Judy MacDonald Johnston: Prepare for a good end of life

Translator: Joseph Geni Reviewer: Morton Bast

翻译人员: Scarlett Huang 校对人员: Yuting Liu

What would be a good end of life?

什么是一个生活美好的结尾？

And I'm talking about the very end.

我所说的是最终的结尾

I'm talking about dying.

我所说的是死亡

We all think a lot about how to live well.

我们都在想如何更好的生活

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

而我想要谈的是 如何更美好地告别人生

I'm not a geriatrician.

我并不是老年病学家

I design reading programs for preschoolers.

我为学前班的孩子设计阅读课程

What I know about this topic

我对这个话题的了解

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

来源于一个定性的研究，其中有两个案例

In the last few years, I helped two friends

在过去的几年，我帮助两个好朋友

have the end of life they wanted.

以他们想要的方式，结束了他们的生命

Jim and Shirley Modini spent their 68 years of marriage

Jim 和 Shirley Modini 度过了他们68年的婚姻生活

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

生活在远离城镇的，1,700英亩的牧场里

in the mountains of Sonoma County.

Sonoma 县的山区

They kept just enough livestock to make ends meet

他们喂养了仅仅是能养活他们自己的家禽

so that the majority of their ranch would remain a refuge

所以这大部分的牧场变成了避难所

for the bears and lions and so many other things

给熊，狮子和其他的动物

that lived there.

生活在那里

This was their dream.

这正是他们的梦想

I met Jim and Shirley in their 80s.

我在两个老人年迈八十的时候遇见他们

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

他们只有一个子女，而他选择不要孩子

As we became friends, I became their trustee

当我们成为朋友后，我变成了他们的托管人

and their medical advocate,

与他们的医疗顾问

but more importantly, I became

但是更重要的是

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

我成为了帮助他们结束生活的那个人

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

并且我们学到了 如何有个好的结局

In their final years, Jim and Shirley

在最后的几年里， Jim 和 Shirley

faced cancers, fractures, infections, neurological illness.

他们面对着癌症，骨折，传染病和神经上上的疾病

It's true.

这是真的

At the end, our bodily functions

人到了最后，我们身体的功能

and independence are declining to zero.

和独立性会降低到零

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

我们发现，如果有正确的计划和人

quality of life can remain high.

他们还是可以拥有高品质的生活

The beginning of the end is triggered

结束的开始是被其他所引起的

by a mortality awareness event, and during this time,

像对死亡的意识 并且在此期间

Jim and Shirley chose ACR nature preserves

Jim 和 Shirley 选择了ACR 自然保护区

to take their ranch over when they were gone.

在他们去世后接手牧场

This gave them the peace of mind to move forward.

这给了他们一片祥和，然后继续前行

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

这可能是个诊断，也可能是你的直觉

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

有一天，你会说，这样的事情会打垮我

Jim and Shirley spent this time

Jim 和 Shirley 用这些时间

letting friends know that their end was near

让他们的朋友知道，离他们离开人世的时间不远了

and that they were okay with that.

而他们对此没有埋怨

Dying from cancer and dying from neurological illness

因为患癌症与神经疾病而死去

are different.

是不一样的

In both cases, last days are about quiet reassurance.

两种情况，最后的几天都非常安详

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

Jim 先离去， 到最后他都非常的清醒

but on his last day he couldn't talk.

但是在他最后一天，他说不了话

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

通过他的眼睛，我们知道当他想听我们说话

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

“什么都很好，Jim。 我们会好好照顾 Shirley。

right here at the ranch,

就在此时，在牧场

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

ACR 会永远帮你保护好这里的野生动植物

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

从这个经历中，我想和大家分享五个方案

I've put worksheets online,

我已经把步骤公布在了网上

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

所以如果你愿意，你可以计划你自己结束的方式

It starts with a plan.

这个步骤以着手计划开始

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

很多人会说”我愿意死在家里."

Eighty percent of Americans die in a hospital

但是百分之八十的美国人，在医院里死去

or a nursing home.

或者是养老院

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

所以说想死在家里，并不是一个计划

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

很多人又会说“如果我像那样，一枪打死我”

This is not a plan either; this is illegal.

这也不是，因为不合法

(Laughter)

（笑声）

A plan involves answering

这个计划是能包含了回应的

straightforward questions about the end you want.

直接了当关于你想如何结束的问题

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

如果你不能再独立，你希望自己在哪里？

What do you want in terms of medical intervention?

你希望医疗保护的干预么？

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

谁能让你的计划继续紧接着进行

You will need advocates.

你需要顾问

Having more than one increases your chance

拥有多个顾问增加了

of getting the end you want.

你获得想要的结果的可能性

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

不要断然的说你的配偶和孩子是你最合适的选择

You want someone who has the time and proximity

你需要的是一个有时间和亲近感的人

to do this job well, and you want someone

如果你需要顺利的进行，你需要这样的人

who can work with people under the pressure

那些可以与有压力的人一起工作的人

of an ever-changing situation.

有着变化莫测的可能性

Hospital readiness is critical.

医院随时准备就绪很重要

You are likely to be headed to the emergency room,

你可能随时被带入急救室

and you want to get this right.

而你也希望准确无误的做到这一点

Prepare a one-page summary of your medical history,

所以，准备一页你的医疗病史

medications and physician information.

药物治疗，和医生信息

Put this in a really bright envelope

把这些放在一个很明显的信封里

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

并一同放入你的保险卡，和委托书

and your do-not-resuscitate order.

与你不想要恢复的命令

Have advocates keep a set in their car.

把这些留一份给你的顾问

Tape a set to your refrigerator.

并把录像放入冰箱里

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

当你出现在急诊室，带着这样的包裹

your admission is streamlined in a material way.

你把许可用合法的文件合理化

You're going to need caregivers.

你将需要看护人

You'll need to assess your personality and financial situation

你需要评估你的人格和财政状况

to determine whether an elder care community

去决定你是否需要养老社区

or staying at home is your best choice.

或者呆在家里，是你最好的选择

In either case, do not settle.

不管哪种情况，都不要定下来

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

我们看到过一些不太称职的看护

before we found the perfect team

在我们找到最好的团队之前

led by Marsha,

以Marcia领导的团队

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

我们不会因为你将死去就敷衍了事

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

我们会将你所拥有的录成视频

when you can't get out there,

当你如果不能离开疗养院

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

而Caitlin 不过让你省略每天的晨练

but knows when you need to hear

但是知道什么时候你想听到

that your wife is in good hands.

你的妻子被照顾得很好

Finally, last words.

最后，遗言

What do you want to hear at the very end,

在生命的最后，你想听到什么

and from whom would you like to hear it?

想听谁说这些

In my experience, you'll want to hear

从我的经验来说，你想听到的

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

是那些你担心的事情，都会好起来

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

当你真正的相信了，你就放下了，你会的

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

所以，这是一个关于鼓励恐惧与否定的话题

What I've learned

我学到的是

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

如果我们有计划的规划人生的最后

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

我们会有最大的可能去维护我们生活的质量

Here are Jim and Shirley just after deciding

这是Jim 和 Shirley，当他们决定了之后

who would take care of their ranch.

谁会照看他们的牧场

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

这是Jim， 死之前的几个星期

celebrating a birthday he didn't expect to see.

意外的收获到了一个庆生会

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

这是Shirley，她离去前的几天

being read an article in that day's paper

看到自己上了报纸

about the significance of the wildlife refuge

关于野生动植物避难所的重要性

at the Modini ranch.

在Modini 牧场

Jim and Shirley had a good end of life,

Jim 和 Shirley 有了很好的结束

and by sharing their story with you,

在这里分享着他们的故事

I hope to increase our chances of doing the same.

我希望能大家也能有同样美满的结点

Thank you.

谢谢

(Applause)

（鼓掌）