Saying goodbye is the hardest thing to do, especially to a loved one. Usually, it’s not just “Goodbye,” it’s “See you when you get back,” or “See you when you return from college.”
On the other hand, saying goodbye forever is never easy, whether we have warning that our loved one is going to die or their death is sudden. Is there a way to make this heartrending experience better?
I believe there is, and it starts with a plan – a plan for dying. Other challenges we face in life have instructions, directions and guidelines, but when it comes to dying we seem to have to wing it. “I think he may have wanted it that way,” “She never told me her wishes…” I’m sure everyone has heard words like that following a person’s death, but this type of uneasiness and uncertainty can change with a simple plan.
Three years ago next month, my father died. As a family, we have peace of mind knowing we honoured his wishes. My mother and I were at his side in the comfort of his home as he took his last breath and we said goodbye. It doesn’t matter how many years go by, the tears will always be there. But I know in my heart it was how he wanted to go. My mother-in-law, 17 years ago, had the same wish to die in her home with her family by her side. These are the wishes and plans of a good death.
A saying we often hear is, “He had a good life.” But I think we should ensure that people also say, “He had a good death.”
Even within health care there is uneasiness about dying. We’re good at saving lives, but not so good at ending them. With this week’s blog post, I want to illustrate some things that could make the death of a loved one a little easier, if that’s at all possible.
The World Health Organization suggests an approach that’s meant to improve the quality of life of patients and their families who are facing the problems associated with life-threatening illness. The plan includes prevention and relief of suffering by means of early identification, and impeccable assessment and treatment of pain and other problems whether physical, psychosocial or spiritual.
Death and dying is not the conversation most would have at a cocktail party or bridge night, but it certainly should be part of your family’s dinner table conversation. Think about it. Would you rather let your loved ones know your wishes or have them take a guess in the event of a tragic happening? There’s an amazingly poignant song by The Band Perry called If I Die Young. I recommend you all have a listen. This girl has got it right and she’s only in her 20s. http://youtu.be/JKvIo1EDt0s
It’s natural to feel trepidation about death and fear the disconcerting dying process. I recommend three things that can put your mind at ease. It’s not time sensitive; you can start at any age.
1. Initiate the death and dying conversation. It can be as causal or formal as you feel comfortable with. The key is to start it: “My wish if I were to die would be…” I’ve had the conversation with my husband and teenage children because it’s important to me that they’re not upset over the death planning, but instead have the occasion to remember the good times and celebrate the good life with a good death.
2. Express your wishes to your family, friends and health-care providers. Write it down. It’s important for everyone to know your wishes, not just one person. And share your wishes in advance so there’s no remorse and angst. Unfortunately, during dying and death there are always family dynamics due to the stress and fear of the unknown.
3. Prepare for death, physically, emotionally and spiritually:
a. Learn what resources are available and who is responsible for what.
b. Arrange for care – this you can’t do on your own.
c. Plan for support. It takes a team, family, government programs and community supports.
d. Create a care plan for disease, diagnosis, prognosis and treatment (i.e. pain management).
e. Transition of dying phase – determine location, bringing hospital to home, hospice centre.
f. Funeral plans: Pre-planning is best.
g. Aftercare, closure, legacy… these are hard to do when your loved one is gone. Do it in advance and put some thought to it.
h. Celebration of life is one of the most important things to plan. How do you want yourself or your loved one to be remembered?
i. Grieving and mourning: Saying goodbye! This is natural and it’s OK. I grieved and mourned; now I remember every time I light a candle.
Health-care professionals do their best to support individuals and families to make informed decisions that are consistent with the beliefs, values and preferences of your loved one. But don’t leave it completely up to them. A good death is all about you, your wishes and your family’s comfort zone. Only you can make this precious decision, so plan ahead. The absence of an end-of-life care plan may mean more pain and suffering for everyone.
There’s a formal process called Advanced Care Planning. For information, or to download the book, A Guide to Advanced Care Planning, visit: www.seniors.gov.on.ca/en/advancedcare/index.php. It’s not just a document, it’s a plan that ensures a quality death and it’s a way to ensure that you receive the care that’s most important to you at the end of your life or the life of your loved one.
I wrote my father’s obituary and I carry it in my wallet. I watch every spring as my garden comes to life… and I remember.
Thank you for presenting this with such strong clarity.
Given that my work is around grief and caregiving,
I particularly like this posting. It is informative and sensitive and human. I believe we live in a culture that disregards death and grief which makes this posting especially valuable.