Ending Well: Defining a Good Death

What does it mean to have a good death? It’s a difficult question and one that we rarely talk about with the people who need the answer the most: our families. In the words of poet Mary Oliver, “In my house there are a hundred half-done poems. Each of us leaves an unfinished life.” Perhaps we are waiting to feel “finished” to begin important conversations about the end of life, but given the truth in this poem, we owe it to ourselves to reflect on and communicate what matters to us, long before we sense conclusion.  

In his TED Talk, “Elderhood Rising”, geriatrician, Dr. Bill Thomas reminds us that, “our aging and our ultimate mortality are cornerstones of our humanity.” He points out in his talk that adulthood is often an over-emphasized developmental stage in the human life cycle. We are living longer and there is an entire stage of life after adulthood, something he refers to as “elderhood.” In this stage of life, we probably think about and live in relationship to our own death in a way that we simply do not in other stages of life. At times, it can also introduce fear of a great many things: loneliness, becoming obsolete, diminishment, or loss. At best, this stage can infuse our lives with richness, meaning, and focused attention to what matters most.

When we think about the inheritance that we want to give to our loved ones, we often don’t realize that we are passing on much more than things named in a will. Whether we know it or not, we are passing on an image of what it means to die, something we will all face, but so rarely get a glimpse of. As Care Managers and Caregivers in the home, some of our most important work is when we are caring for an aging loved one at the end of life. The houses are often filled with family and casseroles and stories. Every emotion is present as we move from room to room attending to family and their loved one. What does it mean to have a good death? The answers can be so different from family to family or person to person. The important thing is that we ask one another to graciously give us the intimate gift of knowing what it means to end well.

Tools and Resources for the Conversation:

Hospice:

5 Wishes:

Available at www.agingwithdignity.org Can be tool used to express ed-of-life wishes and to appoint a “Health Care Agent”. Not recognized in Alabama, Indiana, Kansas, Kentucky, Nevada, New Hampshire, Ohio, Oregon, Texas, or Utah. Mental Health Advance Directives

Death with Dignity Act WA State:

This act allows terminally ill adults seeking to end their life to request lethal doses of medication from medical and osteopathic physicians. These terminally ill patients must be Washington residents who have less than six months to live. Department of Health:  http://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/DeathwithDignityAct

WA State Hospital Association

POLST Applies to situations where “life sustaining treatment” is needed. Portable between health care settings and recognized EMS personnel. Must be signed by a doctor, ARNP, or physician’s assistant. https://www.wsma.org/POLST

DPOA: Durable Power of Attorney extends decision-making authority to your healthcare advocate in the event you are unable to speak for yourself. A regular POA ends at the point that you are deemed unable to make conscious decisions.

The Conversation Project: “The Conversation Project is dedicated to helping people talk about their wishes for end-of-life care. Too many people are dying in a way they wouldn’t choose, and too many of their loved ones are left feeling bereaved, guilty, and uncertain. It’s time to transform our culture so we shift from not talking about dying to talking about it. It’s time to share the way we want to live at the end of our lives. And it’s time to communicate about the kind of care we want and don’t want for ourselves.” http://theconversationproject.org/

In-Home Care & Care Management: Partnering with hospice at the end-of-life, Sound Options is able to provide the day-to-day care that relieves family from doing it all so they can focus their attention on the emotional and logistical elements of helping their loved one end well. Whether you need 24-hour live in care, or a 1 hour consultation with an RN/ MSW eldercare expert, we’re here in your time of need. To learn more about how we can help you provide care and have import, give us a call at 800.628.7649.   

Published on July 22, 2015.