That's no way to say goodbye

By Dr. Batya L. Ludman, Psy.D., FT · Published May 16, 2014

My longtime readers will know that over the past 14 years of writing this column, I have not infrequently written about death. As a thanatologist (a word my spellchecker continues to underline in red), I have advanced training and certification in, and frequently deal with, issues of all sorts related to death, dying and bereavement. Counseling people at various stages of living and preparation for moving on is not something from which I shy away. However, many others do, and so I’d like once again to address the importance of talking about death and dying, for yourself and for your loved ones.

A “good death” happens in part because of the meaningful choices you make now and in the future. Although you may not like to think or talk about the time when you or your loved ones no longer walk this earth, most people like to plan how they generally spend their days, and take comfort in being able to do so. While some may say it doesn’t matter what happens once they are gone, as they won’t be here to experience it, others want to know that their end-of-life desires and needs will be addressed and respected.

I have had people in my office express their serious concerns that their wishes will be ignored, and this has upset them greatly.

Years ago, I had the privilege of discussing with each of my parents, in great detail, their wishes in anticipation of the onset of any illness, and helped them to revise their plans when they eventually became unwell. They spoke about what they had hoped for when they were to die, and I was fortunate to be with each parent at the time of their death. My beloved mother went one step further and wrote her own eulogy, and it was read at her funeral. There were no unanswered questions about my dear father’s wishes, either. He and I shared the honor of being on the hevra kadisha (Jewish burial society) in the city where we lived (there is a chapter about this in my book). While having a discussion about death was somewhat difficult, as it meant acknowledging a reality no one wants to face, it was honest, comfortable and reassuring.

For years, my wonderful in-laws have told us exactly what they would like in terms of end-of-life decisions and have already picked out and paid for their burial plots. While that may sound strange to some, this has brought them much comfort and closure, because they don’t want to burden anyone. Sadly they have witnessed many of their friends’ decline and subsequent deaths.

Being able to give your loved one permission to die, as the end draws close, is a tremendous gift. Not everyone can dialogue about death with ease, and those dying often know exactly with whom they can feel comfortable talking, and who cannot handle this important conversation.

Here are a few questions to ponder that may help you become more comfortable with this discussion, whether for you or your loved one.

  1. Is it important for you to talk with your loved ones about end-of-life concerns? If so, with whom would you like your information to be shared, and with whom is it important for you to speak?

  2. Have you written down your desires, and have you let people know where to find this information, or have you discussed in detail what your concerns are?

  3. A living will or end-of-life plan can include anything from what you would or would not like to be informed of should you become ill, to how you would like medical decisions to be handled; from final funeral and burial arrangements, to your message for future generations. Some people, for instance, want to be a partner with their doctor and family in every decision, and others want to leave all decisions to their physicians. Some people want no heroic measures, and others want everything possible to be considered in treatment planning. Are you ready to spend time working on this? If not, are you okay with your reasons for not focusing on this now? I recently discovered an excellent document on the Internet that can help you think about these very important decisions for yourself, and I refer you to to help you get started.

  4. In this day and age, when organ donation is so important, have you shared your feelings and concerns with your loved ones? Do you carry a donor information card?

  5. Being organized is just one gift you can offer to your family. Have you thought about whom you would like your treasures to be left with, and do you have a written will? Have you checked to ensure that your finances are in order, and that you have recorded important information in a way that others can access when needed? Studies have suggested that people who are dying are most afraid of being in pain and being left alone. It is reassuring to know that in 2014 we can help ensure that these and other concerns can be dealt with so that when the time does come to go on to our final resting place, we can do so with greater ease. If you are having difficulty dealing with issues around death, make sure that you seek professional help. This is one area where you certainly don’t have to deal with things on your own.