help them to craft their message absolutely so if you'd like to reach out to me program there's a tab on the web site that people can go to to volunteer information on where your donations go compassion choices is a four star charity according to charity navigator dot org it's very highly ranked and i can say i've been there was a chansons i was twenty years old i started and every dollar helps people to reach out to me directly at you anderson at compassion and choices dot org or reach out to compassion choices directly at w dot compassion and choices documents and at the web site there's also tips about how to say this is what i want to have happen and if i have to get dementia then this is what i want to have happen they have that option there as well that information what's going on all the different states that have a dying legislation going on and believe don't quote me on  that hospice isn't enough you know eight and dying is part of an end of life spectrum that we're focusing on and the overarching goal of compassion choices is to make sure that people have a full range of options at the end of life in dying being one of them so for me personally i don't have any preference as to what people do at the end of life if we take you know joe joe wants aggressive treatment at the end that's great that's in line of his beliefs and values and that's perfectly fine still be written down and should still be written down regardless what it is this isn't and this isn't just for people that you know want a dine or that want you know treatment all our want to have stopped after they reach seventy five regardless of your age of what treatment you want you really need to make sure you have this down in writing  but overall the goal is to make sure regardless of what specific effort we're driving it is to make sure the people are empowered to make the best decision for themselves in accordance with their own beliefs and values that is of the utmost importance but like i mentioned it is a call treatment consumer campaign are free end of life consultation service and you can call in any time it's toll free people respond back to it in twenty four hours we have a full range of services all of which are free to ensure that people can make the best decision for themselves it sounds like had didn't have a suicidal bone in her body but she had a term seize it was precluding all that that's right getting back to the legislation you said that this bill has been sponsored before that's right assembly by john versa cheli john sister in law claudia bursa cheli was dying from from lung cancer john has a loss in his family and he wanted to make a difference he wanted to make sure that people at the end of life had these options in place this is the third legislative session about the bill in the last one we pass a bill through the assembly health committee to the full soundly through the senate health committee and we got a bill to the senate probably a couple of votes shy and now we're working again on the assembly so if i had to guess you know governor christie's opposed this legislation but i would say that within maybe but a year and a half two years we can expect to see this passing a law least that's my right now i meant you as something called the death cafe cafe informal setting and it doesn't and no one's a can to die so when you talk people in the group no one's saying god i can't wait for death or i don't like life me the people there embrace life i mean other people i've met talk about the end of life it seems that people that are fully aware not just technically but they really incorporate the fact they're going to die one day in the way they live their lives these people really live full lives because they know that there's a time line on and so when we're talking about death say the death count by the focus isn't specifically it's certainly that one man out of death cafe who had lost his wife in the last year and he was trying to find some closure so it's a multifaceted approach to making sure that we embrace death as a topic so we can discuss it and no one actually likes it you know i'm talk about a lot but i don't want to die i don't want other people to die i just want to make sure that we can face it head on and when you face it head on the fear goes away like i mentioned and that's the find it funny thing about it is that if you ignore it it gets worse exactly and that's you know that's my stance on discussing aging issues you know the more you ignore the person gets but if you talk about it you can get a plan in place a good plan in place you suddenly get back to as we were saying the beginning of a liberation  would somebody schedule a death cafe or how would they attend one i believe there are there is a death cafe website and they can start their own costs and the money there's no dues you could have from we start one in your home at say perkins if you want to  maybe have a library and less for their library would let you but you can certainly try it's it's fairly informal and the goal it's quite informal and the goal is just to make sure that people are able to get together and talk about this topic and it kind of takes the air out because the hardest part of anything is when you get into the situation of being a terminal illness or you get situation where somebody has passed away is having somebody else make those decisions for you that's right and the biggest part of aging is i tell people make the decisions for yourself why you can and as opposed to just dumping it on somebody else because imagine how you would feel if somebody dumped that information on you or so you know you know somebody you love is terminally ill and you've got to make the decision what do we do talk about it you know and as you said earlier in the show think about what it is that you want right you know and keep pushing at it we're getting close to the end here final words about compassion and choices or cafe or legislation what it would have we left out so far that we should know regardless of stance on death whether you think that is just the beginning whether you think that is awful and scary and should be avoided whether it's something that we should not want to place in around it's something worth addressing whether you're doing that through volunteering with compassion and choices starting a death cafe talk to your family members about it talking to your doctor doing research exercising more it needs to be addressed and when people do that things get better you can find a way to get at peace with it whatever that method is for me part of that is actively campaigning to make sure that people get to die the way they want to die that they actually have options at the end of life and they can choose when that's best for them regardless of what it is so from a personal standpoint i would hope that anyone that find that people have options at the end can volunteer with compassion and choices of people to reach out you can reach me at the end or send compassion and choices dot org reach out to compassion choices directly at the website that we have the w dot compassion choices dot org research and they'll be glad we can thank you for being guests on only seniors and folks again dying is inevitable but doesn't have to be scary on time callahan thank you for joining me on the only seniors