TED2013
Judy MacDonald Johnston: Prepare for a good end of life
Džudi Makdonald Džonston (Judy MacDonald Johnston): Pripremite se za dobar kraj života
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Razmišljanje o smrti je zaštrašujuće ali planiranje unapred je praktično i ostavlja više prostora za duševni mir u našim poslednjim danima. U svečanom i pažljivom govoru, Džudi Makdonald Džonston deli pet praksi za planiranje dobrog kraja života.
Judy MacDonald Johnston - Entrepreneur
By day, Judy MacDonald Johnston develops children's reading programs. By night, she helps others maintain their quality of life as they near death. Full bio
By day, Judy MacDonald Johnston develops children's reading programs. By night, she helps others maintain their quality of life as they near death. Full bio
Double-click the English transcript below to play the video.
00:12
What would be a good end of life?
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Šta bi bio dobar kraj životu?
00:16
And I'm talking about the very end.
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Pričam o samom kraju.
00:18
I'm talking about dying.
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Pričam o smrti.
00:21
We all think a lot about how to live well.
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Svi mislimo o tome
kako je živeti lepo.
kako je živeti lepo.
00:25
I'd like to talk about increasing our chances of dying well.
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Volela bih da pričam
o povećavanju šansi za lepu smrt.
o povećavanju šansi za lepu smrt.
00:30
I'm not a geriatrician.
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Nisam gerijatričar.
00:32
I design reading programs for preschoolers.
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Smišljam programe za čitanje
za decu u zabavištu.
za decu u zabavištu.
00:34
What I know about this topic
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Ono što znam o ovoj temi
00:36
comes from a qualitative study with a sample size of two.
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dolazi iz kvalitativnog istraživanja
sa uzorkom od dvoje ljudi.
sa uzorkom od dvoje ljudi.
00:41
In the last few years, I helped two friends
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U proteklih nekoliko godina,
pomogla sam dvoma prijateljima
pomogla sam dvoma prijateljima
00:43
have the end of life they wanted.
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da imaju kraj života
kakav su želeli.
kakav su želeli.
00:46
Jim and Shirley Modini spent their 68 years of marriage
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Džim i Šerli Modini proveli su
68 godina svog braka
68 godina svog braka
00:49
living off the grid on their 1,700-acre ranch
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živeći samostalno
na imanju od 1700 jutara
na imanju od 1700 jutara
00:52
in the mountains of Sonoma County.
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u planinama okruga Sonoma.
00:54
They kept just enough livestock to make ends meet
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Držali su samo onoliko stoke
koliko je dovoljno za život
koliko je dovoljno za život
00:58
so that the majority of their ranch would remain a refuge
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tako da bi većina njihovog imanja
ostala utočište
ostala utočište
01:01
for the bears and lions and so many other things
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za medvede, lavove
i mnoga druga bića
i mnoga druga bića
01:03
that lived there.
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koja su tamo živela.
01:05
This was their dream.
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Ovo je bio njihov san.
01:07
I met Jim and Shirley in their 80s.
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Džima i Širli sam upoznala
u njihovim osamdesetima.
u njihovim osamdesetima.
01:10
They were both only children who chose not to have kids.
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Oboje su bili jedinci
i odabrali su da nemaju dece.
i odabrali su da nemaju dece.
01:14
As we became friends, I became their trustee
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Kako smo se sprijateljili,
postala sam njihov staratelj
postala sam njihov staratelj
01:16
and their medical advocate,
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i medicinski savetnik,
01:18
but more importantly, I became
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Ali što je još bitnije,
postala sam
postala sam
01:20
the person who managed their end-of-life experiences.
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osoba koja je upravljala
njihovim iskustvima sa krajem života.
njihovim iskustvima sa krajem života.
01:24
And we learned a few things about how to have a good end.
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I naučili smo nekoliko stvari
o tome kako imati dobar kraj.
o tome kako imati dobar kraj.
01:28
In their final years, Jim and Shirley
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U svojim poslednjim godinama,
Džim i Širli
Džim i Širli
01:30
faced cancers, fractures, infections, neurological illness.
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su se susretali s rakom, frakturama,
infekcijama, neurološkim bolestima.
infekcijama, neurološkim bolestima.
01:34
It's true.
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Istina je.
01:35
At the end, our bodily functions
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Pri kraju, naše telesne funkcije
01:37
and independence are declining to zero.
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i nezavisnost se smanjuju na nulu.
01:40
What we found is that, with a plan and the right people,
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Otkrili smo da se sa planom
i pravim ljudima,
i pravim ljudima,
01:43
quality of life can remain high.
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kvalitet života može održati visokim.
01:46
The beginning of the end is triggered
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Početak kraja je pokrenut
01:48
by a mortality awareness event, and during this time,
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događajem koji pokazuje smrtnost,
i za ovo vreme
i za ovo vreme
01:51
Jim and Shirley chose ACR nature preserves
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Džim i Širli su odabrali
ACR prirodne rezervate
ACR prirodne rezervate
01:55
to take their ranch over when they were gone.
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da preuzmu njihov ranč
posle njihove smrti.
posle njihove smrti.
01:57
This gave them the peace of mind to move forward.
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Ovo im je dalo duševni mir
potreban za korak dalje.
potreban za korak dalje.
02:01
It might be a diagnosis. It might be your intuition.
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To može biti dijagnoza.
Vaša intuicija.
Vaša intuicija.
02:05
But one day, you're going to say, "This thing is going to get me."
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Ali jednog dana ćete reći:
"Ovo će me dokusuriti."
"Ovo će me dokusuriti."
02:08
Jim and Shirley spent this time
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Džim i Širli su ovo vreme proveli
02:09
letting friends know that their end was near
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obaveštavajući prijatelje
da im se bliži kraj
da im se bliži kraj
02:11
and that they were okay with that.
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i da im to ne smeta.
02:16
Dying from cancer and dying from neurological illness
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Nije isto umreti od raka
02:19
are different.
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i od neurološke bolesti.
02:21
In both cases, last days are about quiet reassurance.
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U oba slučaja u poslednjim danima
se dešava tiha uteha.
se dešava tiha uteha.
02:25
Jim died first. He was conscious until the very end,
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Džim je prvi umro.
Bio je svestan do samog kraja,
Bio je svestan do samog kraja,
02:29
but on his last day he couldn't talk.
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ali poslednjeg dana
nije mogao da priča.
nije mogao da priča.
02:31
Through his eyes, we knew when he needed to hear again,
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Kroz njegove oči smo znali
kada mu je ponovo trebalo da čuje:
kada mu je ponovo trebalo da čuje:
02:33
"It is all set, Jim. We're going to take care of Shirley
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"Sve je sređeno Džime.
Mi ćemo se pobrinuti za Širli
Mi ćemo se pobrinuti za Širli
02:36
right here at the ranch,
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ovde na imanju,
02:37
and ACR's going to take care of your wildlife forever."
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i ACR će zauvek brinuti
o tvojim divljim životinjama."
o tvojim divljim životinjama."
02:41
From this experience I'm going to share five practices.
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Iz ovog iskustva
podeliću pet praksi.
podeliću pet praksi.
02:44
I've put worksheets online,
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Na internet sam stavila radne listove,
02:45
so if you'd like, you can plan your own end.
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tako da možete da isplanirate
svoj kraj ako želite.
svoj kraj ako želite.
02:48
It starts with a plan.
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Počinje sa planom.
02:51
Most people say, "I'd like to die at home."
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Većina ljudi kaže:
"Voleo bih da umrem kod kuće."
"Voleo bih da umrem kod kuće."
02:53
Eighty percent of Americans die in a hospital
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80% Amerikanaca umire u bolnicama
02:55
or a nursing home.
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ili domovima za stare.
02:57
Saying we'd like to die at home is not a plan.
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Reći da želimo da umremo kod kuće
nije plan.
nije plan.
03:01
A lot of people say, "If I get like that, just shoot me."
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Puno ljudi kaže:
"Ako ja budem takav, samo me upucajte."
"Ako ja budem takav, samo me upucajte."
03:04
This is not a plan either; this is illegal.
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Ni ovo nije plan, ovo je protivzakonito.
03:06
(Laughter)
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(Smeh)
03:10
A plan involves answering
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Kod plana se radi o odgovaranju
03:13
straightforward questions about the end you want.
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na jednostavna pitanja
o kraju koji želite.
o kraju koji želite.
03:16
Where do you want to be when you're no longer independent?
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Gde želite da budete
kad ne budete više samostalni?
kad ne budete više samostalni?
03:18
What do you want in terms of medical intervention?
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Šta želite od medicinske intervencije?
03:21
And who's going to make sure your plan is followed?
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Ko će se postarati
da se vaš plan izvrši?
da se vaš plan izvrši?
03:24
You will need advocates.
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Biće vam potrebni zastupnici.
03:25
Having more than one increases your chance
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Ako imate više od jednog
uvećava se šansa
uvećava se šansa
03:27
of getting the end you want.
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za kraj koji želite.
03:28
Don't assume the natural choice is your spouse or child.
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Nemojte pretpostaviti da su prirodan izbor
vaš bračni partner ili dete.
vaš bračni partner ili dete.
03:31
You want someone who has the time and proximity
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Želite nekoga ko ima vreme i blizinu
03:33
to do this job well, and you want someone
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da ovaj posao uradi dobro,
i želite nekog
i želite nekog
03:36
who can work with people under the pressure
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ko može sa ljudima
da radi pod pritiskom
da radi pod pritiskom
03:38
of an ever-changing situation.
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situacije koja se uvek menja.
03:41
Hospital readiness is critical.
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Pripravnost bolnice je ključna.
03:42
You are likely to be headed to the emergency room,
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Verovatno će vas odvesti
u sobu za hitne slučajeve,
u sobu za hitne slučajeve,
03:44
and you want to get this right.
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i želite da to uradite kako treba.
03:46
Prepare a one-page summary of your medical history,
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Pripremite jednostrani rezime
vaše istorije bolovanja,
vaše istorije bolovanja,
03:49
medications and physician information.
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informacije o lekovima i doktorima.
03:51
Put this in a really bright envelope
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Ovo stavite u kovertu jarke boje
03:53
with copies of your insurance cards, your power of attorney,
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sa kopijama kartica
za zdravstveno osiguranje, punomoćju,
za zdravstveno osiguranje, punomoćju,
03:56
and your do-not-resuscitate order.
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i naređenjem
za zabranu oživljavanja.
za zabranu oživljavanja.
03:59
Have advocates keep a set in their car.
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Neka vaši zastupnici drže primerak
u svojim automobilima.
u svojim automobilima.
04:00
Tape a set to your refrigerator.
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Prilepite jedan komplet
za vaš frižider.
za vaš frižider.
04:02
When you show up in the E.R. with this packet,
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Kada se na urgentnom
pojavite sa ovim paketom,
pojavite sa ovim paketom,
04:04
your admission is streamlined in a material way.
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prijava vam se poboljšava
na materijalan način.
na materijalan način.
04:08
You're going to need caregivers.
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Biće vam potrebni staratelji.
04:11
You'll need to assess your personality and financial situation
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Moraćete proceniti vašu ličnost
i finansijsku situaciju
i finansijsku situaciju
04:14
to determine whether an elder care community
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i odrediti da li je za vas
najbolje da budete
najbolje da budete
04:17
or staying at home is your best choice.
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u domu za stare
ili u sopstvenom domu.
ili u sopstvenom domu.
04:20
In either case, do not settle.
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Svakako se nemojte
samo pomiriti s tim.
samo pomiriti s tim.
04:22
We went through a number of not-quite-right caregivers
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Prošli smo kroz nekoliko
ne baš sjajnih staratelja
ne baš sjajnih staratelja
04:26
before we found the perfect team
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pre nego što smo našli savršeni tim
04:28
led by Marsha,
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na čelu s Maršom,
04:31
who won't let you win at bingo just because you're dying
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koja vas neće pustiti da pobedite
u bingu samo zato što umirete,
u bingu samo zato što umirete,
04:37
but will go out and take videos of your ranch for you
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nego će otići i snimiti
vaše imanje za vas,
vaše imanje za vas,
04:40
when you can't get out there,
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kada vi ne možete da odete tamo.
04:42
and Caitlin, who won't let you skip your morning exercises
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Tu je i Kejtlin koja vam neće dozvoliti
da preskočite jutarnje vežbe,
da preskočite jutarnje vežbe,
04:45
but knows when you need to hear
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ali zna kada vam je
potrebno da čujete
potrebno da čujete
04:47
that your wife is in good hands.
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da vam je supruga
u dobrim rukama.
u dobrim rukama.
04:50
Finally, last words.
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Na kraju, poslednje reči.
04:53
What do you want to hear at the very end,
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Šta želite da čujete na samom kraju,
04:54
and from whom would you like to hear it?
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i od koga želite to da čujete?
04:57
In my experience, you'll want to hear
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Iz mog iskustva, želećete da čujete
04:59
that whatever you're worried about is going to be fine.
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da će biti u redu šta god to bilo
o čemu brinete.
o čemu brinete.
05:03
When you believe it's okay to let go, you will.
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Kada verujete da je u redu
da se pustite, to ćete i uraditi.
da se pustite, to ćete i uraditi.
05:07
So, this is a topic that normally inspires fear and denial.
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Ovo je tema koja obično
pokreće strah i poricanje.
pokreće strah i poricanje.
05:13
What I've learned
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Naučila sam da
05:15
is if we put some time into planning our end of life,
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ako uložimo nešto vremena
u planiranje kraja našeg života,
u planiranje kraja našeg života,
05:18
we have the best chance of maintaining our quality of life.
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imamo najbolju šansu
da održimo kvalitet našeg života.
da održimo kvalitet našeg života.
05:21
Here are Jim and Shirley just after deciding
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Ovde su Džim i Širli
nakon odlučivanja o tome
nakon odlučivanja o tome
05:24
who would take care of their ranch.
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ko će brinuti o njihovom imanju.
05:26
Here's Jim just a few weeks before he died,
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Ovde je Džim
samo nekoliko nedelja pre smrti,
samo nekoliko nedelja pre smrti,
05:30
celebrating a birthday he didn't expect to see.
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slavi rođendan koji nije očekivao
da će dočekati.
da će dočekati.
05:33
And here's Shirley just a few days before she died
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A ovde je Širli
samo nekoliko dana pre smrti
samo nekoliko dana pre smrti
05:37
being read an article in that day's paper
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kako joj čitaju članak
u dnevnim novinama
u dnevnim novinama
05:39
about the significance of the wildlife refuge
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o značaju utočišta za divlje životinje
05:42
at the Modini ranch.
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na imanju Modini.
05:44
Jim and Shirley had a good end of life,
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Džim i Širli imali su dobar kraj života
05:47
and by sharing their story with you,
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i time što delim njihovu priču sa vama
05:49
I hope to increase our chances of doing the same.
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nadam se da ću povećati šanse
da se i vama desi isto.
da se i vama desi isto.
05:52
Thank you.
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Hvala vam.
05:53
(Applause)
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(Aplauz)
ABOUT THE SPEAKER
Judy MacDonald Johnston - EntrepreneurBy day, Judy MacDonald Johnston develops children's reading programs. By night, she helps others maintain their quality of life as they near death.
Why you should listen
Judy MacDonald Johnston is the Publisher and Cofounder of Blue Lake Children's Publishing, which develops educational reading tools for preschoolers through a program called the Tessy and Tab Reading Club. Johnston's credo, "love words early," and her focus on the earliest years of life, is an interesting foil for her other passion: Planning for end of life. Johnston's side project, Good [End of] Life, deals not with happy babies decoding symbols, but with a much more morbid topic: Death. Good [End of] Life is a set of online worksheets and practices that aim to help deal with difficult questions -- like who should speak for you if you cannot speak, and whether to fill out a do-not-resuscitate form -- before it's too late.
In the past 15 years alone Johnston has founded two other companies in addition to Blue Lake Children's Publishing: PrintPaks, a children's software company, and Kibu, a social networking site for teenage girls. Previously Johnston was a Worldwide Project Marketing Manager at Hewlett Packard.
Judy MacDonald Johnston | Speaker | TED.com