“You’re Sorry for Someone’s Loss. But How Do You Say It?” (NYT)

This recent New York Times article contains some do’s and don’ts about expressing sorrow for someone’s loss.  The experts review these topics:

* digital condolences (social media and email)
* getting started (don’t procrastinate)
* draw on your memories (“share a memory of the person who died with the bereaved”)
* offer concrete ways to help
* what not to say (don’t refer to your own experiences with death)
* the importance of reaching out

The article mentions this webpage of sample condolence messages:


Here’s a link to the full article:


Smarter Living
You’re Sorry for Someone’s Loss. But How Do You Say It?
By Christopher Mele
The New York Times
Aug. 24, 2017



“Even healthy people need a living will, but many people don’t want to think about it”

This is a good article from today’s “Washington Post” (washingtonpost.com) on why people may not complete a living will. The author makes the point that even if you don’t have a living will, everyone (healthy or not) should designate in writing a healthcare proxy and, ideally, have a discussion with the proxy about end-of-life wishes.

Here are some excerpts from the article:

* Even though advance directives have been promoted for nearly 50 years, only about a third of U.S. adults have them, according to a recent study. People with chronic illnesses were only slightly more likely than healthy individuals to document their wishes.

* “Many people don’t sign advance directives because they worry they’re not going to get any care if they say they don’t want” cardiopulmonary resuscitation, said the study’s senior author, Katherine Courtright, an instructor of medicine in pulmonary and critical care at the University of Pennsylvania. “It becomes this very scary document that says, ‘Let me die.'”

* That’s where the health-care proxy comes in. Just naming someone isn’t enough, though. To be effective, people need to have conversations with their proxy and other loved ones to talk about their values and what matters to them at the end of life.

The full article is worth reading:


Even healthy people need a living will, but many people don’t want to think about it
By Michelle Andrews
Washington Post
August 7, 2017 at 7:00 AM



“Getting It Right At The End Of Life”

This personal story about the author’s terminally ill mother illustrates the importance of making your end-of-life wishes known and legally supported.


When—just a few days after her eighty-ninth birthday—my mother was diagnosed with a colorectal mass (we would later learn it was cancerous), she restated to me what I long knew to be her fervent wish: no treatment of any kind beyond symptom relief. NO invasive procedures, NO chemo or radiation, NO life-prolonging treatments. NONE! She wanted only one thing: to spend the rest of her days, however many or few there were to be, in her apartment in her lively and supportive community. My job was simply to help make sure her wishes were honored. As it turned out, this was not so simple at all. Just days after the initial diagnosis, despite my mother’s long-standing, clearly stated, and just-repeated wish, I found myself reluctantly making an appointment for a preoperative examination with a surgeon for a procedure to reroute her intestine around the mass. How had we ever come to even consider this?

The full article is here:


Getting It Right At The End Of Life
by Dina Keller Moss
Health Affairs
July 2017; Volume 36, Issue 7

Worth reading!



Grief tests our resilience and teaches us more about life than death

Today, I came across the website Option B (optionb.org), which is focused on resilience. The website’s tag line is: “Resilience is like a muscle. We’re here to help you build it.”

There’s a thought-provoking article from April 2017 by Arianna Huffington about the need to embrace grief. She writes:

“There are few things that test our resilience more than the death of a loved one. Grief can be isolating and grueling and feel insurmountable. But it’s also true that there is nothing that can teach us more about life than death. And when we allow ourselves to receive the lessons that death can teach us, we’ll be more resilient when facing whatever challenges life brings us.”

Here’s a link to the article:


Grief isn’t about ‘closure.’ Nor is it something to overcome or get past. It’s something to lean into, to embrace.
By Arianna Huffington
April 2017
Option B



A story about how grieving begins “with the knowledge of our mortality”

This is a very sweet story by Caroline Wellbery, MD, a friend of mine for over 30 years. I don’t think the article is well-titled. It’s more about stages of grief and how grieving is different with different people.

Here’s a link:


Health & Science
We unplugged my father from everything, as he wished, but I wasn’t ready to let go
By Caroline Wellbery
June 4, 2017
Washington Post


Highlights from Oprah Interview with BJ Miller, MD, Hospice Expert, on Living

On Oprah Winfrey’s TV channel, she has a show called “SuperSoulSunday.”  Earlier this month, she interviewed BJ Miller, MD, a hospice and palliative care specialist at UCSF.  Dr. Miller shares “his revelations about a subject that is often taboo in our culture — the experience of death.”  You can watch the interview online at:


If you’d like to read more about Dr. Miller, hospice specialist and triple amputee, check out Brain Support Network’s blog post from January 2017:


The interview with Dr. Miller is followed by a short film about the late Paul Kalanithi, MD, who wrote the best selling book “When Breath Becomes Air.”

Deb, one of our local support group members, listened to the interview and shared some highlights with us.  Deb’s husband recently passed away with Lewy body dementia.



Deb’s Notes from

Guest:  BJ Miller
Season 7 Episode 709
Aired on 05/07/2017
OWN SuperSoulSunday

Here are my notes from a fascinating episode of the OWN (Oprah Winfrey Network) show “Super Soul Sunday.”  Oprah interviewed palliative care and hospice physician, Dr. B.J. Miller.

1. Life is not avoiding suffering, but finding meaning.

2.  Dying people are still living.  There is a continuity of existence such that death is part of living.

3.  Being a human being is hard.  It helps to have something to push against to get us to rise to the challenge.  (Miller suffered an accident as a teenager and is a triple amputee.)

4.  The fact that we all die makes life precious.  We realize that time is short and that delays have consequences.

5.  We should see the silver linings in our lives every day.

6.  In order to die well and be at peace with ourselves and have no regrets, we should live well.  Every day we should do a self-check: 1) Am I doing something I really care about?; 2) Am I doing what I really want to do?; 3) Did I tell my loved ones that I love them?

7.  We all have these negative feelings about death and losing control.  Yet given the choice to live forever, most people would not choose it.  So death is not so negative.  And you can get to the point that you even welcome death.

8.  One of the best things about living is being able to give and receive love.

“3 Kinds of Grief Nobody Talks About” (by Ken Doka, PhD)

In April 2016, Ken Doka, PhD (drkendoka.com) published a book called “Grief Is a Journey.”  In this excerpt in O, Oprah’s magazine, he describes the three kinds of grief nobody talks about — the loss of a person we once knew, the loss of a person we haven’t yet lost, and the loss of the person we used to be.  Here’s a link to the excerpt:


3 Kinds of Grief Nobody Talks About
The author of “Grief Is a Journey” explains how some of our most cutting losses can go unrecognized by friends and family—and even ourselves.
By Kenneth J. Doka, PhD
April 15, 2016

“Recommended New Books for Those Who Are Grieving” (WSJ)

This Wall Street Journal article from late April is a review of five books for those who are grieving:

1- “Resilient Grieving,” By Lucy Hone.

The WSJ article says:  “Her metaphor for life after loss is both powerful and apt: Think of it as a scattered jigsaw puzzle, where the pieces of one’s former life have been scattered and now must be reconfigured in a new way.”

2- “Option B: Facing Adversity, Building Resilience and Finding Joy,” By Sheryl Sandberg and Adam Grant

The WSJ article says:  “For all of its helpful advice, the book is a whirlwind journey that at times tries to do too much.”

3- “Guesswork: A Reckoning With Loss,” By Martha Cooley

4- “There Is No Good Card for This: What To Say and Do When Life Is Scary, Awful, and Unfair to People You Love,” By Kelsey Crowe, Ph.D., and Emily McDowell

The WSJ article says:  The authors “offer insights into those awkward times when friends and family freeze, not knowing what to say or how to help in times of loss. … Simply asking how things are going is often a good start.”

5- “On Living,” By Kerry Egan

The WSJ article says:  “The best antidote to suffering is the kindness of another human being, she writes. And one such kindness is to listen with empathy and attention as people relate the stories that gave their lives meaning, or struggle to reframe the regrets and pain that continue to unsettle them.”

Here’s a link to the full article:


Recommended New Books for Those Who Are Grieving
Sheryl Sandberg and other authors offer strategies on how to move forward after suffering a loss
By Diane Cole
Wall Street Journal
April 23, 2017 10:06 p.m. ET



“Coping with Grief and Loss: Understanding the Grieving Process and Learning to Heal”

I recently discovered HelpGuide.org, a website that focuses on mental, emotional, and social health.  They have quite a few articles about caregiving, grief, and loss.

Here’s a link to their webpage from April 2017 on “Coping with Grief and Loss:  Understanding the Grieving Process and Learning to Heal”:


PREPARE website – another tool for advance care planning

At the recent American Geriatrics Society annual scientific meeting, some interesting research about advance care planning was presented.  Reading about that research led me to a simple website called PREPARE at prepareforyourcare.org.  The founder of this effort is a Rebecca Sudore, MD, UCSF geriatrician and palliative care specialist.

PREPARE addresses five categories as a means to develop a personalized action plan:
* choosing a medical decision maker
* deciding what matters most in life
* choosing flexibility for your decision maker
* telling others about your wishes
* asking doctors the right questions

The website’s text is large, with lots of graphics.  The website “speaks” the content, which is great for those with visual impairments but, fortunately, can be turned off.  The site is available in both English and Spanish.  According to a Medscape article about the site, the language used is at a fifth-grade level.

PREPARE has created easy-to-use advance health care directives for each state.  Here’s a link to the California form:


If you haven’t made your advance care plans, this is another great tool.

For those interested, Dr. Sudore discusses her research in a blog post and podcast on the GeriPal website: