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The Ombudsman's Report - The Conversation

The Ombudsman Report for October 2023 - "The Conversation"

By Kathleen Heren, Rhode Island's Long-Term Care Ombudsman

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Kathleen Heren

The most difficult conversation to have with others and ourselves is about end-of-life wishes and death. Talking about quality of life as death approaches is not an easy subject to talk about. Let’s discuss why.

No one ever came back from the dead to tell us what dying is like; furthermore, every culture views death and dying differently. For example, I am Irish. I am all Irish, so I was brought up to have a rowdy party when someone dies. I did observe the only thing you can hear at an Irish wake is sorry for your troubles over and over.

People with a strong religious background or faith may believe in some version of life after death, but not all do. The most important thing is to prepare now by documenting what your last wishes will be, as this will release loved ones and those left behind from the burden of trying to figure out what you wanted.

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A "conversation" that needs to occur

In 2019, the University of Alberta developed a Life Conversation Tool designed to help people with terminal illnesses express their needs and wishes to loved ones and caregivers. This questionnaire is a helpful resource for social workers as they interview residents on their wishes, fears, and values, but importantly, it promotes conversation between family members and their loved ones about a subject that can be difficult to start.

In many cases, long-term care residents or those living with a chronic disease like Parkinson’s have not had a conversation of this nature about end-of-life wishes. We live in a death-denying culture because the idea is uncomfortable; because of this, we think of death as a negative experience instead of how to live life to the fullest while we are here. Most people will tell you that they wanted to have "the conversation" with someone about this subject and felt relieved when they had a chance to share their feelings with someone.

The conversation should come before a Medical Durable Power of Attorney is named by the person. If the Power of Attorney knows what a resident or family member wants, it makes it a lot easier to carry out their wishes when other family members try to interfere.

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It's our choice how we spend our final days

It has always puzzled me why families fight when someone is dying. Is it over money? Or is it about guilt because of what someone did or did not do when they could have expressed their wishes? It also could be because someone else was named Power of Attorney. In closing, it is equally important to learn what gives a dying person joy. This is a question that can only be answered by spending time with the person and learning about their wishes.

As individuals, we make decisions about what we want to do throughout life, whether it is employment, the choice of a partner, or even having children. We should be able to decide how we spend the last days of our lives. Start the conversation now so others won’t be able to decide when you cannot.


Kathleen Heren

Rhode Island State Long Term Care Ombudsman

Office of the RI State Long Term Care Ombudsman Program

Alliance for Better Long Term Care Inc

422 Post Road Suite 204

Warwick, RI 02888

401-785-3340 (O)

401-785-3391 (F)

As the Rhode Island State Long Term Care Ombudsman, Ms. Heren shares her expertise by providing a monthly guest blog to Connelly Law Offices, Ltd. In these blogs, she delves into various issues and topics that she encounters in her role. The insights and opinions expressed in these blogs are solely those of the author(s) and do not necessarily represent the views or opinions of Attorney RJ Connelly III or any of the employees at Connelly Law Offices, Ltd.

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Please note that the information provided in this blog is not intended and should not be construed as legal, financial, or medical advice. The content, materials, and information presented in this blog are solely for general informational purposes and may not be the most up-to-date information available regarding legal, financial, or medical matters. This blog may also contain links to other third-party websites that are included for the convenience of the reader or user. Please note that Connelly Law Offices, Ltd. does not necessarily recommend or endorse the contents of such third-party sites. If you have any particular legal matters, financial concerns, or medical issues, we strongly advise that you consult your attorney, professional fiduciary advisor, or medical provider for advice.

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