Saturday, December 30, 2017
"Gerontologists call this the paradox of old age: that as people’s minds and bodies decline, instead of feeling worse about their lives, they feel better. In memory tests, they recall positive images better than negative; under functional magnetic resonance imaging, their brains respond more mildly to stressful images than the brains of younger people."
Want to Be Happy? Think Like an Old Person - The New York Times
Why you should make end-of-life care decisions now - LA Times
Take one hand and hold is gently on your heart as if you were holding a vulnerable human being. You are. As you continue to breathe, bring to mind the loss or pain you are grieving. Let the story, the images, the feelings comes naturally. Hold them gently. Take your time. Let the feelings come layer by layer, a little at a time.
Keep breathing softly, compassionately. Let whatever feelings are there, pain and tears, anger and love, fear and sorrow, come as they will. Touch them gently. Let them unravel out of your body and mind. Make space for any images that arise. Allow the whole story. Breathe and hold it all with tenderness and compassion. Kindness for it all, for you and for others.
The grief we carry is part of the grief of the world. Hold it gently. Let it be honored. You do not have to keep it in anymore. You can let it go into the heart of compassion; you can weep. Releasing the grief we carry is a long, tear-filled process. Yet it follows the natural intelligence of the body and heart. Trust it, trust the unfolding."
A Meditation on Grief - Jack Kornfield
Wednesday, December 27, 2017
Recipes for a Tidy and Tasty Death - The New York Times
Tuesday, December 26, 2017
Sunday, December 24, 2017
Immortality at Midnight - The New York Times
Difficult Sibling Relationships During the Holidays - AgingCare.com
Thursday, December 14, 2017
Monday, December 11, 2017
When a parent gets too old to live on their own but doesn't want help. - The Washington Post
When a parent gets too old to live on their own but doesn't want help. - The Washington Post
Thursday, December 7, 2017
All the while she replayed the events surrounding her daughter’s life and death, mulling the circumstances that compounded the pain, and the kindnesses that offered slivers of relief. She thought often of the anonymous stranger who gave up a bed in the hospital sleep center so that she could rest for a few hours without being far from Eleanora. And she thought about the calls from the insurance company, asking when, precisely, they expected their daughter to die.
“Do you think she’s going to live for 10 days? Or do you think she’s going to live for more than 10 days? Because I have to fill out different paperwork,” Joyal remembers the insurance representative saying.
Joyal began applying her policy brain to the issue and found that parents who’ve lost children are a vastly understudied group. Yet the little research that has been done shows devastating results. “The National Academies of Science said in a report that child death is the most stressful [event] and enduring type of stress a person can experience,” she says. Other studies showed that losing a child results in increased likelihood of psychiatric hospitalization, cardiac problems and premature death.
Monday, December 4, 2017
High-Tech Suicide Machine Makes Death a Painless, Peaceful, Optimal Way to Go | Alternet
Saturday, December 2, 2017
Readers shared their most intense postmortem social media moments.
Monday, November 27, 2017
Grief by Gwen FlowersHealing Arts_Poetry by Gwen Flowers
I had my own notion of grief.
I thought it was the sad time
That followed the death of someone you love. And you had to push through it
To get to the other side.
But I'm learning there is no other side.
There is no pushing through.
But rather, There is absorption. Adjustment. Acceptance.
And grief is not something you complete,
But rather, you endure. Grief is not a task to finish
And move on, But an element of yourself- An alteration of your being. A new way of seeing. A new definition of self.
Sunday, November 26, 2017
What a Home Funeral Is Really Like - True Story of Dying at Home
Tuesday, November 21, 2017
"I had totally failed my friend. I had wanted to comfort her, and instead, I'd made her feel worse. At that point, I still felt she misunderstood me. I thought she was in a fragile state and had lashed out at me unfairly when I was only trying to help. But the truth is, she didn't misunderstand me at all. She understood what was happening perhaps better than I did. When she began to share her raw emotions, I felt uncomfortable. I didn't know what to say, so I defaulted to a subject with which I was comfortable: myself. I may have been trying to empathize, at least on a conscious level, but what I really did was draw focus away from her anguish and turn the attention to me. She wanted to talk to me about her father, to tell me about the kind of man he was, so I could fully appreciate the magnitude of her loss. Instead, I asked her to stop for a moment and listen to my story about my dad's tragic death."
Celeste Headlee The Mistake I Made with My Grieving Friend
Friday, November 17, 2017
Tuesday, November 14, 2017
"The simple practice of caring for him made me love him more than ever before. He was on a heavy dose of morphine the day we took him off life support, and after the doctors left the room, I sat with him and stroked his beard, which the doctors had let grow back to its normal length because there was no reason to keep it trimmed. I started talking, saying all the things they suggest. “I love you. I forgive you. Forgive me. Thank you. Goodbye.” He opened his eyes and rolled them over in my direction. Did he see me? Had he ever seen me? I kept talking, He closed his eyes and did not open them again. For all of my grappling with my feelings, and for all the lies that cinema tells about the death of a family member, this was as close to a "Magnolia Moment" as I was going to get. And yet frogs did not fall from the sky. He slipped away, and I am left searching the movies for answers, still struggling to make sense of a relationship that I couldn’t find the courage to scrutinize while he was alive. The credits have rolled, but I’m still waiting for the movie to end."
The Lies of the Deathbed Scene (and Also the Truth) | Balder and Dash | Roger Ebert:
Saturday, November 11, 2017
Does the very idea of death worry and frighten you? There may be reassurance from a new study that finds those fears might be exaggerated. In fact, the research shows, death is often described as a peaceful, "unexpectedly positive" experience by those who approach it. Death is one of life's guarantees, yet it's something people often avoid talking about, according to study author Kurt Gray. He's an assistant professor at the University of North Carolina at Chapel Hill. "There's almost an unspoken assumption that death is something to be avoided at all costs," Gray said. But his team found that the abstract concept of death may be scarier than the reality.
Dying May Not Be as Awful an Experience as You Think
And while this metastatic cancer will one day kill me, the advanced-care planning conversations I have had with my health-care team have been lifesaving since my diagnosis. I use the word “lifesaving” advisedly because that is what these conversations are truly about. When done well, they can shape care in ways that give people with serious illness a chance at getting the best life possible. This kind of conversation initially helped my care team understand what was important to me and helped clarify my goals of care. Faced with an incurable disease and a prognosis where only 11 to 20 percent survive to five years and there is no statistic for 10-year survival because it so rarely happens, I came to understand that my priority was to seek a “Niagara Falls trajectory” — to feel as well as possible for as long as possible, until I quickly go over the precipice. Quality of life is more important to me than quantity of days, if they are miserable days.
A nurse with fatal breast cancer says end-of-life discussions saved her life - The Washington Post
Tuesday, October 31, 2017
The two law professors draw on books, movies, philosophy, economics, and opera and the book is filled with insights about the ways we find meaning and connection as we think about the past and as we make decisions about the future. In an interview, they answered questions about late-life romance, growing old with grace, and making end of life decisions.
Do you have a favorite example of growing older?
SL: Warren Buffett has grown old with such grace and openness to new ideas.
MN: A common weakness of aging is that people exaggerate their prior defects, being less constrained by how other see them: the excessively talkative becomes insufferably so, the narcissist becomes virtually psychopathic, the nasty and inconsiderate more inconsiderate still. I love it when people really learn something and become better. My late colleague Bernie Melzer, who apparently used to be pretty tough and nasty in his youth, was so graceful, serene, and gentle as he aged. He listened to others more, and tried to understand his own past (as the youngest prosecutor at Nuremberg) in a way he had not done before.
How should we ask and who should we ask, as you suggest Atticus ask of Cicero, for an outside assessment of whether we are still personally and professionally able to perform?
SL: One good way is as a joint activity. We choose someone about our age and accept the fact that one of us is likely to lose it and do danger before the other. Another often more appropriate method is to find a person who is much younger but who also thinks about aging. You want someone whom you will not think is telling you to step down because he or she gains from it.
MN: I think trust is so rare and so important. Basically, you look for a true friend, and that’s not such an easy thing to find. Cicero’s letters show such a long-lasting friendship, with a trust that came from shared activities, interesting differences, but also gossip, teasing, and a depth of commitment that’s rare.
In dealing with regret, how do you know when to try to make amends, do what was undone, or just let go?
SL: As I age I find that serious apologies are more valuable. I try not to explain the reason for my error – as that often sounds like justification rather than apology – but simply say that I understand the wrong.I think an apology is often for oneself as much as it is for the listener.
MN: I think it’s crucial not to believe that apology takes the place of getting on with life and making it better going forward. It’s easy to wallow in guilt, particularly for those of us raised in Judeo-Christian cultures. But guilt is useful only if it changes the future, since it cannot change the past.
You describe “the Scylla of excessive deference to ‘nature’ and the Charybdis of obsession with flight from age.” How do we distinguish between vanity and upkeep? When does trying to hold on to youth become counterproductive?
SL: An especially good question. I think for many aging people there comes the point where they are no longer holding on to youth so much as trying to be younger than other people of their age. No 75 year old thinks he is the strongest and fittest, but he might think that he bench-presses in a manner that is enviable for someone of that age. That’s not bad. So if you find yourself really thinking you are like a young person, it is excessive!
MN: Yes, totally. Essentially you need to love yourself and try to be the best that YOU can be, not someone else. But that is difficult, since we all, but perhaps especially women, are held up to rigid social expectations.
Is it true, as the song says, that “love is lovelier the second time around?”
SL: For some people no doubt, but how could that be generally? Imagine a rule that divorce or some other breakup was were required after 30 years. Would not everyone think that was an absurd requirement. People like to choose.
MN: But there is something about love in later life that is special, or at least can be: a degree of self-knowledge that’s not possible before, an understanding of time and change, a sense of humor about oneself.
What is the most constructive way to think about the past? How do we know if we are dwelling on the past for escape rather than understanding?
SL: If we learn things that are slightly unpleasant it is unlikely to be escape. It is such fun to change one’s mind or come to new views! I like the way so many older people have come to embrace same-sex marriage or other arrangements they could not fathom much earlier in life. Those are not escapes, they are wise or perhaps a quest to be young, but in a good way.
MN: It is hard to know how far searching for self-understanding in the past is valuable; I do think it has some value, but I totally agree with Saul that at any rate one must not do this in a way that precludes future-oriented curiosity and new learning.
What can we do now to keep Gen Xers from being “the elderly poor of the future?”
SL: Increase social security, though it is a costly solution.
MN: Learn from the Nordic countries, who certainly have not totally solved this problem, but at least they understand that we’re all in this world together and we must support one another.
How can we care for older people, including those who are impaired, while maintaining their privacy and dignity?
SL. What’s so great about privacy? If someone treats me with respect, I don’t mind that they know my flaws.
MN: I agree, but I do find that as one becomes well-known one is expected to be an open book, and I like to preserve a lot of space for mystery and for true intimacy, which is not compatible with blabbing everything on Facebook. My solution is that I am not on any social media, not even Facebook.
How can we help people maintain control about end of life decisions?
SL: We can ask them to make decisions in advance but of course they might change their mind(s). In the end, it is impossible except to delegate to a person who seems like minded at an earlier stage of life. Thus, some people will delegate to a religious figure but others would know that is the worst thing for them.
MN: Right, it’s the problem of trust again. Our society gives children the default position here, but children often are bad at this, because it is too upsetting.
What gives a gift of assets accumulated over many years the most meaning?
SL: Two ideas. One is that life is so much easier when one is not fearful, and one has the means to relax and do without tension (about money). A gift that provides that security is so valuable, and can be repeated to the next generation. Second, there is trust. If I give a child money with the wish that that child give it to a worthy cause, that shows great faith in the child, a nice gift.
MN: Well, I totally agree, and so for once I am mute.
Originally published on HuffPost.
Wednesday, October 25, 2017
TIME reports: [A]s the industry has grown, the hospice care people expect — and sign up for — sometimes disappears when they need it most. Families across the country, from Appalachia to Alaska, have called for help in times of crisis and been met with delays, no-shows and unanswered calls, a Kaiser Health News investigation published in cooperation with TIME shows.
The investigation analyzed 20,000 government inspection records, revealing that missed visits and neglect are common for patients dying at home. Families or caregivers have filed over 3,200 complaints with state officials in the past five years. Those complaints led government inspectors to find problems in 759 hospices, with more than half cited for missing visits or other services they had promised to provide at the end of life.
Tuesday, October 24, 2017
The woman who cleans up after 'lonely deaths' in Japan | Japan | Al Jazeera
[T]he concern for women is that the final decision to end their lives may nevertheless be influenced by risk factors that challenge the rhetoric of “choice.”
Here are some of those “gendered risks”.
Longer life span
More likely to experience their partner’s death
Fewer economic resources in old age
More self-sacrificial and less assertive
Women are arguably more self-sacrificial and less assertive than men, whether by nature, socialisation or simply in terms of society’s ideals about femaleness.
Women demonstrate a stronger preference for more structured, passive methods of suicide, with significant physician participation.
More likely to attempt suicide
Entrenched patterns of violence against women
Saturday, October 21, 2017
Saturday, October 14, 2017
In “Patton Oswalt: Annihilation,” the comedian opens up about the death of his wife and how he dealt with his grief over the past year. “It’s therapeutic, but it’s very, very terrifying getting to the therapeutic part. Really terrifying,” Oswalt told TheWrap ahead of the special’s release. He added that “it can be really frightening” to use his grief as part of his comedy because “I don’t know if it’ll end up being therapeutic and I don’t know if it’ll end up like, tainting the therapy if I’m also doing it as part of my comedy.”
Patton Oswalt Gets Personal In New 'Annihilation' Netflix Comedy Special:
Saturday, September 30, 2017
Wednesday, September 20, 2017
When death looms, we are all lost children. This is when we long for ritual and ceremony to help us honor our humanity and feel held by something larger. We've found some of our favorite readings to share with you, and ceremony templates to help you envision what might be possible. Use them to create what fits the dying or deceased person you are honoring, your family and friends. We welcome you to build a loving, digital obituary here too. If you need more personalized support, please reach out for help.
When I was in the government, I worked on the rule described here that requires disclosure of funeral costs. Note the main point below -- what you spend on the funeral is not a reflection of your feelings for the person who has died. Increasingly, families are choosing simple, ecologically friendly funerals with simple, unpolished wood caskets or cremation.
Dying can be an expensive proposition, and when the death of a loved one occurs, nobody is in the mood to go comparison shopping or start hunting down deals. The median cost of a funeral home’s services is $7,180, according to 2015 data from the National Funeral Directors Association. But that’s just the funeral home.
Add to that cemetery costs, grave-digging and grave markers, and Parting.com says the average funeral in the U.S. can cost more like $10,000. And the Federal Trade Commission says even that may be underestimating things. Sometimes, $10,000 barely covers the cost of a casket alone ― especially if you were thinking mahogany or copper. But there are ways to save money on your death. And remember, the amount of money someone spends on a funeral bears no correlation to how much the deceased was loved. Practical people die too.
7 Ways To Save Money When You Die | HuffPost
Sunday, September 17, 2017
To Bereaved Parents
- “You Are So Strong.” In reality we are exhausted from trying to look strong. Try this instead: “I know it’s hard to be strong right now. I’m here for you to lean on anytime. I have an open heart and time to listen.”
- “Be Glad You Have Other Children.” We may have other children, but they cannot replace the child we’ve lost. Try this instead: “No child is replaceable, but I hope having your surviving children around you helps in easing the pain of your loss.”
- “You’re not the first mother who has lot a child.” Yes, but this is the first time I’ve lost my child. Try this instead: “I know mothers who have lost children and how much they grieved. That has made me aware of what a fight this is for you. You will continue to be in my thoughts.”
- “My child almost died, I know how you feel.” If you said this, you only had a clue about how it might feel to lose a child. Try this instead: “My child had a close brush with death, which was terrifying enough. There can be no comparison to actually losing a child.”
- “Time heals all wounds.” In time the mind covers wounds with scar tissue and pain lessens. But it’s never gone. Try this instead: “I hope in time your pain and grief will soften. Knowing it will take time, I stand beside you for the long haul.”
- “Everything Happens for a Reason.” There is never a good enough reason as to why our children were taken. Try this instead: “It goes beyond reason for any child to be taken from a mother. There was certainly no good reason to lose yours.”
Thursday, September 14, 2017
Joanne Fink's new illustrated book, When You Lose Someone You Love, is a touching reminder that just when we feel most alone, we can reach out to find compassion and understanding. It will be released October 10, 2017 from CompanionHouse Books.
Tuesday, September 12, 2017
John Cleese: It is. Death is certainly present in my life, and there’s humor to be mined from it. Somebody was saying to me last week that you can’t talk about death these days without people thinking you’ve done something absolutely antisocial. But death is part of the deal. Imagine if, before you came to exist on Earth, God said, “You can choose to stay up here with me, watching reruns and eating ice cream, or you can be born. But if you pick being born, at the end of your life you have to die — that’s non-negotiable. So which do you pick?” I think most people would say, “I’ll give living a whirl.” It’s sad, but the whirl includes dying. That’s something I accept.
John Cleese on Monty Python and Political Correctness:
Sunday, September 10, 2017
Saturday, September 9, 2017
A gentle parting eases the pain of death:
seventysomething: When it's time to stop fixing life's holes | PBS NewsHour
[H]ow should educators handle the death of a student's loved one? A new website — GrievingStudents.org — is trying to help teachers and school leaders answer that question. It's a database of fact sheets, advice and videos...."The teachers want to know exactly what and what not to say to a student." And that's the challenge: Most teachers aren't trained social workers. Which is why Luz Minaya welcomes the extra resources. She teaches Spanish and technology at a public middle school in New York City. The 17-year teaching veteran says she received "no training" for how to deal with student grief. "You go to college and you study to become a teacher. But no one tells you how to deal with the emotional aspect of students," Minaya says. Her school has a large population of Latino students. Many are very close to their grandparents, Minaya says, and when an elder dies, she's seen that grief affect behavior, attendance and performance. "Teachers really have a major role in the safeguarding of the student," Minaya says. "I don't want to have to depend on the guidance counselor or wait for the social worker who comes once a week." The Coalition's new site includes lots of guidance for teachers that's refreshingly specific, like this: Avoid comparisons. Saying "my father died, too" shifts attention to a competing loss and away from the grieving student. Also, avoid trying to comfort a student with any sentence that begins with "at least." Educators shouldn't try to make light of the situation or find good in the sad, says Schonfeld. The teacher's goal should be to support grieving students by making clear to them that they are safe and have someone to talk to.
Grief In The Classroom: 'Saying Nothing Says A Lot' : NPR Ed
Tuesday, September 5, 2017
Sally Quinn on her husband Ben Bradlee's struggles with dementia in his final years - The Washington Post
Sally Quinn on her husband Ben Bradlee's struggles with dementia in his final years - The Washington Post:
Friday, September 1, 2017
I’ve realized that Grief doesn’t just visit you for a horrible, yet temporary holiday. It moves in, puts down roots—and it never leaves. Yes as time passes, eventually the tidal waves subside for longer periods, but they inevitably come crashing in again without notice, when you are least prepared. With no warning they devastate the landscape of your heart all over again, leaving you bruised and breathless and needing to rebuild once more. Grief brings humility as a housewarming gift and doesn’t care whether you want it or not. You are forced to face your inability to do anything but feel it all and fall apart. It’s incredibly difficult in those quiet moments, when you realize so long after the loss that you’re still not the same person you used to be; that this chronic soul injury just won’t heal up. This is tough medicine to take, but more difficult still, is coming to feel quite sure that you’ll never be that person again. It’s humbling to know you’ve been internally altered: Death has interrupted your plans, served your relationships, and rewritten the script for you. And strangely (or perhaps quite understandably) those acute attacks of despair are the very moments when I feel closest to my father, as if the pain somehow allows me to remove the space and time which separates us and I can press my head against his chest and hear his heartbeat once more. These tragic times are somehow oddly comforting even as they kick you in the gut.
The Day I'll Finally Stop Grieving
Friday, August 25, 2017
Is stoicism the best way to cope with the “miasma of melancholy” (Nora Ephron’s phrase) that can shroud the declining years? William Hazlitt thought so: since there has already been, for each of us, “a time when we were not”, and this “gives us no concern”, why be afraid of death? Julian Barnes saw off such arguments in his book Nothing to Be Frightened Of, as did Larkin in his poem “Aubade”.
McCrum is more patient with those who find reasons to be cheerful. “If you have religion,” Sally Vickers (a Christian) says, “it gives the drama of death a place in the theatre of things.” As to ageing, Adam Phillips argues that “Every stage of the life cycle is interesting”, and there are “more possibilities when we are 70”.
Denial is another coping mechanism (William Empson considered death a topic “people should be prepared to be blank upon”). It doesn’t let you off the grave but may ease your passing. When McCrum visits a friend who is dying from leukaemia, he’s troubled by his deluded talk of recovery. But he accepts that it would be cruel to disenchant him. I had a similar experience with my father. Having been told the worst (inoperable cancer, just weeks to live), and having made sure I knew it too, he chose not to discuss it again.
“The dying have a right to their decease,” McCrum says, though in the UK the law is stacked against them. What terrifies most of us is the prospect of dependency. We had it before, as infants, but have no memory of that; this time we’ll be conscious of it, with the knowledge that our dependency will only get worse. Interventions that prolong life can also impair it; as the neurosurgeon and author Marsh says, death is often a preferable outcome. McCrum himself hopes for a quick death, in his sleep; better that than a decade of incontinence in institutional care. Yes, the will to live persists, even in those with no quality of life. But if their brains were fully functional, would they choose to go on?
Every Third Thought by Robert McCrum review – how to think about death | Books | The Guardian:
The Sacred Silence of Visiting the Dying - The Manifest-Station
New Japanese augmented-reality service lets you meet with deceased loved ones at their graves | SoraNews24
The Japanese tombstone-engraving company Ryoshin Sekizai has released a new augmented-reality service that is sure to change lives… and deaths. They’re offering to set up a virtual “gravesite” for your deceased loved ones, where you can visit them as if they were really there.
New Japanese augmented-reality service lets you meet with deceased loved ones at their graves | SoraNews24:
But his email account lived on. I would leave it logged in and up on my computer on the tab to the left of my own email. (I still do.) He wasn’t getting many emails, mostly junk or notices from various lists he had been on — notifications from Alice’s school and alerts about lost neighborhood dogs. Then one day a new message popped up: “hi dad” I stared for a while at Alice’s message, so plaintive and weightless, without even the anchor of punctuation. I wondered if I should reply. I asked a therapist friend, who said: “Don’t answer as her father unless you ask Alice and she agrees to it.” It took me a few days to figure out how to ask Alice casually. During that time, I searched and read every email and text he had sent her. I studied his punctuation, his cadence, his vocabulary and his endearments. So many exclamation points. And then I texted her: “I’m on your dads email. can i write you from it?” She replied: “wait what? oh ok” “i guess i want to pretend,” I explained."
Are You There, Dad? It’s Me, Alice - The New York Times
Thursday, August 24, 2017
ABC Breaking News | Latest News Videos
"When you don't look like yourself, you don't feel like yourself, and your personality changes,'' he said. "When she's glammed back up, her personality shines." Christine, who suffers from mild dementia, has become a bit of a star and earned the nickname "Glams" since Quinn began livestreaming the makeup sessions on Facebook. "With the elderly, they can really start to become isolated when their friends move away or pass away,'' Quinn said. "The Facebook videos allow her to interact, and she loves it." Initially Quinn could only get away with putting some foundation and lipstick on his mother, but now he says she's open to brighter colors and more glamorous looks. "She gets a kick out of it now,'' he said. "Sometimes when people are on medication, it kind of squishes their personality. I tell the nurses, 'Give me 20 minutes with my mom to do her makeup, and you will see an entirely different person.'''
Makeup artist's magic helps cheer his mom after his brother's death - TODAY.com
Tuesday, August 22, 2017
Most hospices fare well in first public release of Medicare quality scores
Sunday, August 20, 2017
I'm so often asked what it's like working with death, both those who are aware they're nearing the end of days, accompanying them through their death vigil, and working with families caring for their own dead....Something almost magical happens for many who are dying. Once they get through the initial shock of a diagnosis, once they've processed where they are, and what this means, and made some decisions, and begun to get some of their ducks in a row, there is a shift...to something incredibly powerful.They nearly always reach this stage where more than anything, they want to squeeze every drop of living out of every day that remains. And doing this work? You get to be a part of that journey, a part of that beauty and magic and wonder. Yes, there's a bittersweet element to it, but oh, the sweet parts? Are so very sweet!And no, it isn't this way every time; it's far more likely to happen for clients who transitioned to or have a plan in place for palliative care. If they're yet fighting to survive, and if that fight involves an endless merry-go-round of treatment, they're likely caught up in that rig-a-ma-roll - and all too often folks aren't transitioned to palliative care when they should have been - but that will be a different diary entry, one all about cure versus care.But oh, when someone reaches this space; when they've come to terms with the reality of their mortality, and they're free to look at what remains, from a deeply authentic place? These folks are oftentimes some of the most fully present, deeply alive people you will ever encounter. Time and again I am told something like, "Cancer gave me a gift, a gift I wish I'd long ago been smart enough to realize I'd always had: It helped me realize what really matters. Oh, if only I'd realized this sooner. But at least I have now, and I'm going to make every last minute count."Being around these folks, yes, it can be bittersweet, yes, but oh, how beautiful it can be, and how glorious to engage so frequently with folks who are living from a place of such depth, such authenticity.
Death Doula Diary: Working At The Bookends of Life
Sunday, August 13, 2017
In Barbara Cook’s Final Days, Her Friends Came to Sing at Her Bedside - The New York Times:
Friday, August 11, 2017
To qualify for hospice care, two doctors must certify that a patient is expected to live no more than six months. But patient James B. Nelson discovered that sometimes the doctors are wrong.
"It was decided that I was not dying fast enough," he told Arizona Public Media in 2015. "And so, to put it most succinctly, I flunked the hospice program."
Nelson died a few months after giving that interview, but his situation isn't all that unusual.
Government reports show that the median rate of hospice patients discharged before death has climbed steadily since at least 2000, peaking in 2012 and 2013 at almost one patient in five, though more recently the percentage has declined somewhat. But the rate actually varies widely from one care organization to another. Some hospices discharge less than 2 percent of their patients prior to death, while others discharge more than 80 percent. Non-profits have lower rates of live discharge than for-profit hospices. Regionally, live discharge rates are highest in the South.
It's important to understand, though, that when patients are discharged from hospice, they don't necessarily go anywhere. Hospice agencies, whether they are independent or affiliated with an institution like a hospital, usually deliver services to patients in their homes.
Thursday, August 10, 2017
I told Dr. Monaco we have a terminally ill patient who needs to eat and that cosmetically, replacing the front teeth would do a lot to lift his spirits. Dr. Monaco didn’t hesitate; he told me to bring Mr. Sacchetin in and that there would be no charge for his services. When I told Mr. Sacchetin, he was deeply moved.”
Rager’s husband came to the Center first thing that Tuesday morning to bring Sacchetin to his appointment. Monaco took the dental impression and fitted Sacchetin with a “flipper,” an appliance that is commonly used for patients who require something the same day, whether due to trauma or extraction. It was ready that afternoon.
“My heart really went out to him. As soon as I saw him, I knew it was the right thing to do,” said Monaco, who not only waived his fee but also covered the lab costs out of his own pocket. “I was eager to help out in any way I could for someone in need like that,” he added.
When he got his teeth back that afternoon, Sacchetin turned to Monaco with a huge smile of thanks and said, “Beautiful.”
Monaco said the experience nearly brought him to tears. “It really showed that human part of all of us that says ‘I want to leave this world with a smile, looking the best that I can.’ He was so happy when the flipper went right in with a perfect fit, and it was so important to me that he was happy.
A Smile at the End of Life
Monday, August 7, 2017
Please read this before you post another RIP on social media.:
Sunday, August 6, 2017
CONFESSIONS OF A FUNERAL DIRECTOR » 10 Pieces of Advice for Picking Up a Dead Body
Building a system for assisted death from scratch, Li found, was a daunting task. To protect doctors who wanted nothing to do with the practice, she created a specific MAID team for UHN: 18 people to do the assessments and 13 to do the procedure itself. When a patient requests a medically assisted death, the front line doctor alerts the team, which takes over the end-of-life process. Two doctors perform the assessments. A third performs the procedure.
Figuring out the best method for death was also complicated. In Oregon, where assisted death is legal, doctors can write patients a prescription for a lethal oral medication and then walk away. Canadian physicians were surprised to learn that the barbiturates used in that protocol weren’t available here. Instead, doctors and nurses deliver a series of drugs intravenously, a process that is far more intimate than writing a prescription. Assisted death, the polite euphemism used to describe the act, is really a misnomer. Doctors don’t “assist” in a death; they are the active agents. “We are doing euthanasia,” says Li. “We are actively ending a life. And it’s very new to us.”
The doctors who assist in suicide on what it's like to end a life
Saturday, August 5, 2017
"Fratkin is an internist and specialist in palliative medicine. He's the guy who comes in when the cancer doctors first deliver a serious diagnosis. He manages medications to control symptoms like pain, nausea and breathlessness. And he helps people manage their fears about dying, and make choices about what treatments they're willing — and not willing — to undergo."
Rural Doctor Launches Startup To Ease Pain Of Dying Patients : Shots - Health News : NPR
A woman’s dying wish was a milkshake. So a restaurant 3 states away made sure she got it. - The Washington Post
From her hospice bed in Arlington, Emily Pomeranz said she wanted two last things — a Cleveland Indians hat and a mocha milkshake from a restaurant back home in northeastern Ohio. Pomeranz, 50, was dying of pancreatic cancer, and an old friend, Sam Klein, wanted to make her wishes come true. The first was simple. The second would require some ingenuity. Klein said in a Facebook post this week that he contacted Tommy’s Restaurant in Cleveland Heights and inquired about a long-distance milkshake delivery. “’Yes. We will figure out a way to do this,’” Klein quoted the popular restaurant’s owner, Tommy Fello, as saying. Within days, Klein said, that mocha milkshake had made it some 375 miles, across several states, to Pomeranz’s bedside.
A woman’s dying wish was a milkshake. So a restaurant 3 states away made sure she got it. - The Washington Post
Friday, August 4, 2017
A Quaker Approach to Living with Dying
Medicine has become a service industry, and it's making doctors unable to confront death | Seamus O'Mahony | Pulse | LinkedIn
Medicine has become a service industry, and it's making doctors unable to confront death | Seamus O'Mahony | Pulse | LinkedIn:
Senate approves ‘Right to Try’ bill to allow terminally ill patients access to unapproved drugs - MarketWatch
Senate approves ‘Right to Try’ bill to allow terminally ill patients access to unapproved drugs - MarketWatch:
Senate approves ‘Right to Try’ bill to allow terminally ill patients access to unapproved drugs - MarketWatch
Senate approves ‘Right to Try’ bill to allow terminally ill patients access to unapproved drugs - MarketWatch:
In taking part in “You Can’t Ask That,” I wanted to do my bit to change things around, to win back some dignity for the dying, because I don’t think silence serves the interests of any of us. The questions, as it turned out, were unsurprising. Did I have a bucket list, had I considered suicide, had I become religious, was I scared, was there anything good about dying, did I have any regrets, did I believe in an afterlife, had I changed my priorities in life, was I unhappy or depressed, was I likely to take more risks given that I was dying anyway, what would I miss the most, how would I like to be remembered? These were the same questions I’d been asking myself ever since I was diagnosed with cancer, back in 2005. And my answers haven’t changed since then....Yes, I have considered suicide, and it remains a constant temptation. If the law in Australia permitted assisted dying I would be putting plans into place right now to take my own life. Once the day came, I’d invite my family and closest friends to come over and we’d have a farewell drink. I’d thank them all for everything they’ve done for me. I’d tell them how much I love them. I imagine there would be copious tears. I’d hope there would be some laughter. There would be music playing in the background, something from the soundtrack of my youth. And then, when the time was right, I’d say goodbye and take my medicine, knowing that the party would go on without me, that everyone would stay a while, talk some more, be there for each other for as long as they wished. As someone who knows my end is coming, I can’t think of a better way to go out. Nor can I fathom why this kind of humane and dignified death is outlawed....Yes, I’m scared, but not all the time. When I was first diagnosed, I was terrified. I had no idea that the body could turn against itself and incubate its own enemy. I had never been seriously ill in my life before; now suddenly I was face to face with my own mortality. There was a moment when I saw my body in the mirror as if for the first time. Overnight my own flesh had become alien to me, the saboteur of all my hopes and dreams. It was incomprehensible, and so frightening, I cried. “I can’t die,” I sobbed. “Not me. Not now.” But I’m used to dying now. It’s become ordinary and unremarkable, something everybody, without exception, does at one time or another. If I’m afraid of anything it’s of dying badly, of getting caught up in some process that prolongs my life unnecessarily.
Questions for Me About Dying | The New Yorker
Grief’s 7 Stages Don’t Include Envy and Resentment - The New York Times:
Thursday, August 3, 2017
My wife of 30 years has stage 4 metastatic breast cancer that has invaded her spine. She lives in constant pain, using heavy narcotics (such as fentanyl and oxycodone) to get through the day. Although the cancer has spread to quite a few places in her bones, there is no cancer in any major organs....Am I a terrible person for just wanting this to be over? "
Coping with a spouse who has advanced cancer
Tuesday, August 1, 2017
by Robyn Sarah
The key was in my hand. I held my ground,
and listened to the quiet that was like a sound,
and saw how the long sun of winter afternoon
fell slantwise on the floorboards, making bloom
the grain in the blond wood. (All that they owned
was once contained here.) At the window moaned
a splinter of wind. I would be going soon.
hearing the years turn in that emptied place
whose fullness echoed. Whose familiar smell,
of a tranquil life, lived simply, clung like a mood
or a long-loved melody there. A lingering grace.
Then I locked up, and rang the janitor’s bell.
Monday, July 31, 2017
When Senator John McCain revealed that he has brain cancer, well-wishers including President Obama and Vice President Pence, with the best of intentions, tweeted encouraging thoughts about McCain's strength and fighting spirit. Steven Petrow writes in the Washington Post that this inadvertently makes the patient feel responsible for the disease and the outcome.
Warrior or people-pleaser, these character-driven approaches suggest that you are responsible for your outcome. Both are just wrong.
“There’s been pushback against the idea that this warrior mentality is necessary for a successful outcome,” Rohan Ramakrishna, a neurosurgeon at Weill Cornell Medicine in New York who specializes in brain tumors, told me in a phone interview.
Putting it bluntly, Ramakrishna said, “Your response to treatment is a biological one, not a psychological one.”
People use warrior metaphors with good intentions, Ramakrishna explained, but the unfortunate flip side is the implication that it’s your own fault if the cancer comes back, or if you die. Those who triumph over more-curable diseases, such as cancers that have effective treatments, aren’t tougher than those facing glioblastoma — it’s just that the odds are more in their favor.
Sunday, July 16, 2017
Hospice chaplain tries to give patients purpose and peace | The Wichita Eagle
The Death Goes Digital Podcast — Death Goes Digital:
"It's not because people are at the end of life that they don't want to talk about everyday things. Everyone is still mad at the Habs or whatever. They're still people, they still know what's going on," she said. Among those lively patients is Flo. The 92-year-old spent Thursday chatting with the students about her life, raising her family, and her job working at the Lachute Watchman newspaper. "They've got a lot to learn but we can also learn from them. It can work both ways," said Flo. Amy Schecter said after just four days, she is learning quite a bit from the patients at the centre, especially "to really enjoy life. As cliché as it may sound life is super important. Live it, have fun with it, and do your best."
Teens learning life lessons in palliative care | CTV Montreal News
Widower's Grief: Cantus: the Silence of Grief
Saturday, July 15, 2017
I felt like a new parent of a very large adult toddler; I had to watch him constantly. I wanted nothing more than to keep him with me but I was rapidly realizing that I couldn’t handle him. I’d go shopping and come home to a house full of gas — Dad had tried to cook but was used to an electric stove. The week before he walked my dog, as he had for years, and turned an around the block spin into a multi-hour silver alert ordeal. Fire and police finally found them both dehydrated four miles away....Of the top 10 diseases afflicting Americans today, nine are declining. Only one is spiking: dementia. Dementia alone will break the backs of Medicare and Medicaid — it’s projected to account for more than 70 percent of all costs by 2028. Homes don’t have to be like the sadder places I visited, residents acting like drooling zombies parked in front of televisions. As the need for care spikes, America needs to find non-pharmacological ways to improve the lives of those living with Alzheimer’s and dementia, and the jobs of those caring for them. Currently, more than 95 percent of research goes into drugs. No attention is being paid to care.
Tuesday, July 11, 2017
The human body’s most compassionate gift is the interdependence of its parts. As organs in the torso fail, the brain likewise shuts down. With the exception of the minority of people who suffer sudden death, the vast majority of us experience a slumberous slippage from life. We may be able to sense people at the bedside on a spiritual level, but we are not fully awake in the moments, and often hours, before we die.
Every major organ in the body — heart, lungs, liver, kidneys — has the capacity to shut off the brain. It’s a biological veto system. When the heart stops pumping, blood pressure drops throughout the body. Like electricity on a city block, service goes out everywhere, including the brain. When the liver or kidneys fail, toxic electrolytes and metabolites build up in the body and cloud awareness. Failing lungs decrease oxygen and increase carbon dioxide in the blood, both of which slow cognitive function.
The mysterious exception is “terminal lucidity,” a term coined by the biologist Michael Nahm in 2009 to describe the brief state of clarity and energy that sometimes precedes death. Alexander Batthyány, another contemporary expert on dying, calls it “the light before the end of the tunnel.”
The Gentler Symptoms of Dying - NYTimes.com
Sunday, July 9, 2017
Healthy retired nurse ends her life because old age 'is awful' - Telegraph
I love this response from a widow whose husband died suddenly the same week Oswalt's wife died and who, like him, has shared her experience online:
You don’t get to comment on the choices of a widower while you sit happily next to your own living spouse. You didn’t have to stand and watch your mundane morning turn into your absolute worst nightmare. You didn’t have to face the agony of despair and the only person who could possibly bring you comfort had been ripped from your life forever. You didn’t have to stand in the ashes of what was once your life, when the sun itself darkened and the very air you breathed felt toxic in your lungs. Go back to scrolling Facebook and keep your ignorance to yourself.
Who gave you the position to judge when it’s “too soon” for a person who has suffered the worst to be able to find happiness and companionship again? It's been 15 months! How long should a widow sit in isolation before YOU are comfortable enough to release them from their solitary confinement? Because it’s really about you isn’t it? You aren’t actually concerned about the heart of the person who has found the strength and courage to love once more. You’re worried about your own offended sensibilities rooted in old Victorian traditions. Stop pretending you are actually concerned about their “healing.”
...The person who comes after cannot and will not replace the one we lost. To imply that is insulting to the widow, it’s insulting to the new love and it’s insulting to the love who was lost. Earlier I said that I was happy to see Patton Oswalt’s heart had expanded. I used that word intentionally. I say expanded because that's what widowed hearts do. They expand. One love isn’t moved out to make room for someone new. An addition is built. Just like my love for my daughter was not diminished by the birth of my son, so too, the love widows can have for someone new does not diminish the love of the one lost. The expansion of the heart is part of the grieving process.
Thursday, July 6, 2017
"Finding ways to embrace our dead, instead of hiding them, is all a part of death positivity. We don’t need to fear our dead. We don’t need to hide them. We don’t need to be ashamed of them. Instead, we need to welcome the dead into our lives and allow them spaces among the living. However that looks at a hospital, I don’t know. But I do know that sending the dead out the same door as the trash isn’t it."
CONFESSIONS OF A FUNERAL DIRECTOR » Let’s Stop Throwing the Dead Out with the Trash
If you feel your purpose in life is to make something that will outlive you, it doesn’t matter as much that your body’s only temporary; indirectly, some part of you will still be sticking around. “The current findings support the notion that creative achievement may be an avenue for symbolic immortality, particularly among individuals who value creativity,” the researchers wrote. We’re all going to die one day, a fact that’s easier to swallow if you plan on leaving something behind.
The Most Creative People Are Also the Least Afraid of Death -- Science of Us
Sunday, July 2, 2017
...I would always hope that this widow or widower can live the remainder of their lives creating the treasure of good memories about a flawed person, rather than hoarding a storehouse of repressed hurt. Most aren’t saints; most are just human. Please, please, allow all of the honest feelings to come out as you grieve."
When your dearly departed loved one was a bit of a devil | The Fresno Bee
We’ve allowed death and the whole dying process to become a medical event. In our communal sadness, we’ve become very insecure in hospital settings and often forget to think of our own wishes and demands, letting ourselves be buffeted about by hospital policies or funeral home pronouncements. Before we’re even cognizant of it, we find ourselves moving mindlessly along the conveyer belt that is the $14 billion funeral and death care industry.
Funeral planning can be its own spiritual practice. There’s a worksheet I hand out during my workshops on new possibilities in end-of-life rituals that involves jotting down “kitchen sink” wisdom. What do you believe with all your heart? What has your life taught you thus far? What matters most? What is your credo? We cover everything from the practical (tips on running a household, finances, fixing stuff) to the personal (relationships, personal integrity, politics) and the spiritual (musings on what life’s all about, God, goodness, meaning-making).
Creating the New American Buddhist Funeral - Tricycle
Wednesday, June 28, 2017
Reflections on Life: Grief - A Poem that Resonates
Monday, June 26, 2017
the frail cat of many years
came to sit with me
among the glitter of bulb and glow
tried to the very last to drink water
and love her small world
would not give up on her curious self.
And though she staggered — shriveled and weak
still she poked her nose through ribbon and wrap
and her peace and her sweetness were of such
that when I held my ear to her heart
I could hear the sea.
Saturday, June 24, 2017
"We feel like we've done our job well if our patient passes away in the place and manner they chose (many people want to die at home in their own bed). And, crucially, without pain. It make us feel better if we know we've achieved that."
24 Deeply Honest Confessions From A Hospice Worker