Preparing for a Good End of Life
“Those who contemplate their aging, vulnerability and mortality often live better lives and experience better deaths than those who don’t.”
This article is one of the best ones I have read that address the issue – it is an excerpt from the author’s book “The Art of Dying Well: A Practical Guide to a Good End of Life,” which will be published on Feb. 19 by Scribner.
End of life decisions can be the most challenging for anyone – especially for the family of the one dying. If you have a parent or older loved one who has not made their end-of-life choices known to you, please have that conversation.
Here are the key takeaways:
Have a vision - Some doctors assume that everyone wants to extend life until there is no joy left in the living of it. They’re mistaken…. Living as long as possible was at the very bottom of most people’s lists. Imagine what it would take to die in peace and work back from there…. Advanced medicine is replete with treatments that postpone death and prolong misery without restoring health.
Talk to those you love about what a good “quality of life” means to you and put it in writing in a letter or advance directive.
Stay in charge - If your doctor isn’t curious about what matters to you or won’t tell you what’s going on in plain English, fire that doctor and find another.
Know the trajectory of your illness - If you face a frightening diagnosis, ask your doctor to draw a sketch tracking how you might feel and function during your illness and its treatments. A visual will yield far more helpful information than asking exactly how much time you have left. Such predictions are as unreliable as weather forecasts, and most doctors vastly overestimate.
A sketch, on the other hand, will yield a surprising amount of actionable intelligence. It may help you, in particular, to recognize the advent of the precarious health stage.
Find your tribe and arrange caregivers - Dying at home is labor-intensive. Hospices provide home visits from nurses and other professionals, but your friends, relatives and hired aides will be the ones who empty bedpans and provide hands-on care. You don’t have to be rich, or a saint, to handle this well…. People who die comfortable, well-supported deaths at home tend to have one of three things going for them: money, a good government program or a rich social network of neighbors or friends.
Don’t be afraid of hospice - It won’t make you die sooner, it’s covered by insurance, and you are more likely to die well, with your family supported and your pain under control.
Take command of the space - No matter where death occurs, you can bring calm and meaning to the room. Don’t be afraid to rearrange the physical environment.
Think of death as a rite of passage - In the days before effective medicine, our ancestors were guided by books and customs that framed dying as a spiritual ordeal rather than a medical event. A spiritually mature individual was expected to contemplate it ahead of time….
Don’t reduce the end of your life to a medical procedure or strip it of ceremony and humanity. Make sure you live and die as a full human being.