Archive for category: End of Life

Steve Jobs’ last words, spoken with great delight, were, “Oh wow! Oh wow! Oh wow!” What was he seeing? Perhaps what those returning from near-death experiences consistently report — a sense of moving through a dark tunnel beckoned by a compelling bright light, feelings of peace and well-being, the knowledge of being outside of the body, what some call an intense feeling of unconditional love, and encounters with beings of light. This piercing of the veil of “the other side” unwaveringly suggests that “passing over” is a beautiful experience.

In stark contrast to these images, we live with a cultural consciousness about death that personifies it as “the Grim Reaper” or “the Angel of Death.” Not knowing when or how our time will come, many live in fear of the unknown and uncontrollable aspects of death with a sense of a foreboding encounter with darkness and evil. Nowhere is this more vividly demonstrated than in an Internet image search of the word “death” that yields haunting black-and-white images of skulls, crossbones, and the Grim Reaper. I encourage you to take a moment and do an image search now. These portrayals demonstrate the power of the death taboo on both our conscious and unconscious awareness.

Among the top 10 images, several date back to artwork from the 1300s during the Black Plague when half the European population was wiped out. The plague was considered a form of punishment by God. Symbolically representing death — with depictions of skeletons, skulls, and crossbones — was a common way of mocking it in order to reduce feelings of helplessness and anxiety. People wore these death symbols on their clothing as a way to fool Death into thinking that they had already been touched and should therefore be left alone. If these images are indeed a valid reflection of the collective consciousness about death today, it is no wonder that so many live in fear of death and treat it like the unspeakable elephant in the room.

As children, we could run to the comfort of our parents with our fears. It is a sad commentary on our society that as adults so many of us silence and suppress our own fears about death’s unknowns, concern about unmanageable pain, the loss of control over one’s own life, and the possibility of being isolated from loved ones at life’s end. Rather than sharing our beliefs, thoughts, fears, and concerns about dying and death, we suffer in silence having no idea how to wrap our brains around the reality of death or to even broach the subject with our loved ones or doctors. Far too many of us, including terminally ill patients, put a smile on our face and silently suffer in emotional isolation. The death taboo interferes with our ability to have a healthy relationship with death.

The good news is that since the 1960s, momentum has been building to transform our culture of death. Among the most apparent changes and influences:

• Beginning in the late 1950s, the conversation about human mortality and the American culture of death moved from academia and religious institutions to the general public — raising the topic from our unconscious to conscious minds.

• The hospice movement came to the U.S. in the 1970s, exposing the dying and their families to healthier role models of how to relate to death.

• The sharing of accounts of near-death experiences in popular literature began in the mid-70s, consistently offering beautiful new images of death.

• Philanthropic funding led by the Robert Wood Johnson Foundation and George Soros’ Open Society Foundation began in the 1980s, and focused on changing theculture of death in America through legislation, public engagement, and changes in the fundamental philosophy of death in the professional education of doctors and nurses.

• In 2011, the 79 million baby boomers began turning 65 at a rate of 10,000 each day. This will continue for another 17 years.

• A 2009 Newsweek poll estimated that 93 million Americans (30 percent) self-identify as “spiritual but not religious,” saying they are deeply spiritual but claim no specific religious affiliations. This group has doubled in size in the past decade and is a driving force of change in social rituals around birth, marriage, and death that are not rooted in religious doctrines.

Buoyed by the confluence of these forces, this is an exciting historical moment where matters of our beliefs and values regarding life and death are concerned. Both culturally and individually, we have a great opportunity to rethink our most fundamental definitions of “birth” and “death.” Our physical and spiritual understanding of these terms must be reconciled in the process. Here are some questions to ponder:

• When does life start and when does it end?
• Are these terms specific to the physical beginning and ending of life or are there other dimensions of our existence that precede and follow what we commonly refer to as a lifespan?
• Is the physical birth and death and lifespan of an individual all there is?
• Or, is there more than meets our eyes?
• Is the start of life “good” and the end “bad” as reflected in current social attitudes?
• Or, is this a matter of interpretation?
• How does the fact that the personhood you commonly know as yourself will die inform the way you live your life?
• When a loved one is dying, are you able to bring your authentic self to the situation and be a comfort, helper, and to communicate your loving fearlessly?

Never has there been a time when we had a greater opportunity to reevaluate our beliefs and values regarding life and death and to hold ourselves accountable for the quality of our relationship to both. Let’s talk about this. Please share your thoughts below.

The centerpiece of the American culture of death is a taboo that inhibits our ability to encounter the territory of dying, death, and bereavement with wisdom, competency, and discernment. We are acculturated to fear and resist death. However, this inhibition also deprives us of some of the greatest intimacy, tenderness, and depth of connection available in the human experience.

Our culture sanitizes dying and death, not only by diverting our attention to the technological medical gymnastics that just might avert death’s approach, but by juxtaposing death to life as though one is inherently bad and the other intrinsically good. We live in a polarity consciousness of good versus bad, right versus wrong, rather than both/and. While there is a place for optimism, there is also a place for reality where death is concerned.

All too often we flee into the illusionary safety of denial rather than accepting that we, or one we love, is dying. Under the influence of the death taboo, we are far more likely to enter the room of a dying loved one with a cheerful “your color looks good today, honey” than to express our unbridled truth of “I think you are dying and I’m scared and don’t want to lose you.”

We assume the truth would be too unbearable. Under the guise of protecting one another (or perhaps ourselves) we silently comply with the overriding belief that it is better not to give voice to death. However, when we don’t tell the truth to each other about death’s presence, we buy into a kind of dishonesty that contaminates our relationship and fosters a gulf of separation and isolation even between the most loving partners.
Why underestimate each other? What if the other person doesn’t want to be protected?  What if our statements of false hope, intended to protect the other person from our truth, instead tell them that we can’t handle the truth? What if that prevents them from fulfilling their need to draw closer, in deference to our apparent inability to cope? What if buying into our fear is depriving us of a depth of loving we have never known before?  What if this is our last chance to bridge a gap between us, to make room for greater honesty and intimacy?  What if this is our last chance for forgiveness or learning about truths previously withheld that will die with our loved one?  What if a brave step into the vulnerable land of honesty in the face of death would open the door to unimaginable treasures? How sad to live in a lie at the end of one’s life. How sad to risk regrets, not realizing the blessings that come with the alternative – a depth of intimacy that we may never have experienced before and that will never be available again.

Being vulnerable at these times and willing to go where we have never been before allows us to be of service to one another in handling unfinished business such as saying goodbyes, extending or asking for forgiveness, letting go of secrets, asking for answers, expressing our love, putting our affairs in order, and tending to whatever we feel the need to attend to before death comes. I remember how my mother and I consciously embraced her dying process by giving each other the freedom to express whatever was present for us. We drew our hearts together rather than letting a wall of withholding come between us. We had profound conversations about the meaning of life and death and our respective beliefs about God. She filled in the blanks about pieces of her history that never quite made sense to me. She told me what mattered to her most and whom she wanted to see. I got to know dimensions of her that I never noticed before. We dropped all masks and pretenses and shared an intimacy we had never broached before in those final months. I am so bountiful with her love and was left with no regrets.

Sadly, if the approach of death is not acknowledged then the dying and his or her loved ones are denied access to the very resources, such as Hospice care, that can provide maximum physical and emotional comfort. Hospice and palliative care workers are skilled in supporting and mentoring us through to the end of life, showing us the path to the very wisdom, competency, and discernment that our death taboo stifles in us. Ironically, there are blessings at death’s door that are only available to those who accept death’s presence. So, don’t be afraid to touch death – enter this territory with your heart wide open and partake of the full range of its sweetness and its sorrow, its wisdom and its blessings.

Can you imagine “getting over” the death of someone you love deeply in four days? That’s the average paid leave given by American businesses according to “Grief Index: The ‘Hidden’ Annual Costs of Grief in America’s Workplace.” The truth is there is no “getting over” the death of a loved one in either our business or private life. Rather, it takes time for us to find a new normalcy and to restore our ability to function effectively.

Grief can take its toll in all areas of our lives. In terms of the workplace, “Grief Index” provides an eye-opening perspective on the mental, emotional and financial costs of grief incurred by American businesses. It estimates that one in four employees is grieving at any given time. Defining grief as “the normal and natural emotional reaction to the change or end in any familiar pattern of behavior,” the study estimates an average annual cost in lost productivity, lost business and poor performance of more than $75 billion for all grief-inducing experiences. $46.9 billion is attributed to the death of a family member, colleague, friend, or animal companion alone.

Consider the following findings from the “Grief Index” study. Among the 25,000 participants:

• 85 percent of management-level decision makers indicated that their decision-making ranked from “very poor” to “fair” in the weeks or months following the grief incident that affected them.
• 90 percent of those in blue collar and other physical jobs indicated a much higher incidence of physical injuries due to reduced concentration in the weeks or months following the grief incident [compared to their ability to concentrate prior to the major loss].
• When study participants were asked if their reduced ability to concentrate affected them for any period of time beyond any allowed bereavement time, in the case of the death of a loved one, 75 percent indicated that reduced capacity affected them significantly beyond the allowed leave.
• Asked to estimate the amount of lost days they believe were the direct and immediate result of their reduced focus, 50 percent reported at least 30 lost days in which their value to the company or business was dramatically reduced, and may well have contained significant negative consequences in the form of poor decision making, poor supervisory skills, reduced sales ability and increased workplace accidents and injuries. An additional 20 percent reported being affected for substantially longer than 30 days.

In these stressful financial times, it can be challenging for a grieving employee to acknowledge their vulnerability and loss for fear of losing their job. Yet the denial of our grief in order to carry on as expected is far more dangerous than acknowledging that grief is typically a devastating experience that is best healed with time, compassion and reduced expectations of productivity. When we suppress our grief, it expresses itself in other ways such as depression, anger, addiction, substance abuse and physical illness. Consider a very dear friend of mine, with no prior history of heart disease, who suddenly needed heart bypass surgery just five months after his mother died.

The love that connects us is powerful, profound and for most of us, our most treasured possession. So, when someone we love dies, it is quite normal to be torn asunder. Just as our physical resources are diverted to the healing process after a serious illness or injury, so is our mental and emotional energy redirected to the grieving process or the avoidance of this natural process, whether we like it or not.

Grief is an equal-opportunity employer — whether you are a CEO or an assembly line worker, when you are grieving you are a human being with a broken heart. While there are predictable responses to grief, each of us will have our own unique journey through the grieving process. Grief has a life of its own and cannot be neatly compartmentalized on your calendar.

Until now, we have been living in a culture where grief is largely misunderstood, unsupported and silenced by the taboo against talking about or dealing with death in our country. Grieving has been largely a private matter that isolated us from others. The good news is that things are beginning to change in this regard.

There are more and more grief counseling services being made available. If you can’t find any in your community, consider calling Good Grief Center for Bereavement Support . They offer free support to any part of the English-speaking world over the phone toll free at 1-888-474-3388, as well as through their website. If you or someone you love is grieving, consider taking any of the following actions:

• Give Good Grief a call.
• Check out the services of The Grief Recovery Institute — the authors of the Grief Index.
• Find out if there are private grief counseling and/or support group services available in your community.
• See if your employer offers any proactive or responsive grief services.

Some of the specific services you might ask your employer about include:

• Grief education programs or literature for the person who is grieving, their family, and/or business colleagues.
• Referral services for confidential counseling (paid for or not by the company).
• A support network of employees/mentors who have faced a similar personal crisis.
• A flexible conversion plan that allows workers to convert their vacation or personal time to cash, which is then used to offset lost income for co-workers who take time off to deal with a crisis.

If these services are not available through your employer, but you think any of them would be a good idea, suggest them to your Human Services department. Good Grief Bereavement Support also has a program called “Grief in the Workplace” that will work with your company to develop a customized program that fits the culture of your organization.

Remember, grief is normal and if you think you need some help and compassion, you don’t have to be alone in your grief. But you do have to reach out for help. You might be surprised by the resources available.

If you would like to know more about me and my work, please explore my website here.

Also, if you know anyone who might get value from this article please email or retweet it or share it on Facebook.

There are those among us who are leading the way in demonstrating how to break free of society’s taboo around death. While most of us might be likely to awkwardly say “your color looks good today” to a dying loved one, someone who has made peace with death would be more likely to take his or her hand and say, “I love you and am going to miss you so much.”

For most of us, being around dying and death evokes a visceral response of fear and avoidance. We basically view life as good and death as bad. Our fear makes us contract and respond in fight or flight or freeze mode. We react against death and try to keep it away from us precisely because we have been taught that it is bad. People who have made peace with death have a completely different mindset. They tend to see death as normal as birth and are as open to its wonders and mysteries as they are to those of birth. This doesn’t mean that they are exempt from the sorrow and grief of losing a loved one. However, they have learned how to bring their loving, caring, kindness, compassion and even humor to the bedside of the dying.

Next time you find yourself in the presence of a dying loved one while hiding your tears and
sorrow behind a fragile masked smile, consider the following keys to how people who have made peace with death behave:

1. See death as normal. Rather than seeing death as something awful to be avoided at all cost, see if you can shift your thinking by exploring the fact that while death is inescapable, our attitudes and beliefs about death are actually quite negotiable. Challenge yourself to break free of giving death such a bad rap. If you believe in God, consider the fact that God was not suffering a loss of intelligence and simply having a bad day when conceiving of death as essential to the human experience.
2. Don’t try to run away from death or avoid it — be in it and be open to experience it. As with any fear, the fear of death kicks in the fight/flight/freeze response. This instinctual response is built upon the assumption that there is something terribly wrong with death. When you liberate yourself from only seeing death as bad, you will begin to recognize that death is a great teacher of how to embrace and honor life more deeply. Be open to the lessons that death presents to you. Breathe into death rather than standing breathless in fear of death. Stories and memories of the dying and their loved ones are rich with references to sharing a sweeter and more profound love than ever before. Be vulnerable. It’s OK to cry. We don’t need to protect each other from the depth of our emotions, but rather to give each other permission to authentically share our truth.
3. Focus on being of service. Do what you can to make the journey of dying and death easier for yourself and others. When you are not busy being afraid of death, you can set about the business of being of service. If you are the person with a terminal illness this might involve putting your affairs in order — for example, being sure you have an up-to-date will or trust and health care directives, documenting your preferences for your eventual end-of-life ritual, organizing your files and personal affairs, saying thoughtful goodbyes and giving your forgiveness where needed. If your loved one is dying, you can be of service just by showing up and paying attention to what is needed in the moment — a tissue, a foot rub, reading a book, sharing memories, or just silently bearing witness. Don’t forget to include the family and primary caregiver of the dying. Dropping off a quart of soup or calling and asking if you can provide some shopping, cooking, cleaning or laundry relief or something else that would be of help are all expressions of a consciousness of service.
4. Be fearless. Be authentic. Be yourself. Be loving. When you disassemble your fear, you are left with your authenticity. When you are authentic, it is easier to feel and express your loving. When all is said and done, freedom from fear is better than being paralyzed by fear. It takes courage to achieve freedom from the external pressure to conform to a mode of behavior that serves no one. Have the courage to let your loving and caring show no matter how difficult and awkward it might feel to express it. The more you allow yourself to express it, the less awkward it feels. Think about it. If you were dying, what would you rather have someone bring you than love? What could possibly be more precious to you? Think about that next time you just don’t know what to say or find yourself avoiding the dying and their loved ones.
5. Allow yourself and others to fully experience the range of grief and sorrow that are normal parts of dealing with dying, death, and bereavement. Emotions can be messy and challenge our preference for the illusion that we can control life. When we don’t express our emotions, we tend to repress them and/or medicate them away. Consider this request from a grieving woman posted on www.opentohope.com:

“I wish you would not be afraid to speak to me about what is going on in my life, and to ask what you can do to help. If I cry or get emotional when we talk about them, I wish you knew that it isn’t because you have hurt me. The fact that I have suffered has caused my tears … I wish you wouldn’t pretend that nothing is happening to me, because it is a large part of my life. I need my friends and family by my side … I wish you wouldn’t think that if I have a good day, my grief is over, or that if I have a bad day, I need psychiatric counselling. Grieving and what I’m going through is not contagious, so I wish you wouldn’t shy away from me. I wish you knew that all of the “crazy” grief reactions I am having are in fact very normal. Depression, anger, frustration, hopelessness, and questioning of values and beliefs are to be expected during and following what is happening to me. I wish you wouldn’t expect my grief to be over if and when I appear to be smiling or happy. I wish you would understand the physical reactions to grief. I may gain weight or lose weight … sleep all the time or not at all … want to surround myself with business or be all alone, all of which may be related to my grief … Please don’t try to coerce me into being cheerful or tell me that it will be better soon … I wish you would not offer me drinks or drugs to ease the pain. These are just temporary crutches. The only way I can get through this grief is to experience it, and sometimes immerse myself in it. I have to hurt before I can heal. I wish you understood that grief and difficult situations change people. I am not the same person I was before I experienced it nor will I ever be that person again …

To read the full text go to: http://community.opentohope.com/viewtopic.php?f=23&t=107#p190

It is entirely up to each and every one of us whether we stay frozen in fear in the face of dying, death and bereavement or break free and make peace with the normalcy of death. I invite you to try some of the suggestions given above and to share other ideas through comments below.

If you would like to know more about me and my work, please explore my website here.

Also, if you know anyone who might get value from this article please email or retweet it or share it on Facebook.

It is true that there are stages to grief, though no two people grieve in exactly the same way. However, something has been missing in our understanding of grief that offers an opportunity for many of us to lessen our pain and suffering when faced with a major loss. That key is to understand the way we have been culturally programmed to react to death.

Each culture has its own mindset about death that consciously and unconsciously influences the beliefs, thoughts, attitudes, and behaviors of its members. The guidance of a particular culture seeps through the pores of its members, shaping their thinking and behavior. Mostly, we learn through observation, repetition, and the reactions of others if we step out of line. Social norms and taboos guide us in what is considered proper and acceptable and what is frowned upon. Those of us raised in the United States, for example, have been culturally programmed to believe that death somehow shouldn’t even exist — it’s not fair, it’s wrong, and to be avoided at all cost. Is it any wonder than that when dying, death, or bereavement knock at our door, we respond with a fight/flight/freeze response and avoid death like the plague?

We are uncomfortable with even the thought of death. That’s why many hospitals avoid using the word “death” in the presence of patients and their loved ones, even when it is not in reference to them specifically. One contemporary hospital uses a code to spread the word among the medical and nursing staff when a patient dies. Rather than simply saying that someone has died, they say, “Guess who won’t be shopping at Walmart anymore?” If we are this uncomfortable with even the mention of the word “death,” how are we supposed to deal with its reality in our lives? How are we supposed to know how to be in death’s presence let alone tolerate its very existence?

It is not our fault if we are uncomfortable around death, because that is how we have been trained to respond. The fear of death is at once culturally pervasive yet deeply private. Having been taught to fear death and to believe that it is fundamentally wrong and undesirable has set us up to be ill-equipped to deal with it on any level. In terms of grief and bereavement, I can’t help but wonder how much of our suffering is directly attributable to this dysfunctional belief.

Beliefs are the filters through which we interpret the events and experiences of our lives. If one person believes that death is bad and shouldn’t happen, and the other accepts death as a normal part of the human journey, then who is likely to suffer more when grieving the death of a loved one? Clearly, the one who thinks death is bad and wrong. When something is unacceptable to us, we are so busy being angry and resistant to its reality that processing it and dealing with it are overwhelming. When someone accepts death, they can get on with the business of grieving their loss, while those unable to accept death must deal with their negative emotions about its existence as well.

Accepting death is not about liking it, but acknowledging its normalcy and inescapable nature in the course of human life. Acceptance allows us to access the wisdom and intimacy with our loved ones that is available when we are not busy denying death.

When my mother was dying, for example, we acknowledged that she was dying with each other, and that gave us the freedom to say what we wanted and needed to say to each other about what was really going on. I knew, for example, that she was really curious and impatient to find out what happens when you die and that she believed that she would be greeted by loved ones who had predeceased her. So, when she actually died, I was able to be really happy for her and comforted that she would finally have her answer; she would see her mother and husband again, and be freed from all the physical pain she had been experiencing. Did I want her to die? Never — but I was happy for her. During those final months of her life we were also able to share a level of vulnerability and intimacy with each other that we had never had before. We knew time was running out and we took full advantage. My choice to make caring for my mother my top priority for the final six months of her life taught me a depth and breadth of love I had never known before and that I will treasure always. Had I stayed in my fear and allowed it to keep me at arm’s length, I would have missed out on a lot of riches.

Wouldn’t it be in our best interest as a society to transform our fear-based culture of death by encouraging a healthier belief about death as a normal occurrence? What would it be like if we lived in a society that taught us to take time to be of service to the dying and allowed us time to do our grieving? There is so much we could do to educate and prepare ourselves to handle death with greater loving, service, and compassion.

The fact is that the dynamics of fear are exactly what stand in our way of accepting our mortality and in evolving a healthy relationship with death. Fear contracts our energy and paralyzes us from thoughtfully and compassionately responding to the object of our fear. When what is feared is death, quite a conundrum is created because no one can avoid death. Unless we learn to transform the energy of fearing death, we live in fear and die afraid.

The bottom line is a fear-based view of death is unhealthy and fails to serve us as individuals or as a society. Consider your own experiences with death. Do you avoid death and even the topic of death like the plague? Do you see death as defeat or failure — something to be avoided at all cost? When you hear that someone has died, do you automatically react with the belief that it shouldn’t have happened? When you have a bouquet of flowers and they start to wilt and die, does some part of you think it shouldn’t be that way — that they should stay fresh and beautiful forever? Is that why we invented plastic flowers?

If you are not already on board to help bring this change about — I hope you will explore your personal beliefs and behaviors around dying, death, and bereavement and seek out opportunities to help challenge and transform our culture of death in your home, at work, and in the community.

If you would like to know more about me and my work, please explore my website here.

Also, if you know anyone who might get value from this article please email or retweet it or share it on Facebook.