I read a very interesting article in the NY Times last week called, “A Code Death for Dying Patients” and it got me thinking again about how we would all be better served to return to a time where we appreciated death as a natural part of life…where it’s expected and handled with grace and dignity. I obviously believe that hospice is such a special experience because it delivers that grace and dignity at a time when patients and families need it most.
I believe our biggest challenges surrounding the process of dying are driven by two significant factors….fear and the belief that we should never give up. Fear is often a real motivator for patients and families causing them to make poor decisions when they need to be clear and resolute about what they want to happen next. So much of the fear is caused by a lack of information.
I think we would all benefit from a process that would reimburse physicians for having end of life conversations beginning at age 55 and happening again at 65 and finally at 70. Perhaps doctors can talk about the planning that needs to take place and plant the seeds around the concept of AND, Allowing Natural Death, while also sharing real examples of the lack of success around heroic lifesaving efforts.
Certainly they could provide a basis for getting folks to think about “quality” of life vs. simply thinking about “quantity” of life. Without a doubt, physicians could begin discussing the value of hospice for not only patients…but for their loved ones. They could begin to educate about the idea that it’s not giving up if you make every effort to fill your days with love and compassion while ascribing value to the quality of interactions and not the quantity of interactions. Families would benefit from reviewing a document that comes from those conversations and makes clear the expectations and wishes their loved one has for the end of their journey.
We spend so much money in our efforts to keep folks alive and in the end it’s difficult to see the payback…financially or emotionally. Our healthcare system would be better off if we took a fresh look at educating, affirming life and working to accept the premise that death is but a natural part of the life we were meant to live. Chief Tecumseh said it well in his poem about life:
So live your life that the fear of death can never enter your heart. Trouble no one about their religion; respect others in their view, and demand that they respect yours.
Love your life, perfect your life, beautify all things in your life. Seek to make your life long and its purpose in the service of your people. Prepare a noble death song for the day when you go over the great divide.
Always give a word or a sign of salute when meeting or passing a friend, even a stranger, when in a lonely place. Show respect to all people and grovel to none.
When you arise in the morning give thanks for the food and for the joy of living. If you see no reason for giving thanks, the fault lies only in yourself. Abuse no one and no thing, for abuse turns the wise ones to fools and robs the spirit of its vision.
When it comes your time to die, be not like those whose hearts are filled with the fear of death, so that when their time comes they weep and pray for a little more time to live their lives over again in a different way. Sing your death song and die like a hero going home.