Thursday, May 25, 2017

At His Own Wake, Celebrating Life and the Gift of Death - The New York Times

Mr. Shields intended to die swiftly and peacefully by lethal injection, administered by his doctor. Last June, the Canadian government legalized what it termed “medical assistance in dying” for competent adult patients who are near death and suffering intolerably from irremediable illnesses. When his doctor, Stefanie Green, informed him that he qualified, Mr. Shields felt the first hope since a doctor told him more than a year before that he had a rare and incurable disease called amyloidosis, which caused proteins to build up in his heart and painfully damage the nerves in his arms and legs. 
Having control over the terms of his death made him feel empowered over the disease rather than crippled by it, a common response among Dr. Green’s patients. Mr. Shields believed that dying openly and without fear could be his most meaningful legacy — which was saying something. The man had packed five lifetimes of service into one: He had been a civil rights activist, a social worker for children, the head of British Columbia’s biggest union and, most recently, the savior of a floundering land trust that included 7,191 acres of protected wilderness and historic properties.  
His newly developed plan for how he would spend his last moments, though, worried his wife, Robin June Hood. Her husband had not left his bed once since he arrived at the hospice on a stretcher, 17 days earlier. His 78-year-old body had thinned; his voice dimmed. He lasted only 15 minutes in conversation before his eyes fluttered closed. Just leaving the room would exhaust him. She knew he could not make it to the restaurant, and there was no way she could tend to his needs at home, even for one night — especially his last. Happily, Dr. Green had become adept at brokering delicate family discussions over the past year.  She had presided over 35 deaths since the law passed, each intimately different from the next. One man got dressed in his amateur clown costume, complete with wig and red nose, and died telling her jokes. He had insisted on being alone in the room with her, but most of her patients died surrounded by loved ones. Many were too sick to devise elaborate rituals, but others had chosen the location, attendees, readings and music as if planning a wedding. Dr. Green called them something she picked up at a conference on euthanasia in the Netherlands: “choreographed deaths.”
She arrived at Mr. Shields’s hospice room that day to finalize the plans. The couple held hands as she helped them stitch a compromise. On March 23, the last night of Mr. Shields’s life, they would host a party in the hospice solarium with Swiss Chalet takeout for all. The next morning, he would die in his hospice room. Then, his wife and stepdaughter would take his body home and lay it out in his beloved garden for two days. The plan, Mr. Shields said that afternoon, was “absolutely terrific.”

At His Own Wake, Celebrating Life and the Gift of Death - The New York Times

Wednesday, May 24, 2017

Sheryl Sandberg and Elizabeth Alexander on Love, Loss and What Comes Next - The New York Times

“When I meet a woman wearing a ring on a chain around her neck, I know immediately: member of the club,” Sheryl Sandberg said. “I never noticed before.” That club in question would be the unenviable one for people whose spouses have died. “What I loved about the chain was that I could put both our rings on it,” Elizabeth Alexander added. But these two club members, who met recently for breakfast, have more in common than jewelry.
Both are young widows, and both found some comfort in writing about it.  Alexander says, "If you can stay at the bone of what’s true, then that’s your lifeboat."

Sheryl Sandberg and Elizabeth Alexander on Love, Loss and What Comes Next - The New York Times

Tuesday, May 23, 2017

When my dad was dying, we forgot to ask him how he wanted to live | The Independent

 "When it comes to end of life care, we talk about dying. But in my experience, care at the end of life should not be not about death – it should be about life....Professionals arrived to do the job they were sent to do – take bloods, give drugs, request a hospital bed at home. They didn’t take the time to understand that what Dad wanted most was to be outside, to feel the sun, wind and rain on his face. They told us they’d visit sometime the next day. And so we waited. And Dad lost another precious opportunity to be out in the world he didn’t want to leave."

When my dad was dying, we forgot to ask him how he wanted to live | The Independent

Monday, May 22, 2017

Coping With the Death of Old Friends and Siblings as We Age

In her book, Lots of Candles, Plenty of Cake, author Anna Quindlen captures the significance of these relationships. “The thing about old friends is not that they love you but that they know you,” she writes.  On an intellectual level, I know that part of life is death, yet I struggle to reconcile this unfair, if inherent, consequence. “In the second half of our lives, we experience more losses,” says Alan Wolfelt, an author, grief counselor and founder of the Center for Loss and Life Transition. “With aging comes the inevitable deaths of those we love. It’s hard, yes,” he adds, “but it’s also a time of opportunity to live, love and mourn as fully as we can.” 

Coping With the Death of Old Friends and Siblings as We Age:

At the End of Life, A Way to Go Gentle

"[Jessica Nutik Zitter] refers to the usual intensive care unit approach as the “end-of-life conveyor belt.” She argues that palliative care methods should be used to slow down and derail the typical destructive I.C.U. approach that often torments people it cannot heal....According to Dr. Zitter, even what are intended to be temporary intensive care measures can put a patient on that conveyor belt to anguish and isolation. She writes of breathing machines, feeding tubes, cardiac resuscitation, catheters, dialysis and a miserable existence prolonged within long-term acute care facilities. In an account of the evolution of her own ideas about doctoring, she also explains why it remains so difficult to change intensive care units so they can better serve the terminally ill." (About the new book, Extreme Measures: Finding a Better Path to the End of Life)

At the End of Life, a Way to Go Gentle - The New York Times:

My Vexing/Gratifying 7 Years of Caregiving | HuffPost

"As a clinical psychologist specializing in helping families struggling with illness, I thought I had some idea of what I was getting into. But, looking back, I did only partially. Real-life caregiving for my mom was much more personal and perturbing, complex and challenging, gratifying and vexing than my clinical work or academic reading could have prepared me for. Like all family caregivers, I suffered growing pains but learned a great deal." This piece is filled with important insights.  One I especially appreciate is: "Anger is an unfortunate way to avoid sadness."

My Vexing/Gratifying 7 Years of Caregiving | HuffPost

Sunday, May 21, 2017

The 11 qualities of a good death, according to research — Quartz

"The literature review identifies 11 core themes associated with dying well, culled from 36 studies:

  • Having control over the specific dying process 
  • Pain-free status 
  • Engagement with religion or spirituality 
  • Experiencing emotional well-being 
  • Having a sense of life completion or legacy 
  • Having a choice in treatment preferences 
  • Experiencing dignity in the dying process 
  • Having family present and saying goodbye 
  • Quality of life during the dying process 
  • A good relationship with health care providers 
  • A miscellaneous “other” category (cultural specifics, having pets nearby, health care costs, etc.)"

The 11 qualities of a good death, according to research — Quartz

Friday, May 19, 2017

I Know You Love Me — Now Let Me Die

"We now are in a time of medicine where we will take that small child running through the yard, being chased by her brother with a grasshopper on his finger, and imprison her in a shell that does not come close to radiating the life of what she once had. We stopped seeing her, not intentionally perhaps, but we stopped. This is not meant as a condemnation of the family of these patients or to question their love or motives, but it is meant be an indictment of a system that now herds these families down dead-end roads and prods them into believing that this is the new norm and that somehow the old ways were the wrong ways and this is how we show our love. A day does not go by where my partners don’t look at each other and say, “How do we stop this madness? How do we get people to let their loved ones die?” "

I Know You Love Me — Now Let Me Die:

Tuesday, May 16, 2017

Hospice Doctor Describes What Happens The Moment After We Die | HuffPost

“It’s such a profound, stunning moment to see the body finally as a shell and devoid of that person,” [Dr. B.J. Miller] says. “In that moment of transition around the body, you’re really in touch with the continuum of life, that life is proceeding. That individual is gone, but life goes on.”