The Nutshell: A Story of the Gifts from Advance Directives

The Nutshell: A Story of the Gifts from Advance Directives
| by Nancy Ruffner

This is the story of a family tradition that quite literally became “the gift that keeps on giving”. This is how my family handled important communication, especially wishes contained in advance directives. I write this now in observance of NHDD, National Healthcare Decision Day. This is the Nutshell Story.

The Nutshell concept was the brainchild of my mother who was one heckuva planner. Call her well-organized, or chalk it up to the financial prowess of a retired Comptroller, this lady had been financially savvy and organized all her life. Over the years she compiled information she thought would be helpful to our family unit, a sort of ready reference for use when the need arrived.

The Nutshell itself was a jumbo three-ring binder that held copies of my parents’ important legal and financial documents and information that could someday be needed by us daughters. This humble notebook was designed to serve as a guide to the information and paperwork that might be of use in important decision-making.

The name Nutshell, if you’ve not yet guessed, came from the phrase “That’s everything in a nutshell.” The book was simple, the title was whimsical, and the contents would live forever.

The Nutshell itself was a jumbo three-ring binder that held copies of my parents’ important legal and financial documents and information that could someday be needed by us daughters.

I shall never forget the night that we daughters were presented with The Nutshell. It was one of the most impactful events of my life. You can find that story elsewhere among my written and oral “traditions” but I will share a bit of it here with you now.

As daughters my sister and I had been designated as “agents” by our parents by way of Financial and Healthcare Power of Attorney documents. Although most of what was inside The Nutshell were copies, the true location of anything we may need could be located in the Nutshell “Directory”.

Yes, Directory. My mom was quite the organizer. She was a downsizer and organizer before it became “a thing” for aging folks to do, before the advance of a new industry for this function, and before the onslaught of well-meaning articles that suggest we Adult Children should be doing the same.

The Nutshell also held the contact information our parents’ medical providers, an elder law attorney, their financial advisor, and insurance agent.

The information was all there all right, my sister and I murmured as we flipped through the pages the first night we were introduced to this book. I remember reading the instructions to “request extra copies of the Death Certificates no matter how much the cost”. Not yet understanding how they’d be used I thought it odd that extra copies of something would be needed for a one-time event. It seemed counterintuitive.

The Nutshell also held the contact information our parents’ medical providers, an elder law attorney, their financial advisor, and insurance agent. Also inside would be important household information such as contractors or preferred vendors used. For instance, there was a copy of the service agreement with an HVAC company; this was important since their condo was equipped with special filters to assist with my mother’s chronic COPD. We could see who the Homeowners Association contacts were for their condo, and the contact information for their closest or most relied-upon neighbors.

Because in our family we use humor to diffuse tension my sister and I poked great fun at the whole Nutshell idea. Wehowled as we saw the neon-colored page just inside the Nutshell, reading aloud the title “When I Die”. We deemed it morbid and made fun at that “Green Page” and its very presence. But I have to say that when it came to pass (oh, what an apt phrase) when my mother passed, it was The Nutshell to which we made a beeline. We handily found the information we needed. (Guess what? It was on the When I Die page). We made sure that things were done correctly and that nothing or no one was left out.

The Gifts of the Nutshell

As the saying goes “we see it all now”.

Along with our parents’ thinking and decisions about what they wanted,

Along with creating a way to write it all down and compile all the important information,

Along with having legal documents created, and

Along with a conversation and sharing with us the Nutshell-

we daughters had (and have) more gifts than we could hold. We simply did not recognize them at first.

The simple Nutshell was a GIFT, and it in turn contained and rendered many more gifts. I capitalize the word Gift to pay small homage to what unfolded.

Gifts One and Two were gifts from each parent to themselves, and to each other. They had to think about and make decisions about how they wanted things to go, to roll out, what they wanted and what they would have us do on their behalf.

In keeping with one of my favorite phrases, “We can all have a say about how things will go and where we’ll end up”, our parents created The Nutshell.

Gift Three was that they gave it. And they knew they bestowed The Nutshell, and found pleasure in that. Gift Four. Read on.

Gift Five was that my sister and I received it. Oh, sure, we were nervous about the idea that someday our parents were aging and would someday pass, and we were not entirely comfortable talking about such a sensitive time. Yes, we made light of it as was our way, but somehow the information was conveyed and ultimately and solemnly accepted. It resided in our hearts and minds until it was time to put The Nutshell Gifts into play.

The Next Few Gifts were realized during each of our parent’s slowing and decline. We relied on that Nutshell and our parents knew we were referencing it. They helped and witnessed us updating The Nutshell, checking to ensure that those wishes were recorded even if those wishes were changing a bit. (Being on the same page can be a Gift, too. As a Patient Advocate who sees families in turmoil and miscommunication I know the value of “same page”). My sister and I made sure that we would be able to take the action that would be required of us as daughters and as agents. We shared in the receipt of that Gift and we knew how to follow through in caregiving actions with the priorities our parents had laid out.

With all these Gifts bestow-ing, counting them would be no longer possible nor warranted (because some were yet to be realized), nor was it important to. The impact, not the number, would be important.

The next Gift came, I believe, when each of our parents was able to pass in peace from this world. They knew we daughters were doing what they had wanted, and I firmly believe that the Gift of knowing that, seeing that, gave them (their Gift of) peace in return.

Along with witnessing their Gift came our biggest Gift of all: honor. As daughters and as agents we knew what to do and we did it. Not always perfectly, but certainly to the best of our ability. We’d been made more comfortable in our actions. We were even united, at least as much as two daughters could be who were very different in personality and in caregiving approach.

The last Gift? It’s an Ultimate Gift, and it remains here with us now. My sister and I have both peace and honor from knowing that we did what our loved ones had wanted. We’d carried out their wishes.

And we get to carry the Ultimate Gift forward, today and always. It is with that Gift that we both vow to create our own Gifts for the loved ones in our lives and because we, too, can“have a say in how things will go and where we’ll end up.”

Nancy Ruffner

Have you thought about what you want relative to advance directives? Have you documented it and told your loved ones? We help our clients to “have a say in how things will go and where they’ll end up.” Contact us to schedule a complimentary consultation toward services, 919.628.4428 or CONNECT WITH USat www.navigatenc.com.