TED2013
Judy MacDonald Johnston: Prepare for a good end of life
Judy MacDonald Johnston: Priprema za dobar kraj života
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Razmišljanje o smrti je zastrašujuće, no planiranje unaprijed je praktično i ostavlja više mjesta za duševni mir u našim posljednjim danima. U ozbiljnom, promišljenom govoru, Judy MacDonald Johnston dijeli 5 postupaka 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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Kako bi izgledao dobar kraj života?
00:16
And I'm talking about the very end.
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Govorim o samome kraju.
00:18
I'm talking about dying.
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Govorim o smrti.
00:21
We all think a lot about how to live well.
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Svi mi mnogo razmišljamo o tome kako dobro živjeti.
00:25
I'd like to talk about increasing our chances of dying well.
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Želim govoriti o tome kako povećati šanse da dobro umremo.
00:30
I'm not a geriatrician.
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Nisam gerijatar.
00:32
I design reading programs for preschoolers.
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Dizajniram programe za čitanje za predškolsku djecu.
00:34
What I know about this topic
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Sve što znam o ovoj temi
00:36
comes from a qualitative study with a sample size of two.
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dolazi iz kvalitetne studije s uzorkom od dvije osobe.
00:41
In the last few years, I helped two friends
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U zadnjih nekoliko godina, pomogla sam dvama prijateljima
00:43
have the end of life they wanted.
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da imaju kraj života kakav su željeli.
00:46
Jim and Shirley Modini spent their 68 years of marriage
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Jim i Shirley Modini proveli su 68 godina u braku
00:49
living off the grid on their 1,700-acre ranch
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živeći povučeno na njihovom posjedu od 1700 hektara
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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Uzgajali su tek toliko stoke da spoje kraj s krajem
00:58
so that the majority of their ranch would remain a refuge
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tako da je većina njihovog posjeda ostala utočištem
01:01
for the bears and lions and so many other things
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za medvjede i lavove i mnoge druge životinje
01:03
that lived there.
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koje su ondje živjele.
01:05
This was their dream.
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To je bio njihov san.
01:07
I met Jim and Shirley in their 80s.
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Upoznala sam Jima i Shirley u njihovim osamdesetima.
01:10
They were both only children who chose not to have kids.
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Oboje su bili jedinci koji su odlučili da ne žele imati djecu.
01:14
As we became friends, I became their trustee
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Kako smo postali prijatelji, ja sam postala njihov staratelj
01:16
and their medical advocate,
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i medicinski zaštitnik,
01:18
but more importantly, I became
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ali što je puno važnije, postala sam
01:20
the person who managed their end-of-life experiences.
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osoba koja je pomogla u njihovim zadnjim životnim iskustvima.
01:24
And we learned a few things about how to have a good end.
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Naučili smo nekoliko stvari o tome kako doživjeti dobar kraj.
01:28
In their final years, Jim and Shirley
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U njihovim posljednjim godinama, Jim i Shirley
01:30
faced cancers, fractures, infections, neurological illness.
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suočili su se s karcinomima, prijelomima, infekcijama, neurološkom bolešću.
01:34
It's true.
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Istina je.
01:35
At the end, our bodily functions
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Na kraju, naše tjelesne funkcije
01:37
and independence are declining to zero.
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i samostalnost sve se više približavaju ništici.
01:40
What we found is that, with a plan and the right people,
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Otkrili smo da, uz dobar plan i prave ljude,
01:43
quality of life can remain high.
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kvaliteta života može ostati visoka.
01:46
The beginning of the end is triggered
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Početak kraja potaknut je događajem
01:48
by a mortality awareness event, and during this time,
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koji potiče svijest o smrtnosti, i tijekom tog vremena,
01:51
Jim and Shirley chose ACR nature preserves
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Jim i Shirley odlučili su da ACR prirodni rezervat
01:55
to take their ranch over when they were gone.
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preuzme njihov posjed kada ih više ne bude.
01:57
This gave them the peace of mind to move forward.
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Ovo im je dalo duševni mir da nastave dalje.
02:01
It might be a diagnosis. It might be your intuition.
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To može biti dijagnoza. Može biti 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, reći ćete: „Ovo će me dokrajčiti“.
02:08
Jim and Shirley spent this time
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Jim i Shirely proveli su to vrijeme
02:09
letting friends know that their end was near
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obznanjujući prijateljima da je kraj blizu
02:11
and that they were okay with that.
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i da su oni pomireni s tim.
02:16
Dying from cancer and dying from neurological illness
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Smrt od karcinoma i smrt od neurološke bolesti
02:19
are different.
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se razlikuju.
02:21
In both cases, last days are about quiet reassurance.
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No u oba slučaja, zadnji su dani provedeni u tihom mirovanju.
02:25
Jim died first. He was conscious until the very end,
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Jim je umro prvi. Bio je svjestan do samoga kraja,
02:29
but on his last day he couldn't talk.
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ali nije mogao govoriti na svoj zadnji dan.
02:31
Through his eyes, we knew when he needed to hear again,
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U njegovim očima, vidjeli smo da je opet trebao čuti:
02:33
"It is all set, Jim. We're going to take care of Shirley
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„Sve je spremno, Jim. Pobrinut ćemo se za Shirley
02:36
right here at the ranch,
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ovdje na posjedu,
02:37
and ACR's going to take care of your wildlife forever."
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i ACR će se zauvijek brinuti za vaše životinje.“
02:41
From this experience I'm going to share five practices.
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Podijelit ću s vama 5 postupaka koje sam naučila iz ovog iskustva.
02:44
I've put worksheets online,
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Postavila sam smjernice online,
02:45
so if you'd like, you can plan your own end.
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pa ako želite, možete isplanirati svoj vlastiti kraj.
02:48
It starts with a plan.
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Počinje s planom.
02:51
Most people say, "I'd like to die at home."
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Većina ljudi kaže: „Volio bih umrijeti kod kuće“.
02:53
Eighty percent of Americans die in a hospital
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Osamdeset posto Amerikanaca umire u bolnici
02:55
or a nursing home.
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ili u staračkom domu.
02:57
Saying we'd like to die at home is not a plan.
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Reći da bismo voljeli umrijeti kod kuće nije plan.
03:01
A lot of people say, "If I get like that, just shoot me."
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Mnogi ljudi kažu: „Ako završim tako, upucaj me“.
03:04
This is not a plan either; this is illegal.
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Ni to nije plan, to je ilegalno.
03:06
(Laughter)
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(Smijeh)
03:10
A plan involves answering
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Plan uključuje odgovaranje
03:13
straightforward questions about the end you want.
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na izravna pitanja o tome kakav kraj želite.
03:16
Where do you want to be when you're no longer independent?
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Gdje želite biti kada više niste samostalni?
03:18
What do you want in terms of medical intervention?
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Što želite u pogledu medicinske intervencije?
03:21
And who's going to make sure your plan is followed?
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Tko će se brinuti za to da se vaš plan slijedi?
03:24
You will need advocates.
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Trebat ćete zagovornike.
03:25
Having more than one increases your chance
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Imati više od jednog povećava šanse
03:27
of getting the end you want.
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da imate kraj kakav vi želite.
03:28
Don't assume the natural choice is your spouse or child.
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Nemojte pretpostaviti da je prirodan izbor vaš partner ili dijete.
03:31
You want someone who has the time and proximity
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Želite nekoga tko ima vrijeme i blizinu
03:33
to do this job well, and you want someone
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da taj posao obavi dobro, i želite nekoga
03:36
who can work with people under the pressure
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tko može raditi s ljudima pod pritiskom
03:38
of an ever-changing situation.
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situacije koja se neprestano mijenja.
03:41
Hospital readiness is critical.
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Ključna je pripremljenost za bolnicu.
03:42
You are likely to be headed to the emergency room,
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Vrlo je vjerojatno da ćete dospjeti u sobu za hitne slučajeve,
03:44
and you want to get this right.
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i želite to obaviti kako treba.
03:46
Prepare a one-page summary of your medical history,
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Pripremite sažetak vaše medicinske povijesti na jednoj stranici,
03:49
medications and physician information.
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lijekove i zdravstvene informacije.
03:51
Put this in a really bright envelope
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Pospremite to u jarku omotnicu
03:53
with copies of your insurance cards, your power of attorney,
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zajedno s kopijama vaše kartice osiguranja, opunomoćenja,
03:56
and your do-not-resuscitate order.
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i odlukom za ne-oživljavanje.
03:59
Have advocates keep a set in their car.
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Neka vaši zagovornici drže jedan set u njihovom autu.
04:00
Tape a set to your refrigerator.
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Zalijepite jedan set na hladnjak.
04:02
When you show up in the E.R. with this packet,
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Kada se pojavite u sobi za hitne slučajeve s tim paketom,
04:04
your admission is streamlined in a material way.
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materijalno ste osigurani.
04:08
You're going to need caregivers.
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Trebat ćete skrbnike.
04:11
You'll need to assess your personality and financial situation
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Morat ćete procijeniti vašu duševnu i financijsku situaciju
04:14
to determine whether an elder care community
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kako biste odredili je li starački dom
04:17
or staying at home is your best choice.
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ili ostanak kod kuće vaša najbolja opcija.
04:20
In either case, do not settle.
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U svakom slučaju, nemojte praviti kompromise.
04:22
We went through a number of not-quite-right caregivers
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Mi smo prošli kroz priličan broj nedovoljno dobrih skrbnika
04:26
before we found the perfect team
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prije nego što smo pronašli savršeni tim
04:28
led by Marsha,
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kojeg je vodila Marsha,
04:31
who won't let you win at bingo just because you're dying
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koja vam ne bi dala da pobijedite u bingu samo zato što umirete,
04:37
but will go out and take videos of your ranch for you
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ali će izaći van i snimiti video vašeg posjeda
04:40
when you can't get out there,
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kada ne možete sami izaći.
04:42
and Caitlin, who won't let you skip your morning exercises
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I Catilin, koja vam neće dozvoliti da preskočite jutarnju tjelovježbu,
04:45
but knows when you need to hear
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ali zna kada trebate čuti
04:47
that your wife is in good hands.
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da vam je žena u dobrim rukama.
04:50
Finally, last words.
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Konačno, posljednje riječi.
04:53
What do you want to hear at the very end,
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Što želite čuti na samome kraju
04:54
and from whom would you like to hear it?
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i od koga to želite čuti?
04:57
In my experience, you'll want to hear
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Iz moga iskustva, željet ćete čuti
04:59
that whatever you're worried about is going to be fine.
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da će s onim što vas brine biti sve u redu.
05:03
When you believe it's okay to let go, you will.
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Kada vjerujete da je sve u redu, prepustit ćete se.
05:07
So, this is a topic that normally inspires fear and denial.
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Ovo je tema koja inače potiče strah i poricanje.
05:13
What I've learned
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Naučila sam
05:15
is if we put some time into planning our end of life,
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da ako uložimo vrijeme u planiranje kraja života,
05:18
we have the best chance of maintaining our quality of life.
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imamo dobru šansu da održimo kvalitetu života.
05:21
Here are Jim and Shirley just after deciding
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Ovo su Jim i Shirley nakon što su odlučili
05:24
who would take care of their ranch.
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tko će se brinuti za njihov posjed.
05:26
Here's Jim just a few weeks before he died,
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Ovo je Jim samo nekoliko tjedana prije nego što je preminuo,
05:30
celebrating a birthday he didn't expect to see.
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slaveći rođendan za koji nije mislio da će ga dočekati.
05:33
And here's Shirley just a few days before she died
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A ovo je Shirley samo nekoliko dana prije smrti
05:37
being read an article in that day's paper
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kako sluša članak iz dnevnih novina
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 posjedu Modini.
05:44
Jim and Shirley had a good end of life,
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Jim i Shirley imali su dobar kraj života,
05:47
and by sharing their story with you,
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i dijeljenjem njihove priče s vama,
05:49
I hope to increase our chances of doing the same.
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nadam se da ću povećati naše šanse da doživimo to isto.
05:52
Thank you.
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Hvala vam.
05:53
(Applause)
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(Pljesak)
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