Judy MacDonald Johnston: Prepare for a good end of life

Translator: Joseph Geni Reviewer: Morton Bast

Prevoditelj: Senzos Osijek Recezent: Hela Jug

What would be a good end of life?

Kako bi izgledao dobar kraj života?

And I'm talking about the very end.

Govorim o samome kraju.

I'm talking about dying.

Govorim o smrti.

We all think a lot about how to live well.

Svi mi mnogo razmišljamo o tome kako dobro živjeti.

I'd like to talk about increasing our chances of dying well.

Želim govoriti o tome kako povećati šanse da dobro umremo.

I'm not a geriatrician.

Nisam gerijatar.

I design reading programs for preschoolers.

Dizajniram programe za čitanje za predškolsku djecu.

What I know about this topic

Sve što znam o ovoj temi

comes from a qualitative study with a sample size of two.

dolazi iz kvalitetne studije s uzorkom od dvije osobe.

In the last few years, I helped two friends

U zadnjih nekoliko godina, pomogla sam dvama prijateljima

have the end of life they wanted.

da imaju kraj života kakav su željeli.

Jim and Shirley Modini spent their 68 years of marriage

Jim i Shirley Modini proveli su 68 godina u braku

living off the grid on their 1,700-acre ranch

živeći povučeno na njihovom posjedu od 1700 hektara

in the mountains of Sonoma County.

u planinama okruga Sonoma.

They kept just enough livestock to make ends meet

Uzgajali su tek toliko stoke da spoje kraj s krajem

so that the majority of their ranch would remain a refuge

tako da je većina njihovog posjeda ostala utočištem

for the bears and lions and so many other things

za medvjede i lavove i mnoge druge životinje

that lived there.

koje su ondje živjele.

This was their dream.

To je bio njihov san.

I met Jim and Shirley in their 80s.

Upoznala sam Jima i Shirley u njihovim osamdesetima.

They were both only children who chose not to have kids.

Oboje su bili jedinci koji su odlučili da ne žele imati djecu.

As we became friends, I became their trustee

Kako smo postali prijatelji, ja sam postala njihov staratelj

and their medical advocate,

i medicinski zaštitnik,

but more importantly, I became

ali što je puno važnije, postala sam

the person who managed their end-of-life experiences.

osoba koja je pomogla u njihovim zadnjim životnim iskustvima.

And we learned a few things about how to have a good end.

Naučili smo nekoliko stvari o tome kako doživjeti dobar kraj.

In their final years, Jim and Shirley

U njihovim posljednjim godinama, Jim i Shirley

faced cancers, fractures, infections, neurological illness.

suočili su se s karcinomima, prijelomima, infekcijama, neurološkom bolešću.

It's true.

Istina je.

At the end, our bodily functions

Na kraju, naše tjelesne funkcije

and independence are declining to zero.

i samostalnost sve se više približavaju ništici.

What we found is that, with a plan and the right people,

Otkrili smo da, uz dobar plan i prave ljude,

quality of life can remain high.

kvaliteta života može ostati visoka.

The beginning of the end is triggered

Početak kraja potaknut je događajem

by a mortality awareness event, and during this time,

koji potiče svijest o smrtnosti, i tijekom tog vremena,

Jim and Shirley chose ACR nature preserves

Jim i Shirley odlučili su da ACR prirodni rezervat

to take their ranch over when they were gone.

preuzme njihov posjed kada ih više ne bude.

This gave them the peace of mind to move forward.

Ovo im je dalo duševni mir da nastave dalje.

It might be a diagnosis. It might be your intuition.

To može biti dijagnoza. Može biti vaša intuicija.

But one day, you're going to say, "This thing is going to get me."

Ali jednog dana, reći ćete: „Ovo će me dokrajčiti“.

Jim and Shirley spent this time

Jim i Shirely proveli su to vrijeme

letting friends know that their end was near

obznanjujući prijateljima da je kraj blizu

and that they were okay with that.

i da su oni pomireni s tim.

Dying from cancer and dying from neurological illness

Smrt od karcinoma i smrt od neurološke bolesti

are different.

se razlikuju.

In both cases, last days are about quiet reassurance.

No u oba slučaja, zadnji su dani provedeni u tihom mirovanju.

Jim died first. He was conscious until the very end,

Jim je umro prvi. Bio je svjestan do samoga kraja,

but on his last day he couldn't talk.

ali nije mogao govoriti na svoj zadnji dan.

Through his eyes, we knew when he needed to hear again,

U njegovim očima, vidjeli smo da je opet trebao čuti:

"It is all set, Jim. We're going to take care of Shirley

„Sve je spremno, Jim. Pobrinut ćemo se za Shirley

right here at the ranch,

ovdje na posjedu,

and ACR's going to take care of your wildlife forever."

i ACR će se zauvijek brinuti za vaše životinje.“

From this experience I'm going to share five practices.

Podijelit ću s vama 5 postupaka koje sam naučila iz ovog iskustva.

I've put worksheets online,

Postavila sam smjernice online,

so if you'd like, you can plan your own end.

pa ako želite, možete isplanirati svoj vlastiti kraj.

It starts with a plan.

Počinje s planom.

Most people say, "I'd like to die at home."

Većina ljudi kaže: „Volio bih umrijeti kod kuće“.

Eighty percent of Americans die in a hospital

Osamdeset posto Amerikanaca umire u bolnici

or a nursing home.

ili u staračkom domu.

Saying we'd like to die at home is not a plan.

Reći da bismo voljeli umrijeti kod kuće nije plan.

A lot of people say, "If I get like that, just shoot me."

Mnogi ljudi kažu: „Ako završim tako, upucaj me“.

This is not a plan either; this is illegal.

Ni to nije plan, to je ilegalno.

(Laughter)

(Smijeh)

A plan involves answering

Plan uključuje odgovaranje

straightforward questions about the end you want.

na izravna pitanja o tome kakav kraj želite.

Where do you want to be when you're no longer independent?

Gdje želite biti kada više niste samostalni?

What do you want in terms of medical intervention?

Što želite u pogledu medicinske intervencije?

And who's going to make sure your plan is followed?

Tko će se brinuti za to da se vaš plan slijedi?

You will need advocates.

Trebat ćete zagovornike.

Having more than one increases your chance

Imati više od jednog povećava šanse

of getting the end you want.

da imate kraj kakav vi želite.

Don't assume the natural choice is your spouse or child.

Nemojte pretpostaviti da je prirodan izbor vaš partner ili dijete.

You want someone who has the time and proximity

Želite nekoga tko ima vrijeme i blizinu

to do this job well, and you want someone

da taj posao obavi dobro, i želite nekoga

who can work with people under the pressure

tko može raditi s ljudima pod pritiskom

of an ever-changing situation.

situacije koja se neprestano mijenja.

Hospital readiness is critical.

Ključna je pripremljenost za bolnicu.

You are likely to be headed to the emergency room,

Vrlo je vjerojatno da ćete dospjeti u sobu za hitne slučajeve,

and you want to get this right.

i želite to obaviti kako treba.

Prepare a one-page summary of your medical history,

Pripremite sažetak vaše medicinske povijesti na jednoj stranici,

medications and physician information.

lijekove i zdravstvene informacije.

Put this in a really bright envelope

Pospremite to u jarku omotnicu

with copies of your insurance cards, your power of attorney,

zajedno s kopijama vaše kartice osiguranja, opunomoćenja,

and your do-not-resuscitate order.

i odlukom za ne-oživljavanje.

Have advocates keep a set in their car.

Neka vaši zagovornici drže jedan set u njihovom autu.

Tape a set to your refrigerator.

Zalijepite jedan set na hladnjak.

When you show up in the E.R. with this packet,

Kada se pojavite u sobi za hitne slučajeve s tim paketom,

your admission is streamlined in a material way.

materijalno ste osigurani.

You're going to need caregivers.

Trebat ćete skrbnike.

You'll need to assess your personality and financial situation

Morat ćete procijeniti vašu duševnu i financijsku situaciju

to determine whether an elder care community

kako biste odredili je li starački dom

or staying at home is your best choice.

ili ostanak kod kuće vaša najbolja opcija.

In either case, do not settle.

U svakom slučaju, nemojte praviti kompromise.

We went through a number of not-quite-right caregivers

Mi smo prošli kroz priličan broj nedovoljno dobrih skrbnika

before we found the perfect team

prije nego što smo pronašli savršeni tim

led by Marsha,

kojeg je vodila Marsha,

who won't let you win at bingo just because you're dying

koja vam ne bi dala da pobijedite u bingu samo zato što umirete,

but will go out and take videos of your ranch for you

ali će izaći van i snimiti video vašeg posjeda

when you can't get out there,

kada ne možete sami izaći.

and Caitlin, who won't let you skip your morning exercises

I Catilin, koja vam neće dozvoliti da preskočite jutarnju tjelovježbu,

but knows when you need to hear

ali zna kada trebate čuti

that your wife is in good hands.

da vam je žena u dobrim rukama.

Finally, last words.

Konačno, posljednje riječi.

What do you want to hear at the very end,

Što želite čuti na samome kraju

and from whom would you like to hear it?

i od koga to želite čuti?

In my experience, you'll want to hear

Iz moga iskustva, željet ćete čuti

that whatever you're worried about is going to be fine.

da će s onim što vas brine biti sve u redu.

When you believe it's okay to let go, you will.

Kada vjerujete da je sve u redu, prepustit ćete se.

So, this is a topic that normally inspires fear and denial.

Ovo je tema koja inače potiče strah i poricanje.

What I've learned

Naučila sam

is if we put some time into planning our end of life,

da ako uložimo vrijeme u planiranje kraja života,

we have the best chance of maintaining our quality of life.

imamo dobru šansu da održimo kvalitetu života.

Here are Jim and Shirley just after deciding

Ovo su Jim i Shirley nakon što su odlučili

who would take care of their ranch.

tko će se brinuti za njihov posjed.

Here's Jim just a few weeks before he died,

Ovo je Jim samo nekoliko tjedana prije nego što je preminuo,

celebrating a birthday he didn't expect to see.

slaveći rođendan za koji nije mislio da će ga dočekati.

And here's Shirley just a few days before she died

A ovo je Shirley samo nekoliko dana prije smrti

being read an article in that day's paper

kako sluša članak iz dnevnih novina

about the significance of the wildlife refuge

o značaju utočišta za divlje životinje

at the Modini ranch.

na posjedu Modini.

Jim and Shirley had a good end of life,

Jim i Shirley imali su dobar kraj života,

and by sharing their story with you,

i dijeljenjem njihove priče s vama,

I hope to increase our chances of doing the same.

nadam se da ću povećati naše šanse da doživimo to isto.

Thank you.

Hvala vam.

(Applause)

(Pljesak)