Many of the people with whom I talk lead amazingly active lives. Some enjoy skiing atop mountains covered with glistening snow or kayaking on the ocean bays in Newfoundland – as my wife, Naomi, and I did, several years ago. Many bike through the city streets of Philadelphia or drive on the Schuylkill Expressway at rush hour. Some may climb Mount Everest, as did my friend, Werner Berger – who, at age 77, was the oldest man to climb to the seven highest summits on each of the seven continents and earned his place in the Guinness Book of World Records! Whatever your age or level of activity, what would happen if you were in an accident and (even temporarily) could not speak for yourself?

In the middle of October, my mother-in-law, Ruth Segal, a vibrant, active woman, lay dying. She was known as the woman who organized committees in her building, registered people to vote, was involved in a play-reading group, attended the theater with friends, played scrabble weekly and more. Even when she was ill with a lung/heart problem, she was coordinating the patio party for her building from her hospital bed. She had spoken often about her medical wishes, should the time come when she could not advocate for herself. All of her children and their families knew her wishes. When that time came, she decided that living with no quality of life was futile and decided to stop all medical treatment.  I want a pillowBecause she was prepared, because she had written down her wishes, shared them with her children and her doctors, we were able to honor her and the choices she had so carefully made.

It was not easy, but it would have been even more heart-wrenching if we did not know what she wanted and if we could not have agreed on the course of treatment.

Too many times, family members disagree about how best to care for their critically ill or dying family member. Not only can it destroy family relations, it also is heart-breaking for the dying person to have to listen to the arguments about his/her medical care and not be able to advocate for himself/herself. I listen to many who say that they don’t want to be a burden to their families. Writing out your Medical Healthcare Directive is the best way that I know to help your family during this stressful time.

Think of it this way, especially if you lead a healthy and active life: you are making these decisions because you want to be prepared and have a say in how you will be treated. Hopefully, you will recover from whatever the crisis is. Don’t you want to know that decisions were made based on your values and beliefs?

What do you need to do? There are many resources on the internet that can help you make some decisions. One of the most popular is called Five Wishes and identifies such topics as the name of person you want to make care decisions for you when you can’t, the kind of medical treatment that you want or don’t want, how comfortable you want to be, how you want people to treat you and what you want your loved ones to know.

The U.S. Department of Health and Human Services, Department of Aging also has some great information about decisions that you may need to make in a medical crisis, such as whether you want CPR, artificial nutrition and hydration, use of a ventilator and comfort care.

The American Bar Association has a list by state of downloadable forms for you to fill in. Many have found this to be advantageous. However, you may also find it helpful to talk with a third (non-family) person, such as clergy, a therapist, physician or someone well versed in helping people make difficult decisions. What is most important is that, once you have made these choices and written them down, you share them with your loved ones and medical professionals.

Who will decide

Remember, making these decisions in advance and communicating them to the appropriate people is a gift of love that is given to those who will have to make the decisions if /when you can’t. It is a kindness that is never forgotten. If you are ready to explore your thoughts and feelings about end-of-life decisions and would like to have someone with whom to discuss your options, RieOrganize! can help begin the conversation. Text or call Rie at 215.435.5609 or see our website at

This newsletter is dedicated to my mother-in-law,
Ruth L. Segal (z”l)