While I am not a Buddhist, I find the Tibetan Buddhist teachings on death a source of great wisdom and potential liberation – particularly for those still under the influence of the death taboo in the west.  Sogyal Rinpoche, author of The Tibetan Book of Living and Dying, has a particular skill in drawing out the universal messages of these teachings and making them understandable to the western mind without losing any of their authenticity, purity, and power.  What follows is a summary of his teachings on death and impermanence.*

According to Sogyal Rinpoche, reflections on death and impermanence are the very cornerstone of all spiritual paths.  Among Christian contemplatives, for example, is the expression ‘Memento mori’ – ‘remember that you will die.’ Buddhist teachings encourage awareness of the fact that we could die at any moment.  This helps us to maintain awareness of the preciousness of life and encourages us to sort out our priorities.

From a Buddhist perspective, the root cause of all our suffering, is the fact that we do not take enough time through prayer and meditation to come to know ourselves – our true nature, our enlightened, ‘Buddha’ mind.  Beyond our ordinary everyday mind is our true mind, which radiates the qualities of tremendous light or brilliance (wisdom) and great warmth (love and compassion).  Sogyal Rinpoche uses the analogy of the sky to contrast this state of enlightenment to our everyday mind.  Our daily thoughts, feelings, and actions are like temporary clouds that come and go in an endless sky that, like the enlightened mind, is beyond birth and death.

Coming to know our true nature requires overcoming our ordinary mind and moving past our ego.  In our day-to-day lives, we become absorbed and distracted by our thoughts, feelings and activities.  It is easy to allow our ignorance, negative emotions, and actions to obscure our true nature, much the same way that clouds block our awareness of the endless sky.  We all have the potential to connect beyond our ordinary minds to our deeper state of profound wisdom, love, and compassion.  It is this state of mind that is said to endure past death.  If we do not come to glimpse our true nature in life, we will not be prepared to recognize it and enter into it at death.

This transformation of mind is not only essential preparation for death, but like cleaning the smudges off your eyeglass lenses, it allows us to see more clearly in life in such as way that our very perceptions transform and circumstances will appear differently.  Whether or not we are able to see clearly, it is important to remember that even when our ordinary mind is cloudy, the sky-like nature of mind is still there.  Weather is only on the surface.  Deep in the sky-like nature of our minds it is pure.

In many western spiritual traditions, we use the expression ‘let go and let God.’   Similarly, the Buddhists teach that the essential path to personal transformation and freedom comes from learning to stop grasping after impermanence, for indeed, everything is in a constant state of change. The message of impermanence is that one of the main causes of suffering is grasping and attachment.  Since what we grasp for is impermanent, grasping is an act of futility.

We have to learn to let go.  We don’t have to change – simply change our minds and recognize that impermanence is the very nature and fabric of life itself.  We associate impermanence with losing and death, but when we really understand it  – it is the most secure thing.  When we lose the clouds, we gain the sky.  The most permanent thing is impermanence.  When we realize that, we are made stronger spiritually.

Our fear of death, according to Sogyal Rinpoche, is the fear of life, of facing ourselves.  Looking into death is actually facing ourselves because sooner or later we have to come to terms with ourselves.  That is why we tend to think of death only when we are dying.  However, to look at yourself and your life at death is too little too late where personal transformation is concerned.  That is why Tibetan Buddhist teachings stress that we should always contemplate death and impermanence as a way of breaking through to our true nature.

Rainer Maria Rilke said that our deepest fears are like dragons guarding our deepest treasure.  Our fear of the impermanence of life and all that we grasp after awakens in us an awareness that nothing of this world is real and nothing lasts. Milarepa, a revered Tibetan poet and sage, said it this way – ‘All worldly pursuits have but the one unavoidable end, which is sorrow: acquisitions end in dispersion; buildings in destruction; meetings in separation; births, in death. Knowing this, one should, from the very first, renounce acquisition and heaping up, and building, and meeting; and faithful to the commands of an eminent guru, set about realizing the Truth (which has no birth or death).’

We come to discover that this understanding about impermanence is really our greatest friend. It drives us to ask ‘if everything dies and changes, then what is really true?  Is there something behind the appearances?  Is there something boundless and infinitely spacious in which the dance of change and impermanence takes place?  Is there something, in fact, we can depend on that does survive what we call death?’  When we allow these questions to occupy us urgently and reflect upon them, we slowly find ourselves making a profound shift in the way we view everything.  With continued contemplation and practice in letting go, we come to uncover in ourselves something we cannot name or describe or conceptualize – something we come to realize lies behind all the changes and deaths of the world.  Our myopic focus upon our desires, what we are grasping for, and that which we are trying to avoid, begins to dissolve and fall away.  As this happens, we catch repeated and glowing glimpses of the vast implications behind the truth of impermanence.

Sogyal Rinpoche describes this transformation saying ‘it is as if all our lives we have been flying in an airplane through dark clouds and turbulence when suddenly the plane soars above these into the clear boundless skies.  Inspired and exhilarated by this new dimension of freedom, we come to uncover a depth of peace, joy and confidence in ourselves that fills us with wonder and gradually breeds in us  a certainty that there is in us something that nothing destroys, that nothing alters, and that cannot die.’  He further describes, ‘as the new awareness becomes vivid and almost unbroken, there occurs a personal and utterly non-conceptual revelation of what we are, why we are here, and how we should act which amounts in the end to nothing less than a new life, new birth – almost a resurrection . . . You discover something in yourself that does not die.’

He also speaks of death using the analogy of being on a train platform waiting for a train.  We know that we must take that train but don’t know when it is coming.  We have great anxiety because our bags are not packed.  We do not prepare for death or live thoughtfully because we think we will live forever.  We know we will die someday – but we prefer not to absorb that thought and to pretend instead that we have an unlimited lease on life.

We become lazy in how we live our lives.  The particular kind of laziness in the west is an active one.  We do everything and anything to avoid ourselves.  We fill our lives with so many activities that there is not really a chance for the truth of ourselves to be revealed.  There is no gap.  Yet, we live with an abiding anxiety since we have not faced ourselves or our death.  There is a deep anxiety and a deep fear because death represents our ultimate fear.

Learning to live in the immediacy of death helps us to sort out our priorities and to realize what is truly important in life.  We learn that there is really not much time to waste.  Death helps us to look into our life in a deeper way.  We come to realize that only two things really matter when we die – how we have lived and the state of our mind.  When we take care of those most important things, then we can relax.  Milarepa said ‘my religion is not to be ashamed of myself when I die.’

An unenlightened mind sees death as defeat – a tragedy.  These teachings show us it is really an extraordinary opportunity for transformation and personal liberation.  When we die, it is only the end of one cycle finishing – the delusions of this life will end if we allow it.  However, those who hold tight to their illusions don’t allow for their liberation to take place. Those who allow it not only surrender to the death of their bodies but they allow their ordinary mind to die with all its delusions as well.  Milarepa described it this way: ‘In horror of death, I took to the mountains. Meditating again and again on the uncertainty of the hour of death, I captured the fortress of the deathless unending nature of mind.  Now all fear of death is done and gone.’

Tibetan Buddhist teachings provide three pieces of advice for the moment of death which also serve practitioners well in how to live their lives: let go of all graspings, attachments, and aversions; keep your heart and mind pure; and unite your mind with the wisdom mind of the buddhas.  Those practicing these techniques in life who are really able to let go inside themselves, find they are able to cope better with outer stress and are less bothered or worried by what transpires in their life.  When we stabilize and integrate this view as part of our being through meditation and through action then we can meet death fearlessly.  By practicing getting into the high ground of our consciousness during life through meditation and contemplation, we prepare ourselves for the moment of death.

There is also advice given for those who are helping the dying.  Essentially, we are called upon to simply be there maintaining a consciousness of unconditional loving – free of attachments.  Love is not expressed by grasping after the life of the dying.  This kind of attachment, Sogyal Rinpoche teaches, is actually what spoils love.  To truly realize love for one another, we have to let go.  When a loved one is dying, we can best serve them by giving them our permission and blessing to die and by surrounding them with our love and encouragement.

*This article is based on the teachings of Sogyal Rinpoche presented in The Tibetan Book of Living and Dying and the following four lectures: Transcending All Fear of Death; The Essence of The Tibetan Book of Living and Dying (parts one and two); and Reflecting on Death.

This is the first in a series of posts on the topic of death that will be published over the next several weeks.

We don’t do death well in this country which results in a lot of unnecessary suffering. Most of us do not talk about death and are terribly uncomfortable being in death’s presence. Yet, death is normal. By treating death like an invisible elephant sitting in the room, we deprive ourselves of making peace with our mortality, of deeply communicating with and comforting each other in the face of death and of taking the opportunity to make meaningful plans for the end of our life’s journey.

Talking about and dealing with death is our last great social taboo. We all know that we will die someday as will our beloved ones and cherished pets and everybody else. Yet, most of us relate to death as wrong — as something that shouldn’t happen.

The taboo against talking about or dealing with death runs deep in our culture. As a result, most of us relate to death much like children squeezing our eyes shut behind our covering hands, as though what we were looking at has disappeared because we aren’t seeing it. According to a 2011 Associated Press-LifeGoesStrong poll, Americans are typically unwilling to face their own mortality and many fear that the mere act of planning for the end of life will somehow hasten their demise.

Despite our difficulty in dealing with death, its presence as our one certainty begs the question of our relationship to death and how that informs the quality of our lives. Treating death as bad and life as good puts us in the position of resisting and avoiding death as though we could somehow beat the 100 to 1 odds that we will indeed die. This polarized view of life and death deprives us of developing a better understanding of the meaning, wisdom and blessings that the full cycle of life and death bring to our lives. Those who have the courage to accept the reality of death and to observe and experience it with their eyes wide open have access to this deeper understanding.

Social taboos take time to lose their grip on us. Typically, a few brave souls recognize a need to swim upstream against the current, and little by little a momentum builds until an alternative way of being becomes an option. Breaking through a taboo happens one person at a time, one situation at a time as a result of conscious and determined effort. The really good news is that we are living in very exciting times in terms of the prospects for disempowering the taboo against death in America. We are seeing more and more hospice and other palliative care programs that are teaching us a kinder and gentler approach to the end of life. Doctors and other health care workers are being challenged to reframe how they view death from seeing it as a professional failure to accepting the limitations of medicine and technology and the wisdom of passing the baton to a palliative care program as a way to comfort patients who are dying.

The baby boomers, now ages 47-65, are becoming elder boomers. Beginning Jan. 1, 2011, an average of 10,000 boomers will turn 65 each day. Thus, death is becoming a much more familiar part of the landscape of our lives as boomers care for aging and dying parents, and watch more and more of their peers face chronic and terminal illnesses and death.

Buddhist teachings advise us to avoid attachments and aversions as they block our ability to be present in the true reality of our lives. With both attachments and aversions we attempt to play God, saying “I must have this” or “I must never have that.” When we resist death, not only are we engaging in a statistically losing battle, but we exhaust our precious energy trying to avoid the inevitable rather than accepting and working with what is truly present. By resisting and avoiding death, while holding on for dear life to life, we end up with a life filled with always trying to second guess what is coming and grabbing hold of whatever we like that comes our way while pushing away that which we do not want.

The result of avoiding talking about or dealing with death is that when we are forced to experience death either as a spectator or as the one who is dying, most of us are woefully ill-prepared mentally, emotionally, physically and spiritually. Death shocks and disturbs us not because it is some awful occurrence but because we have made it so. In reality, death is quite normal. Each of us is born, has a life and then dies. Life and death are inexorably paired — we don’t get to have one without the other. That is not negotiable. However, our attitude and beliefs about death and how we relate to life and death are both socially and individually negotiable.

As a life coach, minister and grief counselor I have encountered an enormous range of beliefs and behaviors regarding death and have seen how profoundly these points of view inform the lives of my clients. At one extreme, I have worked with people who are so terrified by the fact that they will someday die that they are unable to function in their daily lives. At the other extreme are those who have either intentionally explored their fear of death or those who have had a life experience that brought them to a place of peace and acceptance of their mortality. Some among this later group have shared that by changing their perspective on death, they have also changed how they view humanity and they find themselves more deeply compassionate and understanding of themselves and others.

I would love to know your thoughts on this subject. Please leave a comment below or send me an email at: judithjohnson@hvc.rr.com. Here are some questions to think about:

  • How do you relate to death?
  • Does it scare you or are you at peace with your mortality?
  • Have you had any life experiences that have profoundly changed your view of death?
  • How does the reality of death affect how you live your life?
  • What are your thoughts and concerns about death?
  • What would you like to see our society do differently about how we deal with dying and death?

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.

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.

“For most of human history, people died fast.
Now suddenly, we have the opportunity to grow old,
to have an illness for a long period of time,
and to know what’s coming.
We could make this an important phase of life.”
— Joanne Lynn, M.D., “Americans for Better Care of the Dying”

It may sound peculiar, but there are some very exciting things happening where death is concerned in America. The momentum of change in how we view and respond to death is building in many sectors of society as we transform our culture of death. For example, consider the following changes:

  • People are choosing memorial services and celebrations in addition to or instead of a traditional funeral. This allows for a more personalized ritual customized to the particular beliefs and sensibilities of the deceased. It also allows for both mourning the loss of a loved one and celebrating the life he or she lived.
  • Cremation is rapidly becoming the preferred method of body disposition and is projected to surpass burial, reaching 51 percent by 2025 in the U.S. Traditional funerals and burial rites are becoming one of several options rather than the only way to go. Even burial rites are changing with a growing number of requests for environmentally friendly green burials.
  • In medicine, the mission of preserving life coupled with evermore sophisticated technologies have made it difficult for doctors to see death as anything other than a professional failure. With the introduction of hospice and other palliative care programs over the past 30 years, medical schools and the health care industry are beginning to embrace the emerging culture of compassionate comfort care for the dying.
  • The end of life is no longer being seen simply as a time of diminished capacity spent fighting against an illness that is simply taking its natural course. Instead, there is a growing awareness of the need to take time for coming to terms with one’s death, reviewing one’s life, putting one’s affairs in order, and for saying final goodbyes.
  • Advances are being made in the area of local and internet bereavement services which are helping to reduce the isolation of the grieving and are providing support and education about the grieving process. Businesses are becoming more aware of the impact of grief on productivity in the workplace and, as a result, are increasingly providing educational and support services for their employees and community.

Unfortunately, in our personal lives, death is still largely a taboo topic. Most of us are not comfortable talking to each other about our thoughts and fears about the uncertainties surrounding dying and death. The irrational fear that preparing for death will hasten its arrival or cause medical personnel to “pull the plug” stops many of us from putting our affairs in order in advance of need. It’s been reported 30-40 percent of us still do not have advance health care directives to instruct medical personnel and loved ones about personal preferences for emergency and/or end-of-life medical care. Instead, we tend to just let these things happen and be dealt with while in crisis mode.

The deeper and more profound conversation about the meaning and mysteries of death and how our view of death informs how we live our life has not yet reached public discourse. The prevailing belief remains that life is good and death is bad. When someone dies, most think of it as a tragedy rather than seeing it for what it is — the normal course of events. Yet, dying comes with living. No one gets to live without dying. So, death is every bit as normal as birth is, yet we still shroud it in stigma, fear and rejection. Next week’s article will discuss the potential available to us all, both individually and collectively, in making our peace with death.

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.

Not since your conversation about the birds and the bees have you and your parents faced such a difficult conversation. Sooner or later, adult children and their elderly parents need to talk about the parents’ medical, financial and legal affairs. The inescapable truth is that at some point the responsibility will fall upon the children to ensure the quality of the parents’ care, to carry out their wishes and to finalize their personal affairs. Having an effective dialogue about this will depend on the family’s unique circumstances, the parent’s mental, emotional and physical condition and the quality of family relationships. Here are seven tips for successfully discussing these sensitive private matters.

Above all else, be gentle, kind, loving and supportive – treat your parents as you would wish to be treated.

I welcome your comments.

If you would like to suggest a topic for a future blog or ask me to address a particular situation or issue, please email me 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.

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When going to a doctor’s appointment, just showing up is not enough. There are things you can do to support yourself in getting maximum value from the visit. Many people see doctors as experts who are going to fix them and therefore give over all sense of personal responsibility, waiting to be told what to do. The optimum visit is a dialogue between two experts — don’t forget that you are the expert at living in your body!

Here are guidelines for creating more productive visits with doctors.

1. Be Clear About Your Reasons For Seeing The Doctor When Making The Appointment: They need to know the severity and urgency of your complaint to determine when to schedule the appointment and how much time to allow. What you might dismiss as minor may be a red flag of a potentially serious problem. Conversely, something causing you serious discomfort may require time to heal rather than medical intervention and therefore not be seen as urgent by the doctor.

2. Come Prepared And On Time: It’s a great idea to maintain a notebook or computer file where you keep track of your medical history. Then, when you come to the doctor, bring an up-to-date copy of your medical history and a list of your medications (both prescription and over-the-counter) and any natural remedies, treatments or other therapies you are using. If you are seeing other doctors/health practitioners about your symptoms/diagnosis, be sure to bring relevant materials from them as well as your own notes. Consider typing up a list of your questions and concerns for the doctor to help insure that all your needs are addressed. Be sure to leave space on your list to take notes during the appointment including keeping track of follow-up actions.

Many doctors chronically run late for their appointments. Arrive on time anyway in the event that they are running on schedule. If the doctor is late, consider the fact that it is probably because someone else is getting the help they need. Bring your own reading material and carry it with you throughout your appointment. If you work yourself up into a tizzy over the delay, you are likely to be less effective getting your own needs met during your appointment.

3. Be Specific And Factual About Your Concerns/Symptoms: Prioritize your concerns and share them with your doctor at the beginning of your appointment. Ask to address what concerns you most first. If reporting a new problem, describe the frequency, duration, location and severity of your symptoms as well as what makes it better or worse, any treatments you have tried so far and with what response. Also mention any relevant family history.

4. Get Right To The Point: Don’t beat around the bush. Stay focused on the issue at hand. Try not to ramble or go off topic or to get too emotional if you can help it. If you have a friendly rapport with your doctor, handle your business first and then you can chit chat later if time permits.

5. Be Assertive And Ask For What You Want And Need: Sometimes doctors forget their manners, aren’t listening to you or answering your questions to your satisfaction. Let them know how they are failing to meet your needs. You are paying for their time and deserve their undivided attention. If the doctor seems distracted or is rushing you, express your concern in a positive way. For example, you might say, “I know you are busy, but I really need you to help me understand what is going on with my body.” Getting mad usually doesn’t help — but giving honest and clear feedback usually does.

6. Ask For Further Explanation If You Disagree Or Don’t Understand: Your job is to give the doctor information and feedback. So, do that. Let them know if you don’t follow what they are saying or have a different point of view that you want them to consider. Remember this is a dialogue between two experts.

7. If You Want Your Doctor’s Opinion About A New Drug Or Procedure You Heard About, Ask How It Applies To You: You may not like or agree with your doctor’s point of view but should certainly take it into account in any decisions you make. You can always ask for more of an explanation or consult other doctors, but at some point you need to make an informed decision.

8. Summarize And Be Sure You Understand The Follow-up Prescribed: Columbia University women’s health expert Marianne Legato, MD, suggests you leave the appointment with an understanding of why the doctor thinks you have the symptoms or condition you are experiencing; what lab tests he or she is ordering and why, the doctor’s plan for contacting you about the results and a plan for easing your symptoms. Don’t leave with unanswered questions or confusion. Make sure that you have captured everything in your notes.

Remember, doctors are experts we consult about our health, but ultimately we are left to make our own decisions about what advice, prescriptions and protocols we follow and which we don’t. Take good care of yourself.

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.

We live in a society that has an enormous taboo against thinking about and talking about death. Yet there is a 100 percent probability that each of us will die. For the 80 percent who do not put their affairs in order, their loved ones will pay a very heavy price both financially and emotionally.

Most of us hope and pray that our death will come peacefully during sleep when we are very old. In reality, we never know what day or moment will be our last. According to the United States Census, 10 percent of us die before the age of 60; 45 percent die in our 60s or 70s; and the remaining 45 percent die after the age of 80. The importance of putting our affairs in order obviously escalates as we age, yet one in ten of us will have needed to have our affairs in order before the age of 60. So it is critically important for all adult Americans.

My definition of putting your affairs in order is that at a minimum, all adults need to have two legal documents: a health care proxy and a will or trust. It is best to use the legal forms sanctioned by your state government. Let’s first take a closer look at what these documents are and why they are so important before considering why so many of us fail to execute them.

Healthcare Proxy (aka: Medical Power of Attorney): This legal document appoints someone to make decisions on our behalf regarding our health care in the event that we are either temporarily or permanently unable to speak for ourselves. With all the advances in modern medicine, decisions regarding such things as resuscitation, feeding tubes and Hospice care make it increasingly important for us to thoughtfully consider our hypothetical options in advance of need. We need to consider the circumstances under which these decisions might be needed — for example, the resuscitation of an 18-year-old at the site of a car accident versus a 94 year old in a nursing home. It is imperative that we discuss our beliefs and preferences with the person we appoint as our health care proxy. Some people also document their specific wishes in a Living Will (aka: Advance Healthcare Directives). The appointment of your health care proxy is legally more important than filling out a Living Will as your proxy will be your spokesperson in the event of need.

In the absence of a health care proxy to serve as your spokesperson, many physicians view the death of a patient as a professional failure rather than a natural end to life. Therefore, it is not uncommon for them to err on the side of too much poking and prodding to avoid any opportunity for a lawsuit claiming that they did not do everything possible to save one’s life. This happens despite the fact that repeated studies have shown that increased medical interventions at life’s end have not reduced mortality rates, but have only prolonged the dying process.

A Last Will and Testament or Trust: Wills and Trusts are legal tools that allow us to plan ahead for the disposition of our possessions according to our expressed wishes taking into account the impact of taxes. Very simply, the terms of a will or trust dictate the disposition of one’s property.

Many people think wills and trusts are only for the wealthy. Not so. They are for the smart, regardless of the modesty or magnitude of one’s material and financial wealth. If you have no will, you have no voice or choice. Regardless of how much or how little you have, death in the absence of a will means that state law will direct the disposition of your property.

Some people tell themselves they do not need a will because everyone already knows who is to get what. But, this is an example of why I say wills are for smart people! While your loved ones might know your wishes, unless you have a will, they don’t have the legal authority to distribute your property! A will not only expresses your wishes but grants the authority to enforce those wishes. We have all heard horror stories of families torn apart over who gets Auntie Dorothy’s filigreed vase. Therefore, instead of tempting fate with the possibility of your family members jockeying for position over the disposition of your assets, it is wise to spell out your wishes in a will or trust.

So the question remains: why isn’t it the norm rather than the exception for people to put their affairs in order? The answer is quite simply fear, overwhelm, discomfort and superstition — not very good reasons for failing to execute such critically important documents.

The top five excuses and secret fears for not putting one’s affairs in order:

1. If I put my affairs in order, then I will die very soon.
Not true! There is absolutely no connection. This is simply an irrational fear.

2. I’ll do it later. I’m too busy. Or, I’m young, and therefore have plenty of time.
How much time you have is not in your control.

3. It is all too much. I don’t know where to start. I’m overwhelmed.
Just do it! The risk involved in not having these documents is just too high!

4. It’s too creepy to deal with this stuff.
It’s creepy to change a baby’s diaper, but you do it anyway!

5. It’s too expensive. I can’t afford the legal expense right now.
It will be far more expensive both financially and legally for your loved ones if you don’t get this done and you forfeit the right to direct your own affairs.

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.

Both individually and collectively, we are paying an enormous emotional and financial price for being silenced by our society’s taboo against talking about death and dying. Other societies educate their members about the reality of death and the processes of dying and grieving. We do not. We are left to figure it out for ourselves, relying on doctors and funeral directors to tell us what to do once we are face to face with death. We don’t know what to say, what to do, how to cope or to grieve. Most of us simply let “the experts” lead us around by the nose — too stunned to take charge of the situation ourselves.

Consider the following observations and facts about the costs we bear for this:

(1) Eighty percent of Americans do not put their personal affairs in order before they die.

(2) In 2009, Medicare paid 55 billion just for doctor and hospital bills for the last two months of patients’ lives. That’s more than the budget for the Department of Homeland Security or the Department of Education. And, it’s been estimated that 20-30 percent of these medical expenses may have had no meaningful impact. Most of the bills are paid for by the Federal Government with few or no questions asked. (“The Cost of Dying,” 60 Minutes, 8/8/10

(2) Many doctors view their inability to “cure” a patient as a professional failure and are therefore reluctant to suggest palliative care even when they know there is little to no hope of recovery. Largely as a result, the average stay in Hospice care is just two weeks.

(3) Most hospital patients, relying on doctors to advise them of their healthcare options, fail to take into consideration the vested interests of the doctors and hospitals. As a result, many terminal patients are given false hope by a frenzy of tests and procedures that do little more than protect the doctors and hospitals against potential lawsuits and provide financial benefit to the doctors, hospitals, insurance and drug companies while denying the patient the opportunity to transition into his or her process of dying.

(4) A vast majority of Americans say they want to die at home, but 75 percent die in a hospital or nursing home…18-20 percent of Americans spend their last days in an ICU. ((“The Cost of Dying,” 60 Minutes, 8/8/10)

(5) Most of us have no idea how to discuss the reality of death with our loved ones and are thereby denied the opportunity to share our thoughts, feelings and fears with each other. As a result, many terminally-ill patients put a smile on their faces and silently suffer in emotional isolation.

(6) The average funeral in the U.S., including a cemetery plot and grave, costs between $10,000 and $12,000. Only about 5 percent of Americans preplan their end of life rituals. The rest leave it to their loved ones to figure out while grieving their loss. Bereft family members rely on funeral directors to tell them what to do. Left to second guess what would have been meaningful to the deceased, loved ones typically overspend for fear of not doing enough. Most of us are not even aware of the many less costly and, in many cases, more emotionally gratifying alternatives that are available for saying our final goodbyes.

(7) Legal fees for a simple will are several hundred dollars. The legal fees associated with finalizing an estate where there is no will or a poorly written will run thousands.

(8) While we silently suffer with each other, the medical, accounting and legal estate planning industries are booming at our expense.

For those who agree with me that we need to make some fundamental changes, I’d like to suggest that we begin by breaking through the taboo against talking about death in this country. A good place to start is to explore our own thoughts, feelings and experiences. Taking ownership of our own point of view empowers us to more fully participate in making meaningful decisions on our own behalf and that of those we love. The alternative is to continue to live in denial, fear, silence and paralysis.

I invite you to consider the following questions. You might want to find a quiet place and write your responses:

1. Which of the following best defines how and what you think/believe happens when we die? (More than one might apply).

  • We simply stop being – going out like a fire. Our physical body dies and that is all we are.
  • We are spiritual beings having human experiences and at death our body dies, but our spirit or soul lives on.
  • We only live this one life.
  • Our souls reincarnate, taking on different physical identities to work off karmic
    imbalances accrued from this life and previous lives.
  • We go to heaven, hell or purgatory.
  • Other. Please elaborate.

2. Did anyone educate you about death? If so, who was it and what did you learn?

3. Have you experienced the death of a loved one? If so, what was that like for you? How did it change you?

4. do you think and how do you feel about your own death?

By breaking the silence within ourselves on this topic, we set the foundation for making decisions that are in alignment with our deepest beliefs and values about life and death. It is in claiming these values and beliefs that we are best able to meet our death on our own terms – with greater self-determination about such things as our end of life healthcare, the disposition of our belongings and the kind of end of life ritual that would be appropriate for us. It also supports us in coping with the death of our loved ones.

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.