What does it take to have a good death? And what does that mean?
A good death can mean different things to different people. Although most people say they don’t want to die, it’s the one thing of which we can each be sure; we will die. That has been true since the moment we were born.
Our culture is death phobic. We have medicalized and sanitized the dying process. Most of us still die in hospitals or nursing homes, despite our collectively stated desire to die at home. Funeral homes keep the body until the funeral, sometimes having a viewing of the very made-up dead body. But death as an organic part of life has been mostly removed from us.
And with the lack of direct experience of death comes an unwillingness to talk about it; it has become the elephant in the room. The lack of candor on the part of all involved makes it exceedingly difficult. Family members are often afraid to upset their loved one and bring up the subject of death. Patients can be afraid to upset their family if they bring it up. Doctors and health care workers fear talking honestly about a poor prognosis or an impending death might cause the patient to give up hope.
Experience says otherwise; once the forbidden topic has been breached, there is often a great sense of relief and freedom. Finally, someone has given permission for discussion about what can be a difficult and challenging subject. But that permission can allow for some rich and powerful conversations to occur, and a person can have the opportunity to state what is important to them in their dying process; what they do and do not want to happen.
Being clear about one’s values and choices creates the space for other meaningful conversations during the dying process, and it removes a tremendous burden from family members if they are not left in the position of having to make hard decisions about end of life care for their loved one if they aren’t actually sure what that person wanted.
We can die well. At least we can be clear about how we would want the process to be; how we want our care to be and what we do not want to happen. If we get the choice, we don’t have to die under conditions and circumstances that are not in alignment with our values. But if we can’t talk about what we want, then we might not get to have what would, to us, be a good death.