Category: Death & Dying

When I hear “end of life”, I think of the circumstances around the moment we die.
In the context of planning to die well “end of life”encompasses – days, weeks, perhaps months /years — preceding our death — a liminal space in which we have the opportunity to prepare for death. Commencing with an existential slap “End of life” begins with acceptance of our mortality, the sooner the better.
“existential slap” —that moment when a [dying] person first comprehends, on a gut level, that death is close. For many, the realization comes suddenly: “The usual habit of allowing thoughts of death to remain in the background is now impossible,” . “Death can no longer be denied.”¹Nessa Coyle, a nurse and palliative-care pioneer,wrote
My “existential slap” occurred there years ago.

All of us project ahead a trajectory of our life. That is, we anticipate a certain life span within which we arrange our activities and plan our lives. And then abruptly we may be confronted with a crisis … Whether by illness or accident, our potential trajectory is suddenly changed.”

The task of dying well:

“You have to live with awareness of dying, and at the same time balance it against staying engaged in life,” he says. “It’s being able to hold that duality—which we call double awareness—that we think is a fundamental task.”²Gary Rodin, a palliative-care specialist

Despite plans to assure intentions for our final days are fulfilled, there can/will be circumstances beyond our control. Death may come without warning, rendering plans moot. Any dying well plan is a contingency.
The best result for a dying well plan comes in circumstances were control is possible and decisions are made in accordance with expressed desires.

In a perfect world, our final days —end of life — would be laced with “…years of conversation about the need to prepare well for death – medically, communally, and spiritually.”
Because of our cultural aversion to death, engaging in meaningful conversations with family and loved ones may be the most challenging part of dying well.

Goals for Dying Well

Tim Keller’s article: “Growing My Faith in the Face of Death” should be required reading for every Christian.
In the excerpt below Keller conveys two goals of dying well. [my emphasis]

When the certainty of your mortality and death finally breaks through, is there a way to face it without debilitating fear? Is there a way to spend the time you have left growing into greater grace, love, and wisdom? I believe there is, but it requires both intellectual and emotional engagement: head and heart work. And so I set out to reexamine my convictions and to strengthen my faith, so that it might prove more than a match for death.

STILL ON THE JOURNEY

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  Nessa Coyle, a nurse and palliative-care pioneer,wrote
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  Gary Rodin, a palliative-care specialist

It has been more than a year since I began writing in earnest about death and dying. ( If you missed those posts, you can read them HERE ) Writing about death and dying revealed the wisdom of planning to die well. Accordingly, I committed to develop a plan to die well. This post is a report on my “Dying Well Plan”

The dying part of my plan is progressing well. For octogenarians the process of dying is often tenuous and unpredictable. Thankfully that is not yet my experience. I have a number of maladies that could quickly alter my mostly comfortable journey. Each day requires vigilance to avoid pitfalls which could change life’s circumstances.

When we avoid thoughts of death, we unconsciously assume that tomorrow will look a lot like today, so we can do tomorrow what we could do today. But when we focus on death, that increases the stakes at play in the present, and clarifies what we should do with our time.
If you insist on ignoring your own demise, you are likely to make decisions that cause you to sleepwalk through life. You may not be dead yet, but you’re not fully alive either.

https://www.theatlantic.com/ideas/archive/2023/05/death-memento-mori-happiness/674158

Confronting one’s finitude is key to dying well and is, in my opinion, the least challenging step. Developing a “Dying Well Plan” inherently directs one’s attention to their mortality.
Daily life as an octogenarian is rife with reminders. i.e. —Lots of prescription medicine—Looking in the mirror each morning—doctor appointments— Walks through the cemetery—frequent naps—funerals—”senior moments”—Diminished competence …to name a few.
Those and many other experiences serve as memento mori (“Remember! You will die!”). What is different today is not that daily life has changed drastically, but I am now paying attention rather than ignoring or denying reality. In that regard I am reaping helpful benefits:

I can honestly say that confronting my mortality is making me feel more fully alive. It is a work in progress.
There is a tendency to think of developing a dying well plan as an exercise for older or elderly persons. That is a fallacy.
Dying well is contingent upon living well. Living well is a project that spans our entire life.
When we avoid thoughts of death, we unconsciously assume that tomorrow will look a lot like today, so we can do tomorrow what we could do today. But when we focus on death, that increases the stakes at play in the present, and clarifies what we should do with our time.¹https://www.theatlantic.com/ideas/archive/2023/05/death-memento-mori-happiness/674158/
Greeks thought about death as a matter of routine. Socrates taught that the principal goal of philosophers is to rehearse for dying and death. The ancient Hebrews agreed. Qohelet, the “Teacher” of Hebrew scripture, instructs his listeners to remember their God while they are young, “before the days of trouble come, and the years draw near when you will say, ‘I have no pleasure in them’ . . . and the dust returns to the earth as it was, and the breath returns to God who gave it.” Prepare now, the Teacher says, for to dust you will return.²The Lost art of Dying – Dugdale

I an increasingly convinced that memento mori (“Remember! You will die!”) should be an integral part of the church’s liturgy. Those of us in the West today will fail to die well if we refuse to acknowledge that we are finite creatures. 

More to Come.

STILL ON THE JOURNEY

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  https://www.theatlantic.com/ideas/archive/2023/05/death-memento-mori-happiness/674158/
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  The Lost art of Dying – Dugdale