Engage with Grace

Last Thanksgiving weekend, many of us bloggers participated in the first documented blog rally to promote Engage With Grace – a movement aimed at having all of us understand and communicate our end-of-life wishes.
It was a great success, with over 100 bloggers in the healthcare space and beyond participating and spreading the word. Plus, it was timed to coincide with a weekend when most of us are with the very people with whom we should be having these tough conversations – our closest friends and family.

Our original mission – to get more and more people talking about their end of life wishes – hasn\’t changed. But it\’s been quite a year – so we thought this holiday, we\’d try something different.

A bit of levity.

At the heart of Engage With Grace are five questions designed to get the conversation started. Weíve included them at the end of this post. They are not easy questions, but they are important.

To help ease us into these tough questions, and in the spirit of the season, we thought weíd start with five parallel questions that ARE pretty easy to answer:

Silly? Maybe. But it underscores how having a template like this – just five questions in plain, simple language – can deflate some of the complexity, formality and even misnomers that have sometimes surrounded the end-of-life discussion.

So with that, weíve included the five questions from Engage With Grace below. Think about them, document them, share them.

Over the past year there\’s been a lot of discussion around end of life. And we\’ve been fortunate to hear a lot of the more uplifting stories, as folks have used these five questions to initiate the conversation.

One man shared how surprised he was to learn that his wife\’s preferences were not what he expected. Befitting this holiday, The One Slide now stands sentry on their fridge.

Wishing you and yours a holiday thatís fulfilling in all the right ways.


To learn more please go to www.engagewithgrace.org. This post was written by Alexandra Drane and the Engage With Grace team. If you want to reproduce this post on your blog (or anywhere) you can download a ready-made html version here

19 thoughts on “Engage with Grace”

  1. Dr. Rob,
    I’m 41 and relatively healthy yet I had all that pesky paperwork done about a year ago. Why would I do such a thing at my age? Well, accidents happen. Sudden illnesses happen. Life happens, and so does death.

    As a divorced empty-nester, the decisions by default would be up to my my young adult son to figure out. He is not, in my opinion, capable. So who are the folks who get to make the decisions? A former boyfriend who I at one point trusted as the beneficiary of $1MM in life insurance for my son, my brother and finally my mother. In the event that all three refuse, my attorney will handle it. (Said ex is still the beneficiary, but his financial responsibility for my son is no longer an issue.)

    Is it creepy to think about? Maybe for some. I take comfort in knowing that none of my loved ones will be forced to make decisions on my behalf. Even the funeral is spelled out – “Bonfire and a kegger! Celebrate life, have fun!”

    Or I could just be a control freak. 🙂

  2. Dr. Rob,
    I’m 41 and relatively healthy yet I had all that pesky paperwork done about a year ago. Why would I do such a thing at my age? Well, accidents happen. Sudden illnesses happen. Life happens, and so does death.

    As a divorced empty-nester, the decisions by default would be up to my my young adult son to figure out. He is not, in my opinion, capable. So who are the folks who get to make the decisions? A former boyfriend who I at one point trusted as the beneficiary of $1MM in life insurance for my son, my brother and finally my mother. In the event that all three refuse, my attorney will handle it. (Said ex is still the beneficiary, but his financial responsibility for my son is no longer an issue.)

    Is it creepy to think about? Maybe for some. I take comfort in knowing that none of my loved ones will be forced to make decisions on my behalf. Even the funeral is spelled out – “Bonfire and a kegger! Celebrate life, have fun!”

    Or I could just be a control freak. 🙂

  3. I like “Bonfire and kegger.” Since your son is not capable, your ex or brother would be the one (although I would question if you want to keep the ex in charge). The reason for you doing this kind of thing is to take your son out of the logical succession (who it would go to by default). If you say nothing, it will go to him.
    Here’s a question: why do you still have life insurance? If you are no longer supporting your son, you should probably just put the money into retirement. It’s OK to plan for this kind of thing, but in your circumstance it is not quite as crucial.

  4. I like “Bonfire and kegger.” Since your son is not capable, your ex or brother would be the one (although I would question if you want to keep the ex in charge). The reason for you doing this kind of thing is to take your son out of the logical succession (who it would go to by default). If you say nothing, it will go to him.
    Here’s a question: why do you still have life insurance? If you are no longer supporting your son, you should probably just put the money into retirement. It’s OK to plan for this kind of thing, but in your circumstance it is not quite as crucial.

  5. The life insurance amount has been highly debated. I was able to get the policy for almost nothing when I was 20-something and had a LONG time before the kid was of the age of majority. I converted it to whole life when I left that job, after realizing that the premiums would still be much cheaper than anything I could buy on my own.
    Now at 41, those premiums are still $400 a year and there is no way in hell I could get that amount again for that rate. Realistically, $400 a year isn’t going to do much for my retirement anyway. I see your point that I’m overinsured since I don’t even have 20K in debt. No mortgage, no minor child support/maintenance expenses, my vehicle will be paid off in June, etc.

    To answer the question about my ex still being at the front of the line, I’ll paraphrase what I told my attorney: “You need to understand, this man will squeeze a nickel until the buffalo soils his undies.” When my kid was 12, knowing that someone fiscally responsible was in charge (where my son’s father couldn’t touch the money) was important to me. Now that my newly-minted adult child has proven himself irresponsible with pretty much everything, it’s even more important that he not be cut loose with that lump sum of cash.

    The trust is set up where my son gets a stipend until he is 30, then he can access the principal. Increases for life changes such as marriage, children, buying a home, etc., are at the discretion of the trustees. In other words, he’s not going to be turned loose with that much money to set up his own recording studio and buy flashy cars and booze. (Sadly, I do have that little faith in his 20 year old judgement.)

  6. The life insurance amount has been highly debated. I was able to get the policy for almost nothing when I was 20-something and had a LONG time before the kid was of the age of majority. I converted it to whole life when I left that job, after realizing that the premiums would still be much cheaper than anything I could buy on my own.
    Now at 41, those premiums are still $400 a year and there is no way in hell I could get that amount again for that rate. Realistically, $400 a year isn’t going to do much for my retirement anyway. I see your point that I’m overinsured since I don’t even have 20K in debt. No mortgage, no minor child support/maintenance expenses, my vehicle will be paid off in June, etc.

    To answer the question about my ex still being at the front of the line, I’ll paraphrase what I told my attorney: “You need to understand, this man will squeeze a nickel until the buffalo soils his undies.” When my kid was 12, knowing that someone fiscally responsible was in charge (where my son’s father couldn’t touch the money) was important to me. Now that my newly-minted adult child has proven himself irresponsible with pretty much everything, it’s even more important that he not be cut loose with that lump sum of cash.

    The trust is set up where my son gets a stipend until he is 30, then he can access the principal. Increases for life changes such as marriage, children, buying a home, etc., are at the discretion of the trustees. In other words, he’s not going to be turned loose with that much money to set up his own recording studio and buy flashy cars and booze. (Sadly, I do have that little faith in his 20 year old judgement.)

  7. Excellent post. As a Hospice Volunteer we have had these conversations regularly, having provided palliative care for Mom at home and Dad in Long-Term Care. I fought for weeks to increase Dad’s medications. I kept telling them that Dad exhibited the signs of pain, but the doctor was no where to be found. In his clinic one day, his office the next. No one would take a message and he did not respond to nursing staff. A lesson in being the squeaky wheel!

  8. Excellent post. As a Hospice Volunteer we have had these conversations regularly, having provided palliative care for Mom at home and Dad in Long-Term Care. I fought for weeks to increase Dad’s medications. I kept telling them that Dad exhibited the signs of pain, but the doctor was no where to be found. In his clinic one day, his office the next. No one would take a message and he did not respond to nursing staff. A lesson in being the squeaky wheel!

  9. We have been trying to have the end of life conversation with my father-in-law for years. Now at 80 years old, he is due to have his first ever surgery in January. The materials from Engage with Grace and this past week’s Mayo Clinic health newsletter gave us the tools we needed to have the conversation in a way that made it seem important, yet non-threatening.
    By the way, this form from the Mayo Clinic was very useful.
    http://mayoclinic.com/health/senior-health/HA00029

    Thanks,
    J.P.

    P.S. I really enjoy your podcasts.

  10. We have been trying to have the end of life conversation with my father-in-law for years. Now at 80 years old, he is due to have his first ever surgery in January. The materials from Engage with Grace and this past week’s Mayo Clinic health newsletter gave us the tools we needed to have the conversation in a way that made it seem important, yet non-threatening.
    By the way, this form from the Mayo Clinic was very useful.
    http://mayoclinic.com/health/senior-health/HA00029

    Thanks,
    J.P.

    P.S. I really enjoy your podcasts.

  11. Wow. Your comment couldn’t have been nicer for me to read. I am very glad this helped and only take credit for following the lead of those who organized this great campaign. Thanks for the link and for the kind word about the podcast.

  12. Wow. Your comment couldn’t have been nicer for me to read. I am very glad this helped and only take credit for following the lead of those who organized this great campaign. Thanks for the link and for the kind word about the podcast.

  13. I agree with Rob in principal (I have no significant debts, and my only whole life cover is part of my pension plan), but equally I reckon you’d be lucky to generate more than about $8 a month retirement income off another $9600 in pension payments.

  14. I agree with Rob in principal (I have no significant debts, and my only whole life cover is part of my pension plan), but equally I reckon you’d be lucky to generate more than about $8 a month retirement income off another $9600 in pension payments.

  15. I’d endorse the need to have this conversation with everyone who has a direct interest in your position on it (partner, sibling(s), parents as applicable).

  16. I’d endorse the need to have this conversation with everyone who has a direct interest in your position on it (partner, sibling(s), parents as applicable).

  17. My wife and I had this conversation a long time ago and did what was necessary. We really haven’t thought much about it (even through two surgeries) because everything was in place.
    This past weekend our next door neighbor was diagnosed with terminal lung cancer and we have been trying to help his wife through it. They, of course, have not had the discussion and he is no longer able to reasonably engage in the discussion. It is a wrenching example of the need for overcoming the “I don’t want to talk about it” syndrome.

  18. My wife and I had this conversation a long time ago and did what was necessary. We really haven’t thought much about it (even through two surgeries) because everything was in place.
    This past weekend our next door neighbor was diagnosed with terminal lung cancer and we have been trying to help his wife through it. They, of course, have not had the discussion and he is no longer able to reasonably engage in the discussion. It is a wrenching example of the need for overcoming the “I don’t want to talk about it” syndrome.

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