Judy MacDonald Johnston: Prepare for a good end of life

Translator: Joseph Geni Reviewer: Morton Bast

Translator: Alisa Xholi Reviewer: Helena Bedalli

What would be a good end of life?

Cfare do mund te quanim nje fundjete te mire?

And I'm talking about the very end.

E kam fjalen per fundin perfundimtar.

I'm talking about dying.

E kam fjalen per vdekjen.

We all think a lot about how to live well.

Te gjithe ne mendojme per te jetuar mire.

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

Une kam deshire te flas per te rritur mundesite qe te vdesim mire.

I'm not a geriatrician.

Nuk jam nje gjeriatrik.

I design reading programs for preschoolers.

Une projektoj libra leximi per parashkollor.

What I know about this topic

Ajo qe di per kete subjekt

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

vjen nga nje studim kualitativ ne nje cift.

In the last few years, I helped two friends

Gjate viteve te fundit, kam ndihmuar dy miq

have the end of life they wanted.

qe te kene fundin e jetes qe ata deshirojne

Jim and Shirley Modini spent their 68 years of marriage

Jim dhe Shirley Modini kaluan 68 vitet e marteses tyre

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

duke jetuar pa elektricitet ne fermen e tyre 1.700-aker

in the mountains of Sonoma County.

ne malet e rrethit Sonoma.

They kept just enough livestock to make ends meet

Ata mbajten thjesht mjaftueshem bageti

so that the majority of their ranch would remain a refuge

ne menyre qe shumica e fermes tyre te mbetej nje strehe

for the bears and lions and so many other things

per arinjte dhe luanet dhe per shume gjera te tjera

that lived there.

qe jetonin aty.

This was their dream.

Kjo ishte endrra e tyre.

I met Jim and Shirley in their 80s.

I njoha Jim dhe Shirley rreth 80-at e tyre.

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

Ishin te dy femije te vetem qe kishin zgjedhur mos kishin femije.

As we became friends, I became their trustee

Gjate kohes qe u miqesuam, une u bera e besuara e tyre

and their medical advocate,

dhe avokatja mjekesore,

but more importantly, I became

por me e rendesishmja, une u bera

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

personi qe administroi eksperiencat e fund-jetes se tyre.

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

Dhe ne mesuam disa gjera se si te kesh nje fund te mire.

In their final years, Jim and Shirley

Ne vitet e tyre te fundit, Jim dhe Shirley

faced cancers, fractures, infections, neurological illness.

u perballen me kancerin, frakturat, infeksione si dhe semundjetj neurologjike.

It's true.

Eshte e vertete.

At the end, our bodily functions

Ne fund, funksioni i trupit tone

and independence are declining to zero.

dhe pavaresia bie ne zero.

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

Ajo cfare zbuluam eshte se, me nje plan dhe me njerezit e duhur,

quality of life can remain high.

cilesia e jetes mund te qendroje e larte.

The beginning of the end is triggered

Fillimi i fundit shkaktohet

by a mortality awareness event, and during this time,

nga nje rast ndergjegjesimi mbi vdekshmerine, dhe gjate kesaj kohe

Jim and Shirley chose ACR nature preserves

Jim dhe Shirley zgjodhen ruajtjen e natyres ACR

to take their ranch over when they were gone.

per te marre persiper fermen e tyre kur ata te largohen.

This gave them the peace of mind to move forward.

Kjo i dha qetesine atyre per te ecur para.

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

Mund ta quajme nje diagnostikim por mund te jete dhe intuita jote.

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

Por nje dite, ti do thuash "kjo dicka do me marri mua".

Jim and Shirley spent this time

Jim dhe Shirley e kaluan kete kohe

letting friends know that their end was near

duke i lejuar miqte e tyre te dine se fundi i tyre ishte afer

and that they were okay with that.

dhe se ata nuk e kishin problem kete.

Dying from cancer and dying from neurological illness

Vdekja nga kanceri dhe vdekja nga nje semundje neurologjike

are different.

jane te ndryshme.

In both cases, last days are about quiet reassurance.

Ne te dyja rastet, ditet e fundit jane disi qetesuese.

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

Jim vdiq i pari. Ai ishte i ndergjegjshem deri ne fund,

but on his last day he couldn't talk.

por diten e fundit ai nuk mund te fliste.

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

Duke i lexuar syte, ne kuptonim se kur ai kishte nevoje ta degjonte,

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

"Gjithcka eshte ne rregull, Jim. Ne do kujdesemi per Shirley

right here at the ranch,

ketu ne ferme,

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

dhe ACR do kujdeset pergjithmone per kafshet e egra te fermes tende.

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

Nga kjo eksperience, do ndaj me ju pese praktika.

I've put worksheets online,

Kam vendosur ne rrjet plane,

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

dhe nese deshironi, ju mund te planifikoni vete fundin tuaj.

It starts with a plan.

E gjitha fillon me nje plan.

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

Shumica e njerezve thone, "do kisha deshire te vdisja ne shtepi."

Eighty percent of Americans die in a hospital

Tetedhjete perqind e Amerikaneve vdesin ne nje spital

or a nursing home.

ose ne nje azil.

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

Duke thene se deshirojme te vdesim ne shtepi nuk eshte plan.

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

Shume njerez thone, "Nese behem ashtu, me mire me qelloni."

This is not a plan either; this is illegal.

As ky nuk eshte nje plan; kjo eshte e paligjshme.

(Laughter)

(te qeshura)

A plan involves answering

Nje plan perfshin pergjigjet

straightforward questions about the end you want.

e pyetjeve te drejtperdrejta per sa i perket fundit qe deshironi.

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

Ku deshironi te gjendeni kur nuk mund te jeni me te pavarur?

What do you want in terms of medical intervention?

Cfare deshironi per termat e nderhyrjes mjekesore?

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

Dhe kush do jete ai qe te realizoje planin tuaj te ndiqet?

You will need advocates.

Do t'ju duhen avokate.

Having more than one increases your chance

Duke pasur me shume se nje, rrit mundesite tuaja

of getting the end you want.

per te pasur fundin qe deshironi.

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

Mos supozoni se zgjedhja natyrale eshte bashkeshkorti ose femija.

You want someone who has the time and proximity

Ju duhet dikur qe ka kohen dhe afersine

to do this job well, and you want someone

qe te realizoje kete pune mire, dhe ju duhet dikush

who can work with people under the pressure

qe mund te punoje me njerez nen presionin

of an ever-changing situation.

e nje situate te ndryshimit te perhershem.

Hospital readiness is critical.

Gatishmeria e Spitalit eshte kritike.

You are likely to be headed to the emergency room,

Me shume mundesi do ju drejtojne ne nje urgjence,

and you want to get this right.

dhe ju duhet ta beni kete ne menyre te sakte.

Prepare a one-page summary of your medical history,

Pergatisni nje permbledhje ne nje faqe letre te historise tuaj mjekesore,

medications and physician information.

te barnave farmaceutike dhe informacion per mjeket.

Put this in a really bright envelope

Vendoseni kete nje zarf shume te ndritshem

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

me fotokopje te siguracionit tuaj, proces-verbalin,

and your do-not-resuscitate order.

dhe urdherin tuaj te mos-ringjalljes.

Have advocates keep a set in their car.

Sigurohuni qe avokatet te mbajne nje kopje ne makine.

Tape a set to your refrigerator.

Vendosni dhe nje kopje ne frigoriferin tuaj.

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

Kur te shfaqeni ne Urgjence me kete pako,

your admission is streamlined in a material way.

pohimi juaj eshte i efektshem ne nje menyre materialiste.

You're going to need caregivers.

Do ju duhen kujdestare

You'll need to assess your personality and financial situation

Do ju duhet te vleresoni personalitetin tuaj si dhe situaten ekonomike

to determine whether an elder care community

per te vendosur nese nje komunitet per kujdesjen e te moshuarve

or staying at home is your best choice.

ose qendrimi ne shtepi eshte zgjedhja juaj me e mire.

In either case, do not settle.

Ne secilin rast, mos u pajtoni.

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

Kemi kaluar nje numer shume te madh te kujdestareve jo-te mire

before we found the perfect team

para se te gjejme ekipin perfekt

led by Marsha,

i cili drejtohet nga Marsha,

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

qe nuk do ju lejojne te fitoni bingon vetem se ju po vdisni

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

por do shkojne te filmojne fermen tuaj

when you can't get out there,

kur ju nuk mund te dilni atje jashte,

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

dhe Caitlin, qe s'do te lejoje te anashkaloni ushtrimet e mengjesit

but knows when you need to hear

por di kur ju keni nevoje te degjoni

that your wife is in good hands.

se gruaja juaj eshte ne duar te sigurta.

Finally, last words.

Perfundimisht, disa fjale.

What do you want to hear at the very end,

Cfare keni deshire te degjoni ne fundin tuaj

and from whom would you like to hear it?

dhe nga kush deshironi ta degjoni?

In my experience, you'll want to hear

Nga eksperienca ime, do doni te degjoni

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

se per gjithcka qe ju shqeteson, do shkoje mire.

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

Dhe kur te besoni qe eshte ne rregull te largoheni, do largoheni.

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

Pra, kjo eshte nje teme e cila normalisht shkakton frike dhe mohim.

What I've learned

Ajo cka kam mesuar

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

eshte se nese i japim pak kohe planifikimit te fund jetes,

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

kemi mundesite me te mira per te mirembajtur cilesine e jetes.

Here are Jim and Shirley just after deciding

Ketu eshte Jim dhe Shirley pak pasin kane vendosur

who would take care of their ranch.

se kush do kujdesej per fermen e tyre.

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

Ketu eshte Jim disa jave para se te vdiste,

celebrating a birthday he didn't expect to see.

duke festuar nje ditelindje te cilen nuk besonte qe do e shikonte.

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

Dhe ketu eshte Shirley disa dite para se te vdiste

being read an article in that day's paper

qe po i lexonin nje artikull te gazetes se asaj dite

about the significance of the wildlife refuge

per rendesine e strehes se kafsheve te egra

at the Modini ranch.

ne fermen Modini.

Jim and Shirley had a good end of life,

Jim dhe Shirley paten nje fund jete te mire,

and by sharing their story with you,

dhe duke ndare historine e tyre me ju,

I hope to increase our chances of doing the same.

Shpresoj te rrise shanset tona per te bere te njejten gje.

Thank you.

Faleminderit.

(Applause)

(Duartrokitje)