Uticopa Blog

Wasn't it a past US president who said ‘there are two sure things in life: death and taxes'? He was absolutely right, and he wasn't alone. Poets, professors, priests, and the ordinary man in the street have always talked about what unites us all:  in a word, death.

But, what makes a ‘good death'?  Is there such a thing? And how can each of us come to terms with the inevitability of what is facing us?

Education and preparedness is the route.  It's only by understanding and planning for what is to come that we can avoid the stress, anguish and mental unhealthiness that follows avoidance and denial. In truth, death is nearly as unique as the life that came before it - shaped by the attitudes, physical condition, medical treatments, and mix of people that accompanies it.

Many have pointed to a few common factors that can help a death seem good and even inspiring, as opposed to frightening, sad or tortuous. By most standards, a good death is one in which a person dies on his or her own terms, relatively free from pain, in a supported and dignified setting.

But, there are other ways to ease your mind:

• Having your affairs in order 
• Not everyone has the luxury of planning for death. But those who take the time and make the effort to think about their deaths during life and plan for some of the details of their final care and comfort are more likely to retain some control and say-so in their final months and days of life.
• Legal specifics of such planning can include taking steps to get affairs in order by:
• Having an estate plan, with a will, trust, or other arrangement that sets out who gets property and how it should be divided. 
• Specifying final medical care in an advance directive. 
• Making final arrangements for body burial or cremation. 
• Indicating preferences for a funeral or memorial service.
• Psychological preparation includes talking about an impending death with caregivers, family members, and others.
• Controlling pain and discomfort 
• Most people, when asked, say they would prefer to die at home, according to recent polls. Yet the reality is that three-quarters of the population dies in some sort of medical institution, many of them after spending time in an intensive care unit.
• As life expectancy increases, more people are becoming proactive . A growing number of aging patients are choosing not to have life-prolonging treatments that might ultimately increase pain and suffering - such as invasive surgery or dialysis - and deciding instead to have comfort or palliative care in a hospice in their final days. 
• However, this must be the patient's stated wish - not the ‘easy route' by relatives or doctors who are no longer able to care for someone terminally ill.
• Recognise that there are dangers in following the current media obsession with ‘assisted suicide' - hence the reports of the Dignitas Clinic in Switzerland. None of us wants the precipice of the ‘slippery slope' that that kind of mindset conjures up.
• Having few regrets
• Wherever possible, make sure you end life without unfinished business, and for broken relationships to be reconciled.

The right company can help aid a ‘good death'.  Although dying may be frightening, sad or simply unfamiliar to those who are witnessing it, studies of terminally ill patients highlight one common desire: to be treated as live human beings until the moment they die. Most also say they don't want to be alone during their final days and moments. This means that caregivers should find out what kind of medical care the dying person wants administered or withheld and be sure that the medical personnel on duty are fitting in skill and temperament.

Favourite activities or objects can be as important as final medical care. Caregivers should ascertain the tangible and intangible things that would be most pleasing and comforting to the patient in the final days: favourite music or readings, a vase of flowers, a back rub or foot massage, being surrounded by loved ones in quiet or conversation.

Spirituality can help many people find strength and meaning during their final moments. Think about the patient's preferred spiritual or religious teachings and underpinnings, since ensuring access to this can be especially soothing at the end of life.

Above all, I can think of no greater joy than for a dying person to express four thoughts at the end of life:

I love you.
Thank you.
I forgive you.
Forgive me.