“This site is intended as a resource for those facing death—their own or that of a loved one. Please do take a tour of the site and add comments where you have something to add. Let’s talk about it . . . ”

Spiritual needs in the face of death

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Feb 212012
 

Skyscape of cumulous cloudsWhat do people with advanced cancer, congestive heart failure and end stage renal disease have in common? According to researchers, they all testify to the importance of emotional and spiritual issues when facing the end of life: not surprising for many of us.

What is interesting is that people said this kind of thing whether they had a particular religious worldview or not. No matter the patient’s gender, ethnicity, socioeconomic status, education, marital status, mood, diagnosis or self-reported health, they tended to acknowledge the importance of specifically spiritual issues when facing death. Which begs at least one question: “Exactly what, if it crosses so many assumed religious and life experience lines, is spirituality?”

What is spirituality?

It is my observation and conviction that spirituality—however enacted or described—has to do with meaning, even ultimate meaning: the meaning of our own individual experiences and the meaning of the larger whole. The search for meaning, the discovery of meaning and the making of meaning are all spiritual pursuits. These pursuits may be described in religious, philosophical or other terms, but at root, they are spiritual.

A good death

Attending to spiritual concerns, settling issues of faith and purpose and meaning, contribute to what many people mean when they think of a “good death.” Dignity, freedom from pain, supported by others—all of these are ingredients of a good death, but addressing issues of meaning has the potential of enriching the experience for everyone, if there is the luxury of time to explore the spiritual.

In the next few posts, I propose to explore matters relating to spirituality at the end of life, with content appropriate for the dying person, care professionals and loved ones. Please return for these posts and add comments to facilitate a conversation around this important issue.

 Death and spirituality, Preparing for death, Talk about death

A Complicated Grief

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Feb 142012
 

Image of gnarled tree rootsI had a clergy friend who was once contacted by a funeral home to do a funeral for a man he had never met. He agreed and proceeded to contact the widow and to arrange a funeral-planning session with her and any other close family.

As was his custom (mine, too, when planning a funeral), he settled a few matters about the funeral and then asked the family to tell him about their husband and father. There was rather a lot of hemming and hawing and some awkward silences, so he prompted with questions: Any favourite memories? Did he make you laugh? Do you remember a time when you did something special together? The responses were fumbling but basically added up to: “No,” “Not really,” and “I don’t think so.”

In the end the family came up with one positive thing to say about the man who had died: namely, that he had been A Good Provider, since he always brought his pay cheque home.

What a sad commentary on a life, to be sure. It is also a reminder that for some people death and bereavement are painfully complicated by the acknowledgement of missed opportunities, unresolved issues, and in some cases grief that has become almost a daily part of living, before death occurs.

My recommendation to anyone with major issues relating to their past is to seek help to work through them early if possible, to resolve what you can and to return to the questions whenever they present themselves. My prediction is that such griefs will be resurrected with other experiences of grief: seems to be the way we are built.

And for all of us, may we live in such a way that, when the time comes, our loved ones are not at a loss when called upon to relate what they enjoyed, respected and appreciated about us.

 Bereavement, Funerals, Professionals

Making a decision about CPR: PART TWO

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Feb 102012
 

Image of CPR with mannequinGuest Contributor: Viki Kind

4.  Think about the kind of death you are choosing.

With CPR, you might not have the opportunity for a peaceful and profound death experience. When you picture the last minutes of your loved one’s life, do you see strangers straddling the patient on a bed, pushing on the patient’s chest, while the family waits outside in the waiting room? Or do you see a time with family and friends gathered around the bedside, with words of love being expressed, music being played or prayers being said?

The CPR decision is about more than medicine.  It frames the dying experience for the patient and the loved ones.  I would encourage people to balance the chance of CPR working and bringing the person back in a good condition with the desire for a peaceful and dignified death.  This is other reason why healthcare professionals wouldn’t want to die by CPR; there is nothing peaceful or dignified about this type of death.

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 Caregiver, For the dying, How death happens, Preparing for death, Talk about death

Making a decision about CPR: Part One

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Feb 072012
 

DefribullatorGuest Contributor: Viki Kind

CPR or cardiopulmonary resuscitation used to be very simple to understand. Cardio stands for heart, pulmonary stands for lungs and resuscitation means to revive from death. When a patient died, someone would push on the person’s chest to try to restart the heart while giving mouth-to-mouth resuscitation to help the person breathe. Over time, CPR has become more complex as healthcare professionals have discovered advanced ways to try to bring the person back to life. What seemed like an easy question, “Does the person want CPR?” has turned into a more complicated decision.

What do you need to know to make a good decision?

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 Caregiver, For the dying, Preparing for death, Professionals, Talk about death

What does death mean?

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Feb 032012
 

Sillouette of person with arms outstretched and head back against glowing lightWhen I was diagnosed with cancer—years ago now, I am happy to report—I faced an inner crisis of meaning. Sitting on the front step alone at 2:00 am, I realized with a profound shock that the cancer didn’t MEAN anything. It didn’t mean I was good or that I was bad. It didn’t mean my life mattered more or less than anyone else’s: it just happened.

No Meaning to be Had?

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 Caregiver, Death and spirituality, For the dying

Protect your loved ones: Make a will

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Jan 312012
 

Reading glassesShe was a very savvy, determined woman who had been a medical professional and served on a variety of boards and committees. We’ll call her Joan.

Yet, for all her intelligence and savvy, as Joan lay near death in a palliative care ward after battling cancer for 11 years, with a house in her name and two adult kids who’d been living with her, she did not have a Will prepared. A visiting friend casually asked if she had all her affairs in order and she said, “Not exactly.” Not exactly, indeed!

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 Caregiver, For the dying, Preparing for death

Death at Christmas

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Dec 222011
 

Image of blue heart Christmas tree ornamentDeath may touch upon Christmas (or any other major holiday) in a few ways: a loved one may die on or near the date, the family may be keeping vigil through the holidays, and then the first feast day after a death will likely be difficult to face. Whatever the details, death can cast its shadow on even those days we set aside to celebrate life, to give and receive gifts, to enjoy one another’s company.

Some people attempt—often in the name of making Christmas for any children involved—to try to mimic the celebrations of other years without mentioning the fact of impending death or recent death that day. This can be exhausting and, in my observation, usually doesn’t work very well. Like the proverbial “elephant in the room,” trying to avoid or deny the impact of death altogether just guarantees that everyone is thinking about it.

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 Bereavement, Caregiver, Children, Talk about death

A Hospice Visit: What to Say and Do PART THREE

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Dec 202011
 

Image of concerned womanIn the face of death, many of us find ourselves tongue-tied—and in some cases that may be just as well, because lapses into either pat answers or false comforts are generally regrettable. It is, however, a fact that really listening to others, including people who are dying, is one of the most profound gifts we can offer.

In a previous post, I made some suggestions about some gentle and respectful ways to signal to someone who is dying that you are prepared to listen to their questions, their anxieties, their wisdom and their reality. Creating a safe place for this to happen means being ready to let silences happen and ready to suspend judgment for the sake of caring.

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 Preparing for death, Professionals, Talk about death

A Hospice Visit: What to say and do PART TWO

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Dec 142011
 

Hospital intravenous tube in woman's handIn the previous post, I shared an introduction to making a visit to someone who is dying: the basics of hospital etiquette, really. In this post I’d like to share some ways you might attempt to prompt a deeper sort of sharing with someone who is dying. In the next post, I will share some cautions and guidance about where such sharing might take you.

Talking about dying can help someone who is dying but only if they can set the pace and only if they feel you are truly listening as they begin. Asking open-ended questions can help but sometimes the answer might be slow in coming or may not come at all. Remember that just because you are ready to open a door doesn’t oblige the other person to go through it with you.

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 Caregiver, Facing Death book, Professionals, Talk about death

A hospice visit: What to say and do PART ONE

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Dec 022011
 

Stretchers in hospital hallwayVisiting someone who is dying or critically ill is an experience many of us will have in the course of our lives. Whether your visit is to be in the person’s home, a hospice or a hospital, there are a few rules of thumb to guide your time together so that it can be mutually satisfying.

This post introduces some of the basics. In the next post I will include some tips to follow if you wish to try to take things a little deeper during your visit. Check back soon for that second installment in this series of what to say and do when visiting someone who is dying.

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 Preparing for death, Talk about death
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