When the time comes, are you ready for death?

inkwellWill you be ready for that time, physically, mentally or spiritually. One of the largest healthcare costs, regardless of who pays for it occurs in the last 2-3 years of extra life beyond normal life expectancy. Why? Often it’s because we, the patient and our loved ones are not properly prepared or ready for life to end and insist on heroic and costly measures to sustain it.

Most of us if we go on a holiday, get married, divorce, or contemplate any other major endeavor, plan for it meticulously. Often we seek the advice of experts in their field; we discuss it with our friends and relatives. When it comes to the biggest of the big events of life – death, most of us do little or no planning. One has to wonder why that is so. Death is certain. Everyone gets at lease one. The uncertainty comes from the when, the where and the how. Your death effects you in a very direct way, but it also effects your family, friends, associates and others on whom you have an effect. Preparing them is as important as preparing yourself.

The fact is human nature does not lend itself to long range pre-planning for much of anything. Otherwise “Last Minute” clubs for holidays wouldn’t be as popular as they are and certainly there is no expectation that Last Minute clubs will partner with funeral homes anytime soon.

The farther you are from normal life expectancy the more invincible one feels.

If you are under 45 your mindset puts you into the invincible group. Beyond that, the older one gets the less emphasis bravado plays in your thinking and ones own mortality takes on a sharper focus. When aches and pains start to take on more meaning than they ought to and conjure non existent ailments your own mortality start to become more important to your thought process. By age 70, friends and relatives have caused you to attend funerals at a more frequent pace; creating more contemplative opportunities about your turn to be the center of attention.

Of those that do some planning, most of the plans deal with what comes after death, not end of life, the event itself. The focus is what happens to my wife, kids, Mom and Dad etc. Being in the financial services business, I can offer you life insurance, health insurance, long term care insurance. But these are all for the benefit of your family’s financial security, after your death. “But, I can’t control my death”, you say. Oh No?! Let’s just analyze that for a minute.

Below is a table of selected countries’ normal life expectancy at birth and Healthy Life expectancy or HALE as published by the World Health Organization (WHO). Healthy Life Expectancy is defined as “…the average number of years that a person can expect to live in “full health” by taking into account years lived in less than full health due to disease and/or injury.”






Life Expectancy at Birth both sexes (age)





Healthy Years from Birth to Age





Unhealthy Years





Stats for 2007 – WHO

Regardless of the total life expectancy, or the health care system, the remarkable consistency among English speaking industrialized nations is the years one lives in less than healthy state. At the beginning of the 20th century, the life expectancy was 30-45 years. Public health measures are credited with much of the recent increase in life expectancy.

During the 20th century, the average lifespan in the United States increased by more than 30 years, of which 25 years can be attributed to advances in public health. While I suspect that when life expectancy was 30-45 years, very little of that was unhealthy years, as death came pretty quick after onset of injury or disease.

The point to be made here is that modern medicine and technological advancements are able to sustain life well beyond “healthy years”. This begs the question. Ignoring the financial cost of sustaining human life, how much quality of life is one prepared to give up to sustain one’s life. Put another way, at what point inside the “Unhealthy Years of your life are you prepared to let go and decide life is no longer worth living? Now, clearly, our society does not tolerate suicide or euthanasia, but one need not assist in prolonging life, when it is otherwise contra-indicated.

Governments are now wrestling with this very issue on a macro basis due to the healthcare costs involved in sustaining these “Unhealthy Years”. Unfortunately the costs go up exponentially as life approaches the ultimate life expectancy.

The historical reasons for not adequately addressing the issue of “quality of life” and “end of life” are numerous. Culturally, the issue is quite new; not having heretofore to deal with it. People just did not live that long after becoming ill with injury or disease and ability to prolong life was limited. Dispassionate, detached end of life, hospice and death discussions for many are difficult subjects especially if it involves a loved one. Fear is a biggie. Many people fear the unknown. What happens after death, yes the Bible says this the Koran says that, but, but…etc.

The consideration of these issues must start with your self. It needs to start before you enter the “unhealthy years”. Just like you plan for the financial well being of your loved ones after death, you must plan for the “end phase” of your own life. Starting while healthy, and at some distance from your life expectancy, permits you to be a little more dispassionate and objective about the issues that need to be dealt with. Having achieved broad stroke milestone decisions during health, it becomes easier to reaffirm your positions and decision you undertook earlier as you approach end of life. It also becomes easier to lead your loved ones into these discussions for times when they need to make your decisions on your behalf, if you are unable to do so.

For your piece of mind, for your family, you must come to terms with “end of life”. Get a perspective, through books, agencies, doctor, councilors, family, and friends. Develop a sound logical consensus within your own mind of what’s rational and reasonable. If you do, you will be in lock step with Government and insurance funded healthcare systems that will and has to limit the funds available to prolong life beyond reason. Most of us wish death if it has to come, to come peacefully and at the end of a meaningful life with no lose ends. End of life planning is just another socially responsible act on many levels.~