How Transitions Came To Be

One of my neighbors in Mattapoisett recently asked me how Transitions began. Here’s what I wrote:

As a counselor and hospice chaplain, I found too often families of my dying patients were left with a mess when their loved one died.  Some grieving spouses suddenly had to take over all the financial and mundane tasks their loved one had taken care of -- and didn't know what needed to be done, and didn't even  know who their spouse's attorney, accountant, and business partners were.  So in addition to ministering to someone in deep grief, I and the hospice social worker had to help get all the tasks organized and done.  Others hadn't given any thought to what they wanted for a funeral -- and how to pay for one.  Still others  had no idea what their loved one had for life insurance.  In some cases, it was nothing short of chaos, all on top of the deep grief the family was experiencing. 

So, I realized many families simply needed help to make sense of the chaos and get done in an organized way what needed to be done. .

 I began by creating a loose-leaf notebook to help get a family organized, to help them plan ahead for the end of life. Originally the notebook simply had a series of forms which could be filled out: The forms included:

* A list of important contacts, with phone numbers and email addresses

*  A document locator  so the family would know where to find  important documents, such as life insurance policies, wills and trusts, living wills, bank statements, and funeral instructions. 

*  A list of insurance policies with contact information for each

*  Empty sleeves where important documents could be placed 

* A checklist so the family will know what needs to be done, both before and after death. 

 So that was the beginning.  Each notebook could be customized to meet the needs of individual families.  And it grew naturally from there. 

I added a section about memorial services and funerals – with a sample order of service for Christians, including appropriate Bible readings and hymns. Since some of my clients were Jewish (and I had one Muslim as a hospice chaplain), I developed sample services for those religions.  I also have developed a sample service for those who don’t want a religious send off.  Burial options are included  as well – traditional, scattering of ashes, “green” burials, and other alternatives.  So this section is customized for each family’s wishes.  What’s really wonderful about planning ahead is that the dying person gets to design exactly how he or she wants to be remembered.  People love being in control of their sendoff. 

Another section was actually suggested by several hospice patients who wanted to know what it’s like to die.  It’s a loaded question because what they were really asking was – does it hurt?  Will I be in pain?  Is it messy?  So now there’s an information-packed section on the dying process -- what actually happens when someone dies.  Note:  My experience is only with hospice patients who have died of a terminal illness under the care of hospice MDs, nurses, aides, social workers, and chaplains.  I can’t speak about those who die without all that help.  While every hospice death is a little different, most follow a definite process.  People normally go through several stages of decline before actual death occurs.  This section describes that physical process.  I relied on several of my hospice RNs and Aides for much of this section, plus a good deal of research by recognized medical experts.  It also talks about the emotional journey most people approaching death goes through and the anticipatory grief involved. 

This section also addresses the family and how they can best support a dying person.

I’ve added a section about grief, hoping that it will help family members as they cope with the loss of a loved one, with local resources they can draw on for support. 

Unfinished but in process is a section for the family afterwards, with a list of all that needs to be done from the time of death to up to over a year afterwards.  (Did you know the IRS requires two income tax filings after someone dies?)  A friend who recently buried her father suggested this section because she was surprised at everything she had to do after he died – and he actually had been very well organized ahead of time.  Still, there was much left for her to do. 

So each Transitions Notebook has turned out to be a work in process, tailor-made for each family.   It will not surprise me if it continues to evolve as my clients needs are revealed.  In the meantime, a family will have in its hands everything it needs in one place to make the loss of a loved one a little easier to bear.