Death: The Topic No One Wants to Discuss

Life is a journey.

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.   

Thanks to Google Images

New Ways to Think About Grief

When grieving, we want to talk to someone who has walked in our shoes.

Someone you love dies, or develops a chronic illness, or becomes gravely ill.

The man or woman in your life betrays you with another lover.

You become unemployed and subsequently lose your home.

The emotional result of any of this is intense sorrow and grief.

None of us can control or manipulate grief, which can become an hour-to-hour and day-to-day experience.  Grieving is a living, evolving process that at times can surprise and frighten us in its power to hold us and take over our thought processes and actions.

Grieving is often long-term, but natural.  It is part of a healing process that if we understand it and accept it can gain our respect and even our trust.  It helps to trust that grief has a worthwhile purpose; that we need to go with it, let it take us into bitter territory.  Because there we will eventually experience change and come out on the other side where acceptance, a new calm and healing will replace our anxiety and pain. 

Have you ever noticed that counselors often have experienced deep sorrow, loss or pain?  Or have you ever needed someone when you were suddenly struck down by grief and the person you sought out had suffered a loss or hurt like yours?  Our human connection helps us survive, but the truth of walking in someone else’s shoes is deeply imbedded in our psyche.  We often don’t think we can get what we need from someone who has not walked where we are walking.

Nancy Berns, a professor of sociology at Drake University, talks about the common myth that when tragedy strikes we all go through stages of grief.  You know them: denial, anger, bargaining, depression and acceptance.  Elisabeth Kubler-Ross established these stages in her book ON DEATH AND DYING.  The wrong approach to grief is using the term STAGES.

Berns has talked to grieving people who worry when they are not angry—are not at that so-called stage.  Berns response comes from contemporary research: People’s experiences with grief do not go through orderly or predictable stages.  Nor is there a clear ending.  Our grieving lessens and changes over time, but we can experience waves of grief throughout life. 

Bottom line (and this should give those who are grieving some comfort) there is no standard to follow.  Grief is often unrelenting, mysterious, and certainly a process that cannot be labeled.  Berns speaks of a woman who still grieves for her dead son after three years.  The mother doesn’t search for closure—she doesn’t want to forget him.  Yet if she were to speak to a health provider about this, he or she might suggest that this mother has prolonged grief or exaggerated or chronic grief.  She might be labeled as having a disease that needs care.

Berns states: Popular applications of the universal road map (stages of grief) often describe closure as the destination.  When people travel a different route, park too long in one spot, or do not want to go in the direction others suggest, they are often defined as abnormal…the concern—people are not getting to the closure destination fast enough.

Berns’ healthy conclusion: each person has a right to his or her own way of living through loss.   There is no template for grief.

Q: So what can you say to comfort a person who is grieving?

A: Though terrible loss may or may not come your way, like the death of a spouse or a child—just living gives you some preparation.  Think of things you have lost—the loss of a pet, a job, and a child going off to college, a friend moving away.  That’s a loss and a change and it required of you and your emotions a period of adjustment.  There is not a definitive pathway that you followed to adjust—but you did.   Certainly greater loss will bring more intense pain and longer grief.  Your human experience will take your hand and guide you along the way.

A final thought: I recently heard a woman who had lost her father at a crucial time in her life proclaim that one should always hold on to the memory of that pain.  Hers made her who she is, changed her forever, but led her down a path where she became useful and capable in her own life.

Thanks for the ideas of R.H. Douglass MSW

Thanks to Michael Brooking Photography