Dying Well

The art of living well and the art of dying well are one. Epicurus

I know it's coming up - Mother's Day, but my mother is dead. Now I am on the front line as my friends point out. Though I get it, that none of us gets out of here alive, death still feels...well, a lot of things. For now I’ll just say, “weird.” Death boggles the mind. From all my mental stumbling around the topic of death. One practical question has emerged. How does one die well?

Philosophers, poets, artists, and many psychologists urge us to live a meaningful life, then we’ll be able to slip away peacefully with a smile on our face. Da Vinci sums that idea up with “As a well spent day brings happy sleep, so life well used brings happy death.”

Certainly, it can’t hurt to live a meaningful life which is intrinsically rewarding. If a meaningful life leads to a good death, that’s a big bonus.

What, however, contributes to meaning when we’re on our deathbeds? According to Dr. Charles Garfield, an expert on dying well, the dying person finds meaning in two ways. First people get meaning by reviewing who has loved them and who they have loved. Second the dying person finds meaning in thinking about what they have done to contribute to the greater good – to helping others and to making the world a better place.

We might need to get a good head start on these things if we want to die well. As I think about my mother's life, she had loved greatly and was loved greatly in return. Her life was immensely purpose-driven. That part was a slam-dunk for her. She had also written a little autobiographical book which she and her care-givers re-read and discussed in her last few months of life.

Another part which Mom did very well, according to experts, was resolving significant interpersonal conflict before she died. If untangling those relationships doesn’t happen before death, then it needs to happen at the end.

Dr. Ira Byock, a palliative care doctor, wrote in his book, The Four Things That Matter Most, that there are four basic messages people need to work out and express before the end of life. Their loves, as mentioned previously (who they have loved and who loves them), who they want to thank, who they forgive, and who they want to forgive them.

Though Mom had one sister from whom she was estranged, she had done her part in openly expressing her love. She had also given her forgiveness and asked to be forgiven though her sister did not reciprocate. That’s okay if it ends up being one-sided according to Byock. Expressions of love, gratitude, giving and asking for forgiveness can be acknowledged even with people who have already died.

With meaning and relationships in order – what remains for a good life ending? For the rest, we need a little help from our friends. Mom had given me clear health care directives which I relayed and had enforced though she lived in Tennessee and I was in Washington. No artificial nutrition by tube, no artificial resuscitation. Yes, do relieve pain and suffering through medication or whatever is needed unless relief involved moving her. Still it was hard for me to do. Up until a few days before her death, I was still hoping for her recovery.

Luckily, friends and caregivers, helped me see when it was time for hospice care. Afterwards, I realized how helpful that was for Mom at the end. She had also hoped to see her sisters. One of them was able to come see her and she was able to talk daily with the other.

Other than those things (finding meaning, cleaning up relationships, following health directives and other desires), what I realized, and researchers agree, is that loving presence as one is dying is extremely important for most people. Mom had wonderful caregivers who continued to talk to her, play her favorite music, hold her hand, and to treat her as an important person even after she had several strokes which left her with no ability to speak, move, eat, or even smile. My husband and I continued to call every day. Her friends and relatives continued to visit.

One of her favorite people, we all called him “Chief” (because he was a chief of police), visited Mom a few days before she died. Chief leaned over and kissed Mom and told her he loved her. Miraculously she whispered, “I loved you too.” She was still in there!

I don’t know if this matters to others, but it mattered to Mom,(and it turned out to matter to me) to have all her ducks in a row. By that I mean she had already given me information for her obituary, had prepaid for her service and burial, and knew what she wanted done for her funeral. There was some last-minute drama from a few of Mom’s friends who thought some things should be done differently than I did. Luckily I could simply say, “This is what Mom wanted.” End of discussion.

I’m still looking to Mom, even after her death, as my role-model. I still have a lot to do. Top of mind...I am making sure that I remember the people in my life whom I love and who love me. I bring them to mind regularly and check in with visits, calls, emails, and texts. I am also doing my best to encourage others (and continuing the journey myself) regarding the importance of compassion for ourselves and others. We are human creatures. We have many avenues for experiencing meaning and joy, particularly through our relationships. We also suffer. We die. As strange as the process of death seems, even wilder is this feeling that we are still connected.

How might we live the good life all the way until the end by considering right now how we might die well?