Tag: End of Life Care

Many of us have shared the common experience of attending to someone who is in the hospital, whether that was for a birth, death, medical treatment, or a surgery. This experience is unique for each person. For all caregivers though, it is vital to care for oneself, so that one can be available to the needs of their loved one without burnout.

A few weeks ago I was with my husband as he went through major surgery followed by a seven day stay in the hospital, including three days in ICU. This journey began when we flew from Denver to San Francisco for a couple of days of R and R, before we settled into the hospital.  Travelling in a large city when one is “directionally challenged” as I am, can feel a little disorienting. Going into a very large hospital, that functions like a small city can be extremely disorienting.

We arrived by streetcar early in the morning and my husband was assigned bed #6 for pre-op in a department that had 28 operating rooms. This hospital clearly had a lot of surgery going on, and his would last 9 hours!  Pre-op included consultations with two surgeons, an anesthesiologist, a couple of medical residents, the surgical nurse, and the contact nurse who kept me posted throughout the day. All this, before it was even 9 o’clock in the morning.

The Watchdog Experience

For seven straight days, I was a watchdog, an advocate for my husband’s care and a powerless observer. While it was helpful to have a role that gave me a focus, it was also exhausting. I was fortunate to have my dear cousin providing support, but fundamentally I was on my own. My husband was sleeping or having his own experience, and the staff was appropriately paying attention to him and not to me. I had to define my own role, find places to eat, get out for fresh air and find ways to feel grounded and connected to the outside world so that I felt more embodied and aware of myself.

I did my best to not be distracted by the on-going intensity in order to stay present and clear. Finding humorous moments like when they brought my husband lunch and his banana had a nametag on it, were times that brought me back to myself in the midst of a disorienting experience. I meditated, walked, used an earthy essential oil, and then I would focus and return to a sense of relaxed immediacy. It was an altering seven days and finding ways to stay enlivened was essential. My world got very simple: take care of myself and do what I could for my husband.

Pre-op for Caregivers

If there were to be a pre-op for caregivers in this situation what might be included?

  1. Get the information you need so that you are prepared:  Know where you will be sleeping, especially if you’re from another state.  Ask questions and get answers.
  2. Connection to Oneself:  Know some basic tools for grounding yourself.  Meditate, walk, or read an enjoyable book.  Conserve energy, so that you have the energy to care for your loved one.
  3. Humor:  Look for humor, or ask for that from loved ones.  Notice what uplifts you.
  4. Connection to Outside World:  Connect with others at the moment.  Smile with your loved one, or acknowledge the kindness of a nurse.  Have conversations with people from your familiar world.

Don’t count on anyone else making these things happen or even suggesting them.  These are just some of the simple, but important ways one can take care of oneself.

My business is Advance Health Care Directive Guidance. I support people in preparing their Advance Health Care Directives. I am a strong advocate, personally and professionally, for choosing the person whom can best speak for you when you aren’t able to speak for yourself.  We were fortunate I didn’t have to, but I was prepared to follow my husband’s wishes if need be.  I could simply become the wakeful caregiver and didn’t have to make any tough decisions this time.

Reva Tift M.AAdvance Health Care Directives

~ Consultations for the End of Life Care

© Copyright 2014 Reva Tift, Director Advance Health Directive Guidance

When my father was dying I was surprised to find that there was a deep disagreement within my family about what type of care would be best for him. I recognized these divisions as ones that would emerge at stressful times, and they represented long-standing familiar dynamics in our family. Looking back I could have predicted these disagreements and proactively prepared for them. If our family had been able to talk about my father’s end of life care ahead of time, I believe we could have avoided some miscommunication and hurt feelings.

Planning End of Life Care – Everyone Benefits

This experience made it clear to me that planning end of life care is not only for one’s own benefit but also for the benefit of one’s family and close friends. This has also been validated by my 30+ years experience of working with mid-life and aging issues. I have observed and learned that it is a kindness to everyone to have our end of life wishes decided upon, documented, and communicated.

In Colorado proactively preparing for end of life care includes:

  • Naming a health care agent
  • Clarifying the many details of the type of care we want to receive

Our health care agent will potentially be our most important spokesperson and will speak for us when we are unable to do so for ourselves. This individual will be our advocate with health care professionals and family members, some of whom may have differing opinions about what might be best for us. We name our health care agent in the Medical Durable Power Of Attorney for Healthcare Decisions.

We clarify the care we want to receive in the Advance Directive For Medical/Surgical Treatment. This document addresses issues such as:

    • Life-Sustaining Procedures
    • Artificial Nutrition and Hydration
    • Care If In A Permanent Vegetative State
    • Anatomical Gifts

When I work with people who are facing an urgent medical situation my priority is to help assist them with the basic choices discussed above. When people are interested and able to examine end of life issues before they are urgent, our conversations then explore the many possibilities which can help make the experience of our planning for end of life more uplifted and comfortable.

Planning End of Life Care – Questions to Reflect Upon

  • Who would be your voice if you were unable to speak for yourself?
  • If you were writing the script, would you choose to die at your own home with hospice, or in a nursing home?
  • Often a great deal of money can be spent on end of life care. How would you choose to spend your financial resources?

Ask yourself what questions you might have about your own or a family member’s end of life care. Please consider that now may be the best time to thoughtfully plan and make clear decisions for your advanced directives.

Reva Tift, M.A. is the director of AHCD Guidance that provides a comprehensive process with which to document preferences for end of life care. Since 1979, Reva has worked extensively with mid-life and aging issues through teaching and consultations in both small and large group settings. Drawing on her experience as a teacher, psychotherapist, wife, mother, and mentor Reva offers knowledge and guidance in making thoughtful decisions about the care we would like to receive at the end of our lives.

Reva Tift M.A. Advance Health Care Directives

~ Consultations for the End of Life Care

© Copyright 2014 Reva Tift, Director Advance Health Directive Guidance


Reva Tift, MA, AHCD Guidance | tel. 303-444-0152 | | Email or Call to setup a consultation appointment. While forms vary from state to state, the decisions are common to us all. | Offering appointments by Zoom, by phone or by FaceTime.


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Please note that the information provided by Reva Tift, MA, of Advance Health Care Directives is presented only to support your own decisions concerning your end-of-life choices and wishes. You should consult your family members, personal physician, attorney and/or estate planner for questions about your particular situation.
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