TED演讲：为美好的临终生活做计划

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当我们想到死亡的时候总是可怕的，但是提前准备是切实的，并且可以为临终前的安静留下足够的空间。在一个庄严并深思熟虑的演讲中，Judy MacDonald Johnston 分享了5个为美好的临终生活做计划的方法。

TED视频TED演讲稿

What would be a good end of life?

什么是一个生活美好的结尾？

And I'm talking about the very end.

我所说的是最终的结尾。

I'm talking about dying.

我所说的是死亡。

We all think a lot about how to live well.

我们都在想如何更好的生活。

I'd like to talk about increasing our chances of dying well.

而我想要谈的是，如何更美好地告别人生。

I'm not a geriatrician.

我并不是老年病学家。

I design reading programs for preschoolers.

我为学前班的孩子设计阅读课程。

What I know about this topic comes from a qualitative study with a sample size of two.

我对这个话题的了解来源于一个定性的研究，其中有两个案例。

In the last few years, I helped two friends have the end of life they wanted.

在过去的几年，我帮助两个好朋友以他们想要的方式，结束了他们的生命。

Jim and Shirley Modini spent their 68 years of marriage Jim living off the grid on their 1,700-acre ranch in the mountains of Sonoma County. Sonoma

和 Shirley Modini度过了他们68年的婚姻生活生活在远离城镇的，1,700英亩的牧场里县的山区。

They kept just enough livestock to make ends meet so that the majority of their ranch would remain a refuge for the bears and lions and so many other things that lived there.

他们喂养了仅仅是能养活他们自己的家禽，所以这大部分的牧场变成了熊，狮子和其他的动物生活在那里的避难所。

This was their dream.

这正是他们的梦想

I met Jim and Shirley in their 80s.

我在两个老人年迈八十的时候遇见他们

They were both only children who chose not to have kids.

他们只有一个子女，而他选择不要孩子。

As we became friends, I became their trustee and their medical advocate, but more importantly, I became the person who managed their end-of-life experiences.

当我们成为朋友后，我变成了他们的托管人与他们的医疗顾问

但是更重要的是，我成为了帮助他们结束生活的那个人。

And we learned a few things about how to have a good end.

并且我们学到了，如何有个好的结局

In their final years, Jim and Shirley faced cancers, fractures, infections, neurological illness.

在最后的几年里， Jim和 Shirley他们面对着癌症，骨折，传染病和神经上上的疾病。

It's true.

这是真的

At the end, our bodily functions and independence are declining to zero.

人到了最后，我们身体的功能和独立性会降低到零

What we found is that, with a plan and the right people, quality of life can remain high.

我们发现，如果有正确的计划和人，他们还是可以拥有高品质的生活

The beginning of the end is triggered by a mortality awareness event, and during this time, Jim and Shirley chose ACR nature preserves to take their ranch over when they were gone.

结束的开始是被其他所引起的，像对死亡的意识，并且在此期间

Jim和 Shirley选择了ACR自然保护区在他们去世后接手牧场。

This gave them the peace of mind to move forward.

这给了他们一片祥和，然后继续前行

It might be a diagnosis. It might be your intuition.

这可能是个诊断，也可能是你的直觉

But one day, you're going to say, "This thing is going to get me."

有一天，你会说，这样的事情会打垮我

Jim and Shirley spent this time  letting friends know that their end was near and that they were okay with that.

Jim和Shirley用这些时间让他们的朋友知道，离他们离开人世的时间不远了，而他们对此没有埋怨。

Dying from cancer and dying from neurological illness are different.

因为患癌症与神经疾病而死去是不一样的

In both cases, last days are about quiet reassurance.

两种情况，最后的几天都非常安详

Jim died first. He was conscious until the very end,  but on his last day he couldn't talk.

Jim先离去，到最后他都非常的清醒但是在他最后一天，他说不了话。

Through his eyes, we knew when he needed to hear again,

通过他的眼睛，我们知道当他想听我们说话

"It is all set, Jim. We're going to take care of Shirley right here at the ranch, and ACR's going to take care of your wildlife forever."

“什么都很好，Jim。我们会好好照顾 Shirley。就在此时，在牧场ACR会永远帮你保护好这里的野生动植物。

From this experience I'm going to share five practices.

从这个经历中，我想和大家分享五个方案

I've put worksheets online, so if you'd like, you can plan your own end.

我已经把步骤公布在了网上所以如果你愿意，你可以计划你自己结束的方式

It starts with a plan.

这个步骤以着手计划开始

Most people say, "I'd like to die at home."

很多人会说”我愿意死在家里."

Eighty percent of Americans die in a hospital or a nursing home.

但是百分之八十的美国人，在医院里死去或者是养老院

Saying we'd like to die at home is not a plan.

所以说想死在家里，并不是一个计划

A lot of people say, "If I get like that, just shoot me."

很多人又会说“如果我像那样，一枪打死我”

This is not a plan either; this is illegal.

这也不是，因为不合法

A plan involves answering straightforward questions about the end you want.

这个计划是能包含了回应的直接了当关于你想如何结束的问题

Where do you want to be when you're no longer independent?

如果你不能再独立，你希望自己在哪里？

What do you want in terms of medical intervention?

你希望医疗保护的干预么？

And who's going to make sure your plan is followed?

谁能让你的计划继续紧接着进行

You will need advocates.

你需要顾问

Having more than one increases your chance of getting the end you want.

拥有多个顾问增加了你获得想要的结果的可能性

Don't assume the natural choice is your spouse or child.

不要断然的说你的配偶和孩子是你最合适的选择 

You want someone who has the time and proximity to do this job well, and you want someone who can work with people under the pressure of an ever-changing situation.

你需要的是一个有时间和亲近感的人，如果你需要顺利的进行，你需要这样的人。那些可以与有压力的人一起工作的人，有着变化莫测的可能性。

Hospital readiness is critical.

医院随时准备就绪很重要

You are likely to be headed to the emergency room, and you want to get this right.

你可能随时被带入急救室而你也希望准确无误的做到这一点

Prepare a one-page summary of your medical history, medications and physician information.

所以，准备一页你的医疗病史药物治疗，和医生信息

Put this in a really bright envelope with copies of your insurance cards, your power of attorney, and your do-not-resuscitate order.

把这些放在一个很明显的信封里并一同放入你的保险卡，和委托书与你不想要恢复的命令

Have advocates keep a set in their car.

把这些留一份给你的顾问

Tape a set to your refrigerator.

并把录像放入冰箱里

When you show up in the E.R. with this packet,your admission is streamlined in a material way.

当你出现在急诊室，带着这样的包裹你把许可用合法的文件合理化

You're going to need caregivers.

你将需要看护人

You'll need to assess your personality and financial situation to determine whether an elder care community or staying at home is your best choice.

你需要评估你的人格和财政状况去决定你是否需要养老社区或者呆在家里，是你最好的选择

In either case, do not settle.

不管哪种情况，都不要定下来

We went through a number of not-quite-right caregivers before we found the perfect team led by Marsha, who won't let you win at bingo just because you're dying but will go out and take videos of your ranch for you when you can't get out there, and Caitlin, who won't let you skip your morning exercises but knows when you need to hear that your wife is in good hands.

我们看到过一些不太称职的看护，在我们找到最好的团队之前，以Marcia领导的团队，我们不会因为你将死去就敷衍了事，我们会将你所拥有的录成视频，当你如果不能离开疗养院，而Caitlin不过让你省略每天的晨练，但是知道什么时候你想听到，你的妻子被照顾得很好

Finally, last words.

最后，遗言

What do you want to hear at the very end, and from whom would you like to hear it?

在生命的最后，你想听到什么，想听谁说这些？

In my experience, you'll want to hear that whatever you're worried about is going to be fine.

从我的经验来说，你想听到的是那些你担心的事情，都会好起来

When you believe it's okay to let go, you will.

当你真正的相信了，你就放下了，你会的

So, this is a topic that normally inspires fear and denial.

所以，这是一个关于鼓励恐惧与否定的话题

What I've learned is if we put some time into planning our end of life, we have the best chance of maintaining our quality of life.

我学到的是如果我们有计划的规划人生的最后我们会有最大的可能去维护我们生活的质量

Here are Jim and Shirley just after deciding who would take care of their ranch.

这是Jim和 Shirley，当他们决定了之后谁会照看他们的牧场

Here's Jim just a few weeks before he died, celebrating a birthday he didn't expect to see.

这是Jim死之前的几个星期意外的收获到了一个庆生会

And here's Shirley just a few days before she died being read an article in that day's paper about the significance of the wildlife refuge.

这是Shirley，她离去前的几天看到自己上了报纸-关于野生动植物避难所的重要性。

At the Modini ranch，Jim and Shirley had a good end of life, and by sharing their story with you,

在Modini牧场Jim 和 Shirley有了很好的结束，在这里分享着他们的故事

I hope to increase our chances of doing the same.

我希望能大家也能有同样美满的结点

Thank you.

谢谢

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