On Dying Well

As my parents moved into their “golden years” and closer to that ultimate life passage we call death, my mother often said that if she and my father lost their wits and assumed a vegetable like state they would drive off a cliff. It was a bit of a joke but also the only clear expression of their end-of-life wishes. It also had a stunning flaw; it neglected to identify who would do the driving.

Few of us have any better a plan for our final days. So many of us struggle just to meet the basic demands of daily living. Who wants to think about dying anyway? And how many of us are eager to set aside large chunks of our income, as we are constantly advised, to pay for an insurance policy that will put us in a skilled nursing facility? Visions of echoing halls, green walls, moaning voices, and sad hollow faces come quickly to mind.

Most of us hope that we will die quickly, preferably in our sleep, with little suffering and completely unaware. Yet statistics show that nearly 50% of US citizens die in hospitals and another 25% die in nursing facilities. The odds do not look good. It is prudent to make plans.

How do you get the end-of-life that you prefer? The first step is to do some serious thinking about what you want. What would be your ideal way to go? What would be the worst way? Certainly you are more likely to get what you want if you know what that is. Envisioning can be a powerful force. Marion, a friend of mine at Sufi camp, shared the story of her devote Irish Catholic mother who prayed every day for a “good death.” To her a “good death” meant dying at home in her sleep, quickly and without pain. In the end, she got what she prayed for — she died peacefully in her sleep. This story made a big impression on me. It made me wonder about how much control we really have over our deaths.

My maternal grandmother provides another interesting example. She was in her late eighties and still living in her own home when she had a heart attack. She had not been taking her heart medicine. This was somewhat understandable considering she had fifteen pills to take per day and swallowing was no longer easy for her. In the hospital shortly after the heart episode, my mother informed my grandmother that she could no longer live alone and would have to move in with my mother. The relationship between them had always been a bit fraught especially with my mother’s tendency to hysteria when my grandmother got under her skin. Which, you might imagine, was a frequent occurrence. My grandmother died that night. The doctor was shocked. He had no idea she was at risk for dying. The family was less surprised. One interpretation of my grandmother’s rapid departure was that she did not wish to be a burden to my mother, her only child, who was still recuperating from a brain tumor operation. The other interpretation, the one favored by the grandchildren, was that my grandmother had no intention of giving up her freedom and living with my mother. She took the only way out. I imagine there’s a bit of truth in both.

Do we really have control over the manner or timing of our deaths? I have heard plenty of stories of loved ones who have managed to delay their deaths in order to make it to a wedding or past another Thanksgiving, or for a cherished son to arrive from over seas or for a wife to receive one more social security check. Other people seem have the knack for timing their departure in that brief interlude between visits or when family members leave the room for a bathroom break and a cup of coffee. I don’t believe they are trying to be mean or leave their families feeling guilty but simply need to die alone.

A second step in dying well is to finish up business with significant others.

Sara’s grandparents did not want to be a burden to their children in their final years, so they put their money into an eldercare facility that promised to attend to their needs at whatever level so long as they lived. Their plan did not involve their children. The location of the facility was far off the beaten track and difficult to reach. Their children were not expected to visit. Unfortunately, upon moving into the facility, the couple soon discovered that it was not to their liking, by then, of course, it was too late. The money was gone. Furthermore, the promised care turned out to be less than exemplary. As their mental faculties declined so did staff attention. Evidently no one warned them that the best care goes to those with concerned families that make frequent visits. No one warned them that beside the practical matters of physical care are the matters of the heart. Closing doors is not the same things as having closure. If something needs to be finished, the soul or divine intervention have a way of pushing it in our face until it is addressed. Clearly, in this case some family dynamics was begging for attention. The grandchildren have stepped in.

Sometimes completion is not only up to the person dying.

When I heard that my mother had gone into coma I struggled with the choice of going home to see her one last time or staying to record a TV show I was producing which was scheduled for the following weekend. In retrospect the choice seems a no-brainer, but at the time I had little experience with death and had just been home to visit my mother two weeks before. The TV show was a new project, lots of people were involved, I had a well-paying temp job too, etc, etc. My sister said, “Don’t come back, remember her how she was.” It sounded reasonable and it fit well with what I wanted to do. It was not the right choice. During that last week I kept thinking I would go back if she was still alive after the taping of the show. Each day my mother continued to live. Then I heard from my sister that the nurse was wondering why my mother was still alive when she wasn’t eating or drinking anything. In a flash of insight, I realized it was me that was holding her back. It was my indecision, my ambivalence about seeing her. I cried — for her, for my selfishness, for a daughter losing her mom and then I let her go. She died later that night.

I make a point now of telling everyone in a similar situation to go back and be with family when death is a possibility. People need the encouragement because it is hard to break with routine. It’s hard to face death. And it is much better if you do. The show I insisted on stay for, by the way, did not work out as planned. Although the live performance by the Indian band was fabulous, the recorded version was completely off. Only the chinking sound of a tambourine can be heard, like the scolding of a bird or the rattle of the dead.

A third step in dying well is to be complete with yourself, to accept and let go. In the ten days of my last visit with my mom, she spent the time finishing up business — sending out letters, completing a family history photo album, and saying good-bye to friends and business associates. At the time, I didn’t understand her actions. I wanted her to talk to me about her thoughts of dying, of spiritual things. I didn’t realize that she was showing me how to die. In one rather poignant moment as we were going through some of her toy design artwork and deciding what to keep, she said in a plaintive voice that still brings tear to my eyes when I remember it, “I guess I’ll never get to that project.” It was her way of letting go. I wish I had had the presence of mind to ask her more. Instead, aware of her pain, I pushed the moment away saying, “I guess we don’t need to do this now.” If not now, when?

Dying well means taking care of all aspects of our earthly stay — the practical, emotional and spiritual. We need to make sure that our bodies will be warm, comfortable and clean when we are no longer able to care for them and that we will receive no heroic life-sustaining treatment when we prefer to die. Also, we need to made peace with our significant others and obtain forgiveness from those we have intentionally or inadvertently hurt. We also need to forgive ourselves for things left undone and dreams not accomplished. Finally, we need to let go. When we have addressed all these, perhaps then we are free to have the kind of death we desire.

WANT TO USE THIS ARTICLE IN YOUR EZINE OR WEB SITE? You can, as long as you include this complete blurb with it: Grief Transformation Coach Michelle Peticolas, Ph.D. helps people transform their grief with a holistic approach to mind, body and spirit that heals trauma, reframes past attachments and releases limiting beliefs while uncovering a true life purpose and direction. If you’re ready to shift into a whole new way of being with death and loss, a new way of living your life, get Michelle’s complimentary guide, Essentials for Grieving Well at www.secretsoflifeanddeath.com