Death. If you created a party game where you had to quick! give a negative word, death might be the first one uttered. We fear death, avoid death, make jokes about it to ease our pain. But every one of us is mortal and so truly death is part of us—it is the end each of us will and must face.
And life. It’s a journey, a phrase expressed by spiritual writers, a concept and image befitting the mysterious bends and turns in life that none of us can foresee.
But is ignorance bliss when it comes to our death and individual mortality? No.
Ask yourself, where would you want to die?
90% will answer, at home.
Consider. Where do most people die? 80% in nursing homes and hospitals.
Why the severe disconnect? Monica Williams-Murphy, an ER physician, writes that we as a culture have created it because of what we believe about death.
- Death is a medical event;
- Medical technology can delay or cure death;
- Talk of death does not belong in social circles; thus practical decisions related to it, like advance directives, funeral plans, or living wills are rarely addressed;
- We have lost deep intimacy in our relationships, resulting in a scramble to keep the dying one with us so that we can clean up the mess we have made before they die.
Just this week death has been more present in my life. A young man in our community died suddenly; a close friend who I love dearly is dying in hospice; and a friend has more than once questioned my decisions concerning the care of my 96-year-old mother who is in late stages of dementia. You might say I am fulfilling one of Williams-Murphy’s cures for the 80/90 disconnect:
- Take a natural view of death. Understand that death is a natural event that can usually be comfortably and peacefully managed at home or in a pleasant hospice setting.
Williams-Murphy writes USUALLY—the accidental death of the young man in our community was a shock. But we all know this happens and we all know someone this sadness has happened to: my father died at 45 of a heart attack leaving 3 little kids; daily, accidental deaths or incidents of war leave families bereft.
- Know that the appropriate use of medical technology at the end of life is the aggressive treatment of pain or any uncomfortable symptoms. Not: ventilators, ICU admissions, and CPR. We must effectively move from “high tech” to “high touch” medicine at the end of life. Comfort and communication from friends and family should be the focus.
Williams-Murphy states that the above can only be accomplished if we are able to talk about death and dying in our social situations and acknowledge that death is fundamentally part of each of our lives. If we openly talk about death, we ease the decision-making burden of families because they will know what we need and want when our time comes.
My loving friend in hospice lives this. Lives it right now, surrounded by her sons, her husband and family, her friends. Surrounded by love. And my mother has come to know it, also surrounded by caring people who understand that dementia is a progressive disease, that patients need to be watched and monitored so they will not hurt themselves or wander away. I chose safety and consistency for my mother; I had to admit that she has a mental illness.
Finally Williams-Murphy writes:
- We must discover the power and gifts inherent in the end-of-life period when the sure knowledge of coming death creates an emotional window of opportunity—love may be freely expressed, old grudges fall away in insignificance, and closure obtained that remained elusive at other times of life. We must focus on creating quality of time at the end of life so that these gifts may be enjoyed.
I don’t wish death into your lives. I do provide here a link to find Advance Directive forms for the state you live in and beg you to have this discussion with those you love. http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3289
You don’t need a malignant diagnosis to begin the process. Take a healthy walk and talk—it’s an integral part of the journey of life.
Thanks to Dr. Monica Williams-Murphy and her blog post Create Peace and Dignity at the End of Life.