Preparing for the natural end of our lives

Most of us don’t want to talk about death. But we need to be prepared for the inevitable.

Our culture soft-soaps the inevitability of death.

Yet, at some unknown time, we’ll all come to the natural end of our lives. This is certain. But our culture doesn’t help prepare us for this reality. In today’s world, adults can talk about almost any subject — other than death. It’s not a topic that comes up in day-to-day conversation, in coffee shops with friends, or at social gatherings. It’s a taboo subject.

We don’t discuss death with our kids. We’re fearful they’ll be scared. Children are often excluded from funerals and memorial services. Indeed, we’ve transformed “funerals” into “celebrations of life.” I never understood that. To me, a celebration of life is a birthday, not the day life ends. Death is the enemy to be conquered or ignored, until we can’t.

Over my long career as a psychologist, I’ve had the privilege to work with many adults who were terminally ill, supporting them as they came to the end of their lives. They taught me a great deal about living and about dying. There’s a long line of adults who hope to die in their sleep. But that’s not always the case. None of us really know how we will experience our ending or what we feel or think, particularly if we have some time when we are actually dying.

Several years ago, my wife and I were flying back from Europe. Somewhere over the Atlantic Ocean, our jet lost altitude so quickly that all of the overhead cabins opened, and the flight attendants were knocked to the ground. Passengers started screaming. The plane shook violently, and it was several minutes before the pilot came on the loudspeaker. All of us thought this was the end. To my surprise, a great calm came over me. I reached over to hold my wife’s hand, thinking we should be connected if we were coming to the end of our lives. I hope that when my end does come, I will feel the same way.

So how can we be better prepared for the natural end of life?

Consider your beliefs about death. Many religious adults feel confident that death will precede an afterlife. None of us know for sure what will happen when we die. It’s helpful to reflect on your beliefs, fears and thoughts about death. It’s also helpful to consider how our thoughts about death impact our lives.

If you were to come to end of your life tomorrow, how would you feel about how you’re living your life today? Many of my patients, when diagnosed with a life-threatening disease, make radical changes in how they live. It’s not necessary to be diagnosed with a dread disease to consider how you’re living and whether it’s aligned with what’s important to you.

Reflect on how you cope with loss of control. Many of us older folks are more comfortable with the reality of death but dying is a different matter. There’s a loss of control, loss of agency, and loss of independence, and that can be very frightening for some adults, especially if loved ones came to end of their lives with a disease that is protracted — like cancer or heart disease.

For older adults, it’s important to designate a health care proxy to make health care decisions should you become incapacitated. It’s essential for elders to consider how they want to handle end-of-life decisions and to communicate those wishes to their families. Also, be sure to discuss this with your primary care provider at your annual comprehensive visit.

Paul Schoenfeld is a clinical psychologist at The Everett Clinic. His Family Talk blog can be found at www. healthwellness-library.html.

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