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About Death and Taxes


Today is National Healthcare Decisions Day (NHDD) a day devoted to recognizing the importance of expressing your choices about your health care through advance directives, by creating a living will and designating a medical power of attorney. Our latest Prepared Patient article Advance Directives: Caring for You & Your Family also shares the story of Heather Rubesch's experience of being called upon to make decisions for her mother, Linda, when Linda was critically ill. Both the NHDD website and our article offer resources to help you consider your options, define your wishes and share them with your loved ones and health care providers. And Health Dialog, a disease management company, also is offering access to conversations with patients and families discussing their decisions in a video, Looking Ahead: Choices for Medical Care When You're Seriously Ill.

What a challenge it is for us to make these plans, to have these talks' to think about and then to put in writing your ideas about some of the most difficult health care decisions that you 'well, really your family and physicians, may ever need to make on your behalf. How hard it is to actively plan for the end of life hoping that that day is far, far, away---or that somehow no decisions or choices may be needed.

Years ago, I came across and spent several absorbing days reading one of the most profound and disquieting books I have ever read, The Denial of Death by Ernest Becker.  It was disquieting but oddly comforting too. Reading it made me see that I am part of a long line of humans who have struggled with our knowledge of mortality and that we often act in strange but understandable ways to avoid thinking about death.

Yet, thinking about death and making plans for the health care you want to receive when you may not be able to express your wishes can also be liberating. I felt a sense of accomplishment and relief when I created my advance directives with my husband that was a little similar to my feeling yesterday when after weeks of'  gathering receipts and W-2's, filling in the forms and then dropping our tax returns in the mailbox. Both are unwelcome but necessary adult rites of passage.  In many ways, making plans for the end of our lives is just one more thing to check off an annual to do list.  By doing so, we ease the pain and confusion our loved ones may experience if they find themselves needing to make difficult decisions about our care. We have a chance now to consider what we want and advise them of our wishes. This may be the biggest and most timely refund they could ever receive.

More Blog Posts by Dorothy Jeffress

author bio

Dorothy Jeffress, MBA, MSW, MA, ([email protected]) executive director, joined CFAH in March 2008. Prior positions include vice president, Center for Information Therapy, 2005-2008, where she assisted with the IxAction Alliance membership program, the annual Ix Conference and finance/administration for the IxCenter; and as the assistant vice president of Value Based Purchasing for the National Business Coalition on Health (NBCH) from 2003 to 2005, where she directed the eValue8 Request for Information (RFI) program. She also worked with NCQA from 1999 to 2002 where she was the director of constituent relations and a senior health care analyst in HEDIS performance measure development. She has also worked for the Massachusetts Department of Public Health as the director of a CDC/state-funded women's health promotion and chronic disease prevention program. She has managed a TPA for self-funded employee benefit programs and also been a benefit manager for a mid-sized employer. Dorothy has an MBA from Clemson University and an MSW in clinical social work and an MA in theology from Boston College.

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End-of-Life Planning   Plan for your End of Life Care   Aging Well   Dorothy Jeffress  

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