Dying in Peace

If you want to die in peace, you have to do some things in order to increase the likelihood that you will. If you do nothing the odds are that you will not die in peace, as most of us define peace. Actually, you have to engage in a multi-step learning process to come to grips with dying in our time and how you really feel about it.

This road sign is a metaphor for the route we must take. Let’s equate dying peacefully as spending time in that bucolic vacation cottage away from the metropolis. First, you must exit the metaphorical freeway, the “medical express.” Your vehicle needs to function to get you there. It can’t fall apart on the way, and it can’t run out of fuel; we must slow down, and arrive at our destination with a little fuel left in the tank. Accomplishing this is a long-term proposition. It may be doable on the spur of the moment, but I wouldn’t want to presume success, as it’s all to easy to overshoot the exit.

“Fuel in your tank” relates to the prospect of accepting death a little sooner than we might without having thought things through (this does not mean that we will necessarily die sooner). Metaphorical fuel translates into real-life vital force. What might we do with some life force in our end days? How about using it to live as best as is possible as we fade away? If this is more attractive than using life-force to battle the inevitable in a machine-driven environment, keep reading. (recent statistics indicate you’ll live longer this way, too!)

Doing something means a lot more than considering and filling out advance directives—as challenging as even doing that may be. Doing something must begin months, if not years, before we die, and includes acquiring knowledge and acceptance of:

• how we die in the twenty-first century
• how hospitals and doctors function by default
• the notion and practice of heroicism and the real time and place for heroic action
• what we must endure, by default, on the way to receiving palliative treatment
• personal ownership of our destiny
• willingness to face ourselves squarely and decide that we will decide our fate or give up choice—and the responsibility for it—to systems, institutions, doctors, or our children.

To increase our likelihood of dying peacefully, we must have reasonable expectations. Do you know the four basic trajectories for how we die medically? Do you understand the medical culture and its default values? Are you familiar with how to advocate when hospitalized? Have you reflected upon your own values regarding heroic action and when you think you ought to take it? If you are ill, or have recovered from invasive treatment to cure ailments, have you considered whether or not you have already engaged in heroic action? Do you know what occurs when first responders arrive and the constraints under which they function? Do you know what palliative care is, and how to access it? Are you fully aware of what hospice is and what it offers? Have you considered when it would be appropriate for medical providers to query you or introduce the topic of end of life pathways? (I have found that people of all ages—twenty, fifty, eighty—retain a troubling notion of propriety about this, and that they suffer needlessly due to it…) Have you really given thought to how you want to end your life on planet earth?

The rose with the fallen petal symbolizes what’s at stake: a life ending. Is the petal our departed loved one? Is the petal you, or I, adrift and bereft after our loved one dies?

The issue is to protect precious moments before irrevocable separation. To use our last weeks, days, hours to commune with one another. To communicate treatment directives if need be. Nothing else really matters, does it? And remember: you will take your experience of your loved one’s demise with you for the rest of your own life.

A few words about advance directives (ADs): they are crucial documents that everyone ought to fill out (unless you explicitly desire systemic defaults as your pathway near and at end of life). Beware, however, that ADs tend to lead us into a false sense of security and complacency. ADs are to dying and death as clear skies were to the Titanic. Having lived through the hospitalized demises of each of my parents (January 2004 and May 2005), I can attest that ADs may fail to answer the many questions that arise, fail to provide adequate or any direction, as a loved one’s death unfolds. Having a suite of ADs does not in any way minimize the need to answer all the questions posed above.

Ribbonhand, as I call the artwork below, represents celebrating a full life through its ending. This doesn’t mean to party (although more power to you if you can). Ribbonhand conveys an attitude. Read it from right to left. If it speaks to you, I encourage your engagement with this site’s articles and resources to help you come to grips with mortality and to plan—as best one can—for a peaceful demise.