Judy MacDonald Johnston: Prepare for a good end of life

Translator: Joseph Geni Reviewer: Morton Bast

Prevodilac: Mile Živković Lektor: Dejan Vicai

What would be a good end of life?

Šta bi bio dobar kraj životu?

And I'm talking about the very end.

Pričam o samom kraju.

I'm talking about dying.

Pričam o smrti.

We all think a lot about how to live well.

Svi mislimo o tome kako je živeti lepo.

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

Volela bih da pričam o povećavanju šansi za lepu smrt.

I'm not a geriatrician.

Nisam gerijatričar.

I design reading programs for preschoolers.

Smišljam programe za čitanje za decu u zabavištu.

What I know about this topic

Ono što znam o ovoj temi

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

dolazi iz kvalitativnog istraživanja sa uzorkom od dvoje ljudi.

In the last few years, I helped two friends

U proteklih nekoliko godina, pomogla sam dvoma prijateljima

have the end of life they wanted.

da imaju kraj života kakav su želeli.

Jim and Shirley Modini spent their 68 years of marriage

Džim i Šerli Modini proveli su 68 godina svog braka

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

živeći samostalno na imanju od 1700 jutara

in the mountains of Sonoma County.

u planinama okruga Sonoma.

They kept just enough livestock to make ends meet

Držali su samo onoliko stoke koliko je dovoljno za život

so that the majority of their ranch would remain a refuge

tako da bi većina njihovog imanja ostala utočište

for the bears and lions and so many other things

za medvede, lavove i mnoga druga bića

that lived there.

koja su tamo živela.

This was their dream.

Ovo je bio njihov san.

I met Jim and Shirley in their 80s.

Džima i Širli sam upoznala u njihovim osamdesetima.

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

Oboje su bili jedinci i odabrali su da nemaju dece.

As we became friends, I became their trustee

Kako smo se sprijateljili, postala sam njihov staratelj

and their medical advocate,

i medicinski savetnik,

but more importantly, I became

Ali što je još bitnije, postala sam

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

osoba koja je upravljala njihovim iskustvima sa krajem života.

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

I naučili smo nekoliko stvari o tome kako imati dobar kraj.

In their final years, Jim and Shirley

U svojim poslednjim godinama, Džim i Širli

faced cancers, fractures, infections, neurological illness.

su se susretali s rakom, frakturama, infekcijama, neurološkim bolestima.

It's true.

Istina je.

At the end, our bodily functions

Pri kraju, naše telesne funkcije

and independence are declining to zero.

i nezavisnost se smanjuju na nulu.

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

Otkrili smo da se sa planom i pravim ljudima,

quality of life can remain high.

kvalitet života može održati visokim.

The beginning of the end is triggered

Početak kraja je pokrenut

by a mortality awareness event, and during this time,

događajem koji pokazuje smrtnost, i za ovo vreme

Jim and Shirley chose ACR nature preserves

Džim i Širli su odabrali ACR prirodne rezervate

to take their ranch over when they were gone.

da preuzmu njihov ranč posle njihove smrti.

This gave them the peace of mind to move forward.

Ovo im je dalo duševni mir potreban za korak dalje.

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

To može biti dijagnoza. Vaša intuicija.

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

Ali jednog dana ćete reći: "Ovo će me dokusuriti."

Jim and Shirley spent this time

Džim i Širli su ovo vreme proveli

letting friends know that their end was near

obaveštavajući prijatelje da im se bliži kraj

and that they were okay with that.

i da im to ne smeta.

Dying from cancer and dying from neurological illness

Nije isto umreti od raka

are different.

i od neurološke bolesti.

In both cases, last days are about quiet reassurance.

U oba slučaja u poslednjim danima se dešava tiha uteha.

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

Džim je prvi umro. Bio je svestan do samog kraja,

but on his last day he couldn't talk.

ali poslednjeg dana nije mogao da priča.

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

Kroz njegove oči smo znali kada mu je ponovo trebalo da čuje:

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

"Sve je sređeno Džime. Mi ćemo se pobrinuti za Širli

right here at the ranch,

ovde na imanju,

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

i ACR će zauvek brinuti o tvojim divljim životinjama."

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

Iz ovog iskustva podeliću pet praksi.

I've put worksheets online,

Na internet sam stavila radne listove,

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

tako da možete da isplanirate svoj kraj ako želite.

It starts with a plan.

Počinje sa planom.

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

Većina ljudi kaže: "Voleo bih da umrem kod kuće."

Eighty percent of Americans die in a hospital

80% Amerikanaca umire u bolnicama

or a nursing home.

ili domovima za stare.

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

Reći da želimo da umremo kod kuće nije plan.

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

Puno ljudi kaže: "Ako ja budem takav, samo me upucajte."

This is not a plan either; this is illegal.

Ni ovo nije plan, ovo je protivzakonito.

(Laughter)

(Smeh)

A plan involves answering

Kod plana se radi o odgovaranju

straightforward questions about the end you want.

na jednostavna pitanja o kraju koji želite.

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

Gde želite da budete kad ne budete više samostalni?

What do you want in terms of medical intervention?

Šta želite od medicinske intervencije?

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

Ko će se postarati da se vaš plan izvrši?

You will need advocates.

Biće vam potrebni zastupnici.

Having more than one increases your chance

Ako imate više od jednog uvećava se šansa

of getting the end you want.

za kraj koji želite.

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

Nemojte pretpostaviti da su prirodan izbor vaš bračni partner ili dete.

You want someone who has the time and proximity

Želite nekoga ko ima vreme i blizinu

to do this job well, and you want someone

da ovaj posao uradi dobro, i želite nekog

who can work with people under the pressure

ko može sa ljudima da radi pod pritiskom

of an ever-changing situation.

situacije koja se uvek menja.

Hospital readiness is critical.

Pripravnost bolnice je ključna.

You are likely to be headed to the emergency room,

Verovatno će vas odvesti u sobu za hitne slučajeve,

and you want to get this right.

i želite da to uradite kako treba.

Prepare a one-page summary of your medical history,

Pripremite jednostrani rezime vaše istorije bolovanja,

medications and physician information.

informacije o lekovima i doktorima.

Put this in a really bright envelope

Ovo stavite u kovertu jarke boje

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

sa kopijama kartica za zdravstveno osiguranje, punomoćju,

and your do-not-resuscitate order.

i naređenjem za zabranu oživljavanja.

Have advocates keep a set in their car.

Neka vaši zastupnici drže primerak u svojim automobilima.

Tape a set to your refrigerator.

Prilepite jedan komplet za vaš frižider.

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

Kada se na urgentnom pojavite sa ovim paketom,

your admission is streamlined in a material way.

prijava vam se poboljšava na materijalan način.

You're going to need caregivers.

Biće vam potrebni staratelji.

You'll need to assess your personality and financial situation

Moraćete proceniti vašu ličnost i finansijsku situaciju

to determine whether an elder care community

i odrediti da li je za vas najbolje da budete

or staying at home is your best choice.

u domu za stare ili u sopstvenom domu.

In either case, do not settle.

Svakako se nemojte samo pomiriti s tim.

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

Prošli smo kroz nekoliko ne baš sjajnih staratelja

before we found the perfect team

pre nego što smo našli savršeni tim

led by Marsha,

na čelu s Maršom,

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

koja vas neće pustiti da pobedite u bingu samo zato što umirete,

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

nego će otići i snimiti vaše imanje za vas,

when you can't get out there,

kada vi ne možete da odete tamo.

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

Tu je i Kejtlin koja vam neće dozvoliti da preskočite jutarnje vežbe,

but knows when you need to hear

ali zna kada vam je potrebno da čujete

that your wife is in good hands.

da vam je supruga u dobrim rukama.

Finally, last words.

Na kraju, poslednje reči.

What do you want to hear at the very end,

Šta želite da čujete na samom kraju,

and from whom would you like to hear it?

i od koga želite to da čujete?

In my experience, you'll want to hear

Iz mog iskustva, želećete da čujete

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

da će biti u redu šta god to bilo o čemu brinete.

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

Kada verujete da je u redu da se pustite, to ćete i uraditi.

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

Ovo je tema koja obično pokreće strah i poricanje.

What I've learned

Naučila sam da

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

ako uložimo nešto vremena u planiranje kraja našeg života,

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

imamo najbolju šansu da održimo kvalitet našeg života.

Here are Jim and Shirley just after deciding

Ovde su Džim i Širli nakon odlučivanja o tome

who would take care of their ranch.

ko će brinuti o njihovom imanju.

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

Ovde je Džim samo nekoliko nedelja pre smrti,

celebrating a birthday he didn't expect to see.

slavi rođendan koji nije očekivao da će dočekati.

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

A ovde je Širli samo nekoliko dana pre smrti

being read an article in that day's paper

kako joj čitaju članak u dnevnim novinama

about the significance of the wildlife refuge

o značaju utočišta za divlje životinje

at the Modini ranch.

na imanju Modini.

Jim and Shirley had a good end of life,

Džim i Širli imali su dobar kraj života

and by sharing their story with you,

i time što delim njihovu priču sa vama

I hope to increase our chances of doing the same.

nadam se da ću povećati šanse da se i vama desi isto.

Thank you.

Hvala vam.

(Applause)

(Aplauz)