Education

Embracing the Inevitable: Why End-of-Life Planning is a Gift

Talking about death and dying is uncomfortable. Most of us avoid it, push it aside, and assume we’ll deal with it when the time comes. But as experts in hospice and palliative care remind us, avoiding these conversations only makes it harder when the inevitable arrives.

by, Niki Weiss
Feb 11, 2025

About This Blog

In a recent episode of the Death and Dying in the Digital Age podcast, host Niki Weiss sat down with Dr. Marianne Matzo, FAAN, a seasoned palliative care nurse and founder of Everyone Dies, a nonprofit and podcast dedicated to End-of-Life education. Their conversation explored the complexities of death in today’s medicalized world, the challenges families face in decision-making, and the importance of having a clear plan long before it’s needed.

The Difference Between Hospice and Palliative Care

One of the most misunderstood aspects of End-of-Life care is the distinction between hospice and palliative care. While they share a common goal—improving quality of life—they serve different purposes:

Palliative Care is available to anyone with a serious illness, regardless of prognosis. It focuses on pain and symptom management and can be integrated alongside curative treatments.
Hospice Care is reserved for those with a life expectancy of six months or less. It shifts focus entirely to comfort care and symptom relief, rather than seeking a cure.

A major issue, as discussed in the podcast, is that many patients and families delay hospice care until the very last moments of life—sometimes mere days or weeks before passing. This delay often stems from a cultural aversion to discussing death, coupled with a healthcare system that prioritizes intervention over comfort.

Why Families Struggle with End-of-Life Decisions

A common scenario in End-of-Life care involves family members struggling to agree on what’s best for their loved one. As Dr. Matzo explained, these conflicts often arise because there were no prior conversations or directives in place.

When a loved one is no longer able to express their wishes, families are left making difficult decisions in a vacuum. Some members may cling to every possible medical intervention, while others may advocate for a more natural passing. Without clear guidance, disagreements can lead to emotional turmoil and guilt.

To avoid this, experts strongly advocate for advance care planning—the process of documenting one’s End-of-Life wishes before they become necessary.

The Importance of Medical Advance Directives

A medical advance directive is a legal document that outlines a person’s medical wishes should they become unable to communicate. This includes:

Whether they want to be resuscitated
Their stance on artificial life support (ventilators, feeding tubes, etc.)
Preferences for pain management and comfort care
Naming a healthcare proxy—a trusted person who can make medical decisions on their behalf

Every state has different laws regarding medical advance directives, but most allow free access to standardized forms. Websites like Five Wishes provide a user-friendly way to document preferences in an accessible, compassionate manner.

Allowing for a Natural Death

A powerful theme discussed in the podcast was the concept of allowing natural death. Modern medicine has given us the ability to prolong life far beyond what was once possible, but this often comes at the cost of quality of life.

In some cases, aggressive treatments do not offer meaningful extension of life but rather prolong suffering. For example, hospital transfers for frail elders can be disorienting and traumatic. As Dr. Matzo pointed out, emergency rooms are not designed for peaceful End-of-Life experiences; they are chaotic, bright, and cold—a stark contrast to a home or hospice setting.

Choosing to allow natural death does not mean giving up. It means recognizing when medical intervention is no longer beneficial and prioritizing dignity, comfort, and peace.

Taking Action: What You Can Do Today

If you haven’t had these conversations yet, now is the time. Here are some simple steps you can take to ensure you and your loved ones are prepared:

Start the Conversation – Talk openly with your family about what matters most to you. Share your thoughts on quality of life, medical interventions, and where you’d prefer to spend your final days.
Complete a Medical Advance Directive – Download your state’s form, fill it out, and discuss it with your loved ones.
Appoint a Healthcare Proxy – Choose someone you trust to make medical decisions on your behalf if you are unable to.
Organize Important Documents – Keep your medicaladvance directive, insurance policies, and any End-of-Life preferences in a dedicated, accessible place. Some call this a "crucial doc box."
Explore Hospice and Palliative Care Options – If you or a loved one is facing a serious illness, ask your doctor about palliative care early. Don’t wait until the final days to explore hospice care—it is a resource meant to be used for months, not just weeks.

Final Thoughts: A Gift of Peace

End-of-life planning isn’t about being morbid—it’s about taking control and removing the burden of tough decisions from your loved ones. It’s about ensuring that when the time comes, your passing is met with peace, dignity, and the comfort of knowing your wishes are honored.

If you found these topics insightful, be sure to watch the full episode with Niki and Dr. Marianne Matzo on YouTube. Also, check out Marianne’s nonprofit, Everyone Dies, where you’ll find more resources, educational materials, and even a podcast dedicated to these important conversations.

By embracing the conversation about death, we create a more compassionate and prepared world for ourselves and those we love.

If something happened to you, would the people in your life know what to do? Don't leave your loved ones in the dark. Start developing your end-of-life and digital legacy plan. My Final Playbook App on the App Store or Google Play or visit us online at Final-Playbook.Passion.io to get started. With My Final Playbook, you'll be able to start and learn how to organize your legal, financial, physical, and digital assets today. Until then, keep your password safe and your playbook up to date.

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Leaving A Music Legacy in the Digital Age

This week on Death and Dying in the Digital Age, we consider end-of-life care and the legacies we leave behind. Niki Weiss sat down with accomplished music therapists Brooke Carroll Lemchak, PhD and Karen Dennery Melita, MMT, MT-BC to explore how music therapy helps bridge the gap between life and death while creating lasting emotional connections that can be there for loved ones when you no longer are. Both Brooke and Karen bring extensive expertise to this conversation, having dedicated their careers to music therapy after completing rigorous academic and clinical training at Temple University. Their combined experience spans decades of working with hospice patients across all age groups, from young children to elderly adults. As board-certified music therapists, they've witnessed firsthand how music can transform end-of-life experiences and create meaningful legacies for those left behind. The Power of Musical Memory in End-of-Life Care Scientific research has shown that musical memories are stored in the prefrontal cortex, one of the last areas of the brain to deteriorate as we age. This explains why individuals with advanced dementia who struggle to recognize family members can still recall and sing along to songs from their youth with perfect clarity. For music therapists working in hospice settings, this connection becomes a powerful way to maintain meaningful relationships until the very end. Through carefully selected songs and musical interactions, patients can express emotions, share memories, and connect with loved ones even when traditional communication becomes difficult. The therapeutic value extends beyond the patient to family members, who often find comfort in seeing their loved ones engage with familiar music. You can create new positive memories that family members can cherish long after their loved one has passed, helping to balance the challenging emotions that come with loss. Creating Musical Time Capsules for Loved Ones In today's digital age, creating musical legacies has become more accessible than ever. Modern technology allows us to easily compile and preserve meaningful songs that represent our relationships with different people in our lives. Unlike physical recordings that can deteriorate over time, digital platforms ensure these musical memories remain intact for future generations and can be a preservation of your legacy. Music therapists encourage people to start building these musical time capsules while they're healthy, rather than waiting until they face a health crisis. This allows for thoughtful selection of songs that truly represent relationships and experiences, creating more meaningful collections for loved ones. The process of creating musical legacies can be therapeutic in itself, helping individuals process their emotions and reflect on important relationships in their lives. It becomes a way to express feelings that might be difficult to put into words, especially for those who struggle with verbal expression. The Impact of Original Songs Sometimes, existing songs aren't enough to express the complex emotions and messages we want to leave behind. Music therapists often work with patients to create original songs that address specific relationships or unresolved feelings. These personalized compositions become powerful tools for healing and closure as well as a personal record to share with future generations. One particularly moving example involved a patient with an estranged daughter. Through songwriting, he found a way to express his regrets and love in a way that traditional communication hadn't allowed. While the song's reception by his daughter remained uncertain, the process itself provided vital emotional release and closure for the patient. The creation of original music often serves multiple purposes: it helps patients process their own emotions, provides a creative outlet during difficult times, and leaves behind a unique, personal legacy for loved ones. These songs become time capsules of emotion, carrying messages of love and healing across generations. Technology's Role in Preserving Musical Legacies Here are several ways technology has revolutionized how we create and preserve musical legacies: 1. Digital Storage Platforms Cloud-based music libraries Dedicated playlist folders for different loved ones Backup systems to prevent loss 2. Recording Options Voice memo applications Professional-quality recording software Digital audio workstations 3. Sharing Capabilities Easy distribution to family members Ability to add personal notes to songs Options for future scheduled sharing Modern digital tools have transformed how music therapists work with patients and how individuals can create their own musical legacies. What once required extensive physical sheet music collections can now be accessed instantly through digital libraries. This accessibility allows for more spontaneous and responsive music therapy sessions while ensuring that created works remain preserved for future generations. Time to Start Your Legacy The time to start creating your musical legacy is now, not when facing end-of-life decisions. Begin by thinking about the special people in your life and the songs that remind you of them. Consider creating digital folders for each loved one, filling them with meaningful music that represents your relationship. Your musical legacy doesn't have to be complex or professionally produced. It can be as simple as a playlist of songs that tell your story or express your feelings. The key is to start the process while you have the clarity and time to make thoughtful choices about what you want to leave behind. Don't wait until tomorrow to begin creating these precious gifts for your loved ones. Whether through existing songs or original compositions, music provides a unique way to ensure your love and memories live on. In the end, these musical legacies become bridges across time, allowing your voice to continue speaking to future generations through the universal language of music. Don't leave any pieces of your legacy to chance. As a next step, you can start and develop your plan by downloading the app, My Final Playbook. Through this app, you'll be able to start and learn how to organize your legal, financial, physical, and digital assets today. In the digital age, planning your legacy is just a click away. Until then, keep your password safe and your playbook up to date.

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