04/20/18

Death doula turns grief into guidance

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Last fall Catherine Hayes’ sister died in a helicopter accident; on April 26 she launches The Departure Lounge

After her sister’s untimely death, Lynn Valley resident Catherine Hayes has started a grief group called The Departure Lounge, set inside a large lodge cabin along the side of Hunter Creek.

By Maria Spitale-Leisk

These facts Catherine Hayes will always remember. It was the day her sister, her rock, was gone.

“She could always rally me in ways that nobody else understood,” says Hayes. “I had her for 43 years, you know, protecting me. Forty-three years – some people never have that, right?”

On Oct. 1 the early fall sun was warming Hayes’ face while she was singing her sister Karen Coulter’s praises to a mutual friend.

Coulter had already earned her engineering ticket to fix helicopters, but she wanted to go further.

“She had always wanted to fly,” says Hayes.

Coulter found her wings and got on with the air ambulance service in Alberta.

She soon found her way back to B.C. and took a job in Campbell River last summer. Coulter was in her element and loving life, according to her sister.

Nothing could prepare Hayes for the call that evening.

Friends were over for dinner and an unfamiliar number was illuminating her phone. Coulter’s helicopter had crashed in a remote forested area on the island, Hayes heard.

She tried to remain calm under the shocking circumstances, while hurrying to catch the next ferry to the island to be by her sister’s side.

In her mind Hayes thought: “I’m just going to go there and clean her up a bit and she’d be OK.”

On the ferry ride over Hayes had her life turned upside down.

“It is like being completely sucker punched just for no reason,” describes Hayes.

Her partner, Shawn, had only left her side momentarily to grab a coffee. Hayes’ cousin delivered the news over the phone while she was alone surrounded by strangers.

“He just said: ‘She died.’”

Her phone dropped and Hayes started screaming. The worst was yet to come.

When she got to Victoria, her sister wasn’t there, which sent Hayes on a wild goose chase.

“We couldn’t find her for a long time,” she recalls.

At first Hayes was told Coulter would be in Victoria. She wasn’t there. Maybe Comox?

Eventually, Hayes learned her sister’s body was still in the helicopter amongst the dense bush in pitch-black darkness.

The coroner wouldn’t arrive until daylight. It’s a scene that hauntingly plays over again in Hayes’ head.

Those first few days were the hardest. Hayes was presented with impossible questions that she couldn’t possibly prepare for.

Did she want the clothes her sister was wearing when she died?

“How do you respond to that?” says Hayes.

She would have recurring flashbacks of trying to reach her sister, but just going around in circles.

There was no beginning and end to her days – time blurred together into one vivid nightmare.

Hayes tried a host of remedies to turn her brain off at night – prescription and non-prescription – to no avail.

In the long days and months after the accident, along with overwhelming grief, Hayes had this nagging fear.

“Who’s going to go next? Is it going to be me? Is it going to be my son?”

The pain and anxiety became unbearable. Hayes compares it to being caught in an avalanche – you don’t know which way is up.

“And every time you do get a breath – you’re slammed again,” she says.

There is no textbook answer for how to handle grief. Hayes had someone say to her, you can’t be sad forever. But Hayes couldn’t see it any other way.

A framed collage of Coulter’s life leans up against a wall in Hayes’ kitchen. She curated the collage with some pictures discovered while cleaning out Coulter’s purse.

There’s a faded photo booth strip of the sisters goofing around in their teenage years.

“She probably even permed my hair and made me do it,” says Hayes, summoning a smile.

Hayes had no idea her sister had held on to the memento all these years in her wallet.

It’s these precious gifts from beyond the grave that buckle Hayes’ knees, often in the most unlikely places and without warning.

With the facts around her sister’s death seared into her brain, Hayes forgot how to take care of herself.

She says she felt like she was walking on her hands and eating with her feet. Nothing felt normal.

It was while hiking in Lynn Headwaters with a good friend that Hayes saw a faint light at the end of the tunnel.

The friend dropped the term “death doula” and Hayes was intrigued. She went home and immediately googled it.

“It was so clear to me that this is what I’m supposed to be doing,” says Hayes.

Except the timing for Hayes becoming a certified death doula was a little off, she admits.

You’re not supposed to take the program when you’re in the throes of grief, but Hayes pushed through to the other side.

She was a student learning about grief when she had already aced the painful exam.

Hayes took a three-month, end-of-life doula program overseen by the Conscious Dying Institute out of Colorado.

The serene setting for the course was an old brick building on the west side of Vancouver, with floor-to-ceiling windows and plenty of natural light.

Just like a birth doula, a death doula maps out the journey according to a personalized plan.

The doula helps a person with anything that might “flare up” during those last months, from tying up loose ends, to mending fences with a loved one, to pain management, to after-death arrangements.

Hayes said some people will take two weeks to answer the questions “because it really causes you to dig deep.”

This end-of-life direction goes deeper than a will or a medical representation agreement.

Families often hire a death doula a few months out from the main event.

A plan is made, called Your Best Three Months.

The doula helps their client check off items on their death wish list, covering off five elements of life from the spiritual to the physical.

Hayes took the test herself, as part of her training. One of the questions she faced was: While you’re still physically able, what do you want to do?

Hayes learned she wants to climb the Eiffel Tower. Step 1 – how is she getting there? She would have to budget her finances, take time off work, book a flight and find a place to stay.

Hayes took her travel planning one step at a time – just like her grief journey.

Half a year after her sister’s sudden death, Hayes is starting to put one foot in front of the other again.

She’s now a certified end-of-life doula and has started a grief group, called The Departure Lounge. The first meeting is April 26, set in a large log cabin with a fireplace nestled alongside Hunter Creek in Lynn Valley.

The guest speaker that evening will be her stepsister, Rev. Colleen Tanaka, who helped pull Hayes out of the grief fog.

There will be guided meditation. For people who want to share, they can talk briefly about their experience with grief. Afterwards, attendees can mingle together over coffee and tea.

It’s almost like matchmaking for the bereaved. After being introduced, Hayes is hoping some people will group up in the community on their own.

Hayes said her unfortunate experience makes her relatable to others who are grieving.

She’s already had an overwhelming response – more than 100 emails from people wanting to share their personal story of grief, including a dad who lost both sons in drunk driving accident.

“It’s like all of sudden I got this street cred,” she says.

Now that she’s getting stronger, Hayes wants to help as many people as she can. “We learn all kinds of things in school but there is nothing that teaches us about death and grief,” she says.

Hayes cites a Gord Downie quote: “Let’s turn our faces toward the sun and get whatever warmth there is.”

This November for her 45th birthday, Hayes will board a plane to Paris and soar towards the sky.

Complete Article HERE!

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04/19/18

Back to the Earth with Green Burials

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The oldest traditions might be best for protecting our environment

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As individuals, communities and businesses continue to shift their priorities to become more ecologically responsible, some opportunities to protect the planet can come from unexpected practices. Green burials are gradually gaining traction as the most conscientious way to return oneself to the earth. This funeral process uses the least amount of unnecessary energy and resources compared to contemporary casket burials and cremation.

All steps in a green burial are optional, but key choices include: rejecting the use of added chemicals through embalming or cosmetizing the body, selecting a biodegradable casket made from unfinished wood or reinforced cardboard materials and foregoing the use of an outer burial container if permitted by the cemetery. There are a growing number of cemeteries that strictly serve individuals who opt for a certified green burial, but many cemeteries will accommodate requests to mix green burials with non-green burial plots. Cemeteries that exclusively serve green burials take additional steps to maintain the natural landscape.

Goodman-Bensman, a Jewish funeral home in Whitefish Bay that serves people of all faith, (4750 N Santa Monica Blvd.) has been offering green burial services for about a year under the official “green burial” name. Debra Watton, president of Goodman-Bensman explains: “Conceptually, we’ve always offered green burials, but not under the [green] name. In the Jewish faith, burial rites were very modest and natural.”

According to Watton, green burials are often included in the final wishes of the deceased. “It’s respectful and dignified, but it’s not what families are used to,” she says. Often the family fears they may not be doing enough to honor their loved one if the funeral is too simple, especially since green burials are more cost-effective than a conventional funeral. Goodman-Bensman recommends that like any final wishes, individuals officially document their desire to be remembered with a green burial, if they choose.

No one wants to plan a funeral after losing a loved one, especially if they aren’t sure how the deceased prefers to be remembered because no arrangements have been made. Watton has received feedback that planning green burials has given some families a sense of peace “because it became a natural process that eased the discomfort of an otherwise difficult topic.”

The usual practices of American funeral homes often date to the 19th century. Embalming wasn’t common until the Civil War as a way to preserve bodies of fallen soldiers in order to return them home for funerals. Now, because of refrigeration, the embalming isn’t necessary in order to make time for planning and having a ceremony. However, without embalming, the traditional wake cannot be factored into funeral planning. In these cases, families can choose to have a final private viewing before the funeral ceremony and burial.

Green burials are another way to make a minimal impact on the earth for the generations that follow. Above all, Watton urges that before someone dies, “People should talk about it. It’s OK to talk about it. It’s OK to talk about it in advance with loved ones and to ask questions before the time of need arises so that clear decisions can be made.”

Complete Article HERE!

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04/18/18

Your Body is a Teeming Battleground

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It’s time to rethink the quest to control aging, death, and disease—and the fear of mortality that fuels it.

By Barbara Ehrenreich

I went to medical school, at least in part, to get to know death and perhaps to make my peace with it. So did many of my doctor friends, as I would find out. One day—usually when you’re young, though sometimes later—the thought hits you: You really are going to die. That moment is shocking, frightening, terrible. You try to pretend it hasn’t happened (it’s only a thought, after all), and you go about your business, worrying about this or that, until the day you put your hand to your neck—in the shower, say—and … What is that? Those hard lumps that you know, at first touch, should not be there? But there they are, and they mean death. Your death, and you can’t pretend anymore.

I never wanted to be surprised that way, and I thought that if I became a doctor and saw a lot of death, I might get used to it; it wouldn’t surprise me, and I could learn to live with it. My strategy worked pretty well. Over the decades, from all my patients, I learned that I would be well until I got sick and that although I could do some things to delay the inevitable a bit, whatever control I had was limited. I learned that I had to live as if I would die tomorrow and at the same time as if I would live forever. Meanwhile, I watched as what had been called “medical care”—that is, treating the sick—turned into “health care,” keeping people healthy, at an ever-rising cost.

In her new book, Barbara Ehrenreich ventures into the fast-growing literature on aging, disease, and death, tracing her own disaffection with a medical and social culture unable to face mortality. She argues that what “makes death such an intolerable prospect” is our belief in a reductionist science that promises something it cannot deliver—ultimate control over our bodies. The time has come to rethink our need for such mastery, she urges, and reconcile ourselves to the idea that it may not be possible.

Ehrenreich is well equipped for her mission; she has a doctorate in biology and years of social and political work behind her, as well as decades of writing. I first discovered her in medical school, when I read her early book Witches, Midwives, and Nurses: A History of Women Healers (1973). From it I learned that my small group of nine women in the otherwise male class of ’77 belonged to a long, if forgotten, tradition. I also learned that social progress is not always an upward-trending line. The author of more than a dozen books, Ehrenreich has a reputation for chronicling cultural shifts before others notice them. She delights in confronting entrenched assumptions, popular delusions, grandiose ambitions—and in teasing out their unexpected consequences.

Often she incorporates firsthand experience into her analysis. For her best-known book, Nickel and Dimed: On (Not) Getting By in America (2001), she spent a year working at unskilled jobs. In Living With a Wild God (2014), she recounted her own spiritual epiphanies in adolescence and her struggle, as a determined atheist, to understand her “furious encounter with a living substance that was coming at me through all things at once.” Before all that, in 2000, she had been diagnosed with breast cancer and begun paying special attention to surprising new science about cancer, cells, and our immune system. Now 76, Ehrenreich explores that science in Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer. Once again, she is swept up by big questions. Not least among them is “whether the natural world is dead or in some sense alive” and behaving in unpredicted and unpredictable ways that have much to tell us about our approach to mortality.

She starts by looking at the many preventive medical procedures we are encouraged, even badgered, to undergo—those regular physical exams, colonoscopies, blood tests, mammograms. She had always pretty much done what doctors advised (she underwent chemotherapy), figuring that it made sense to treat disease before illness overwhelmed the body. But after watching many fitness-obsessed people die early, and realizing that she herself is now “old enough to die,” she questions that premise. Where is the evidence that all the effort at prevention saves lives or delays death?

It’s hard to find, she discovers. In people who have a strong family history of heart disease, treating high cholesterol does decrease mortality, on average. But for those who don’t have that predisposition, it doesn’t. Colonoscopies have not been proved more effective at reducing deaths from colon cancer than other, cheaper, less-invasive tests. Sometimes procedures cause more trouble than they prevent. Mammograms, for instance, detect tumors that might never be fatal, and can lead to over-treatment, which carries its own risks. The insight is counterintuitive—although finding diseases early on should prolong lives, the screenings we undergo don’t seem to lower mortality rates overall—and Ehrenreich decides that she will no longer get most preventive care.

She is just as clear-eyed about other approaches to delaying our decay—exercise, diet, meditation. Though she became a “fitness devotee” herself in middle age, she finds symptoms of cultural malaise rather than health benefits in the fitness and diet obsessions of the past 40 years. Wellness programs do little to reduce companies’ immediate health-care costs, and the pursuit of fitness, Ehrenreich argues, is often simply one more “class cue.” Workouts easily become just that—work, another demand for self-discipline, competition, and control. Ironically, when she reached her 70s, her knees began giving her trouble not from age-appropriate arthritis but from overexertion.

Turning from her critique of preventive medicine and fitness culture as death-postponement strategies, Ehrenreich is even more unsettled by research indicating that our immune system is not the magical “protective cloak” she learned about in graduate school. What really gets her rethinking her scientific beliefs is the evolving story of the macrophage—the specialized white blood cell that she always thought of as her good shepherd “through the valley of the shadow of death.”

Macrophages have traditionally been understood as one of our crucial first-line defenses against disease. They are found throughout our body—in our bones, brain, lymph nodes, lungs, and breasts—and circulate in our blood. They look like the amoebas we learned about in high school, those slippery, one-celled, independent creatures that move by stretching out and contracting, and eat by wrapping themselves around their prey, invaginating and absorbing it. The usual story went like this: Whenever macrophages find threats to our well-being in our midst—bacteria, viruses, fungi, or cancer cells—they kill them and eat them by engulfing and absorbing them. Ehrenreich assumed that keeping her immune system—and valiant macrophages—strong through exercise, diet, and positive thoughts was the key to not getting sick, not getting cancer, not getting old.

But research around the turn of the millennium suggested a different view. Macrophages do not always kill our cancer cells; sometimes they even help them grow and spread. They escort certain cancer cells through the tight walls of our blood vessels, and protect them as they circulate in our bloodstream, looking for a congenial new home. When such a site is found—in a bone or breast, liver or lung—macrophages then support those cancer cells as they mature into the metastases that will go on to kill us.

Scientists are now discovering that the macrophage is as much wolf as shepherd in other diseases as well. It may play a role in auto-immune disorders, and even in the usual afflictions of aging—heart attacks, strokes, arthritis. We thought we knew the causes of those (cholesterol, cigarettes, inactivity) and therefore the recourse (diet, abstinence, exercise); but now it appears that inflammation, caused in large part by our macrophages, may be a trigger. Ehrenreich ponders the heretical question: Can it be that instead of working to keep our immune system healthy, we should all along have been doing the opposite?

Ehrenreich is not, however, an apostle of unwellness, and Natural Causes is not a how-to book. Instead she focuses on the conceptual and “deep moral reverberations” of the discovery that our immune system can aid and abet a “cellular rebellion against the entire organism.” What if our convenient “holistic, utopian” view of the “mindbody” as a “well-ordered mechanism”—kept in harmony by positive thinking and solicitous tending—is wrong?

Ehrenreich proves a fascinating guide to the science suggesting that our cells, like the macrophages that sometimes destroy and sometimes defend, can act unpredictably and yet not randomly. It is almost as if our cells can choose when and how to behave—unregulated by any deterministic mechanism. But that would mean they have “agency, or the ability to initiate an action,” as she puts it. And what would that imply? If macrophages are actually deciding which cancer cells to destroy or to preserve, “maybe, crazy as it sounds, they are not following any kind of ‘instructions,’ but doing what they feel like doing.”Researchers are now finding this same agency everywhere, Ehrenreich reports—in fruit flies; in viruses; in atoms, electrons, and photons. Such discoveries must mean that agency, the capacity for making decisions—electrons jumping up a quantum level or not, photons passing through this hole in a screen rather than another—is not the rare, and human, prerogative we once thought.

Ehrenreich detects a paradigm shift in the making, away from holism and toward “a biology based on conflict within the body and carried on by the body’s own cells as they compete for space and food and oxygen.” This vision of the body as an embattled “confederation of parts”—the opposite of a coherent whole, subject to command and control—is “dystopian,” she writes. And yet it has liberating, humbling implications. “If there is a lesson here,” she proposes, it’s that “we are not the sole authors of our destinies or of anything else.” Of course, the struggle to win the battles within our body may be one we’ll never be able to resist. Who knows? Perhaps we’ll devise high-tech ways to induce, or persuade, our traitorous immune cells to cooperate with our health. But whatever technological miracles appear in our future, Ehrenreich hopes we can come to accept that the ultimate outcome will be, as it has always been, out of our control.

Researchers are now finding this same agency everywhere, Ehrenreich reports—in fruit flies; in viruses; in atoms, electrons, and photons. Such discoveries must mean that agency, the capacity for making decisions—electrons jumping up a quantum level or not, photons passing through this hole in a screen rather than another—is not the rare, and human, prerogative we once thought.

Ehrenreich detects a paradigm shift in the making, away from holism and toward “a biology based on conflict within the body and carried on by the body’s own cells as they compete for space and food and oxygen.” This vision of the body as an embattled “confederation of parts”—the opposite of a coherent whole, subject to command and control—is “dystopian,” she writes. And yet it has liberating, humbling implications. “If there is a lesson here,” she proposes, it’s that “we are not the sole authors of our destinies or of anything else.” Of course, the struggle to win the battles within our body may be one we’ll never be able to resist. Who knows? Perhaps we’ll devise high-tech ways to induce, or persuade, our traitorous immune cells to cooperate with our health. But whatever technological miracles appear in our future, Ehrenreich hopes we can come to accept that the ultimate outcome will be, as it has always been, out of our control.

No, because I’ve noticed, in my life as a doctor, that the truism is true: People die the way they’ve lived—even the demented and even, somehow, the brain-dead. The brave die bravely; the curious, with curiosity; the optimistic, optimistically. Those who are by nature accepters, accept; those who by nature fight for control die fighting for control, and Ehrenreich is a fighter.

Yes, because I’ve also noticed that everyone I’ve seen die does come to accept the inevitable loss of control at his or her finally unevadable death. Usually that happens over weeks or months, sometimes over years; occasionally it happens over days, hours, or even minutes. This acceptance is perhaps as developmentally determined as childhood, adolescence, adulthood, and old age. At the end, something magical appears to occur—something beautiful, something Other—that seems to heal the spirit, allay all fear, and settle, finally, the struggle for control.

Complete Article HERE!

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04/17/18

What a dying old woman taught me about love

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Was this a cause and effect of true love?

I was a newly trained hospice volunteer, and E. was to be my first patient. I had to work up the nerve to cross the threshold.

After gently clearing my throat and shuffling my feet in an attempt to wake her, I bent low to look at her face. Suddenly, her eyes opened wide.

She was as startled as me and said, in a forced whisper, “Who are you?”

“I’ve come to visit for a while,” I replied.

“Why, are you being punished?” she deadpanned.

I laughed a little, mostly with relief. I introduced myself to the dying woman who was a few decades my senior and then nervously began a monologue, telling her all about me. She listened attentively for a while but soon closed her eyes. On a tray table was a wedding photo. I peered at the circa 1940s picture and was taken aback. “Wow!” I said out loud. In her youth, E. had been stunningly beautiful. Bright eyes, fresh face. I looked up and saw her once clear but now milky eyes examining my face, watching my reaction to the photo.

She was bedridden, her bones fragile. During our next visit, I asked the nurse if E. could go outside in a wheelchair. The nurse said it was up to E. We rolled out into the sunlight and fresh air, and that’s when everything began to move faster for us, literally and figuratively.

I maneuvered her down the cracked and bumpy sidewalk into a nearby neighborhood. She lifted her face to the sun and opened her mouth to its warmth. She stayed that way until I parked the chair under a shade tree. I sat down with the trunk as my backrest.

For the longest time, she simply stared at me. Until she slowly stretched out her arms and beckoned me to her. I jumped up, although she didn’t seem in distress. I leaned toward her and she gently cupped my face with her hands. I could feel the pressure of each finger on my face. Suddenly, with purpose, she pulled me close and kissed me. On the lips, with a dry pucker.

I was not made uncomfortable by the gesture. Quite the opposite. I sensed in her a genuine joy and appreciation. So she kissed me. Perhaps the most meaningful kiss of my life.

Those meetings under the tree became our routine, where we shared stories of our lives. We quickly bonded through unabashed, intimate conversations. I told her things about myself that I had never, nor would ever share with anyone else. We simply started talking to each other that way. Instant trust, instant karma. Instant honesty.

E. told me she wasn’t so much afraid of dying as she was of going to hell. She had married young, to a very ambitious man, and as the years progressed, his business flourished, but their marriage did not. He increasingly spent more and more time at the office, with colleagues and away from her. Estrangement set in.

She found a job as a secretary and over time fell prey to the attentions and intentions of her boss — afternoon “lunches” at a motel.

One day, on the ride back to the office, her boss spotted his wife in town, waiting to cross a street. With a violent shove, he sent E. into the passenger side footwell, hissing at her to stay down until he was sure he had avoided detection.

It was a humiliating and illuminating moment for E. She ended the affair. But the deed had been done. She was officially an adulterer. Worse, a mortal sinner. And now, as her life was about to end, she could not shake the guilt and dread that God was about to deliver her to the eternal fires of damnation.

She wept as I knelt beside her chair and held her.

I know something about the Catholic church, having been an altar boy. I reminded her about the convenience of confession. “From what I just saw, I’ll assume you are truly remorseful.” “Yes of course,” she said. “And you have formally confessed this, yes?” “Once a month for the past 66 years,” she said. “Well, then, I think God has gotten the message … you’re off the hook!” “Do you think so?” she asked earnestly. “I know so,” I told her.

As our visits continued, I also shared stories I was not proud of, of my regrets, sins, character flaws, abuse of drugs and alcohol, tales of ruined relationships and marriages and career paths gone awry. How I blamed others and circumstances as if the bad things that happened in my life were not of the choices I made. She was at times scandalized by what she heard, but never judgmental. The process was cathartic, cleansing, transformative.

I felt a lightness of being I had never experienced before.

Within a year, she began to rapidly decline. During the day, I’d find her in a deep sleep. The nurses said she’d lay awake most nights and was eating very little. I started setting my alarm for 1:30 a.m. to make the 40-minute drive to her facility in the San Fernando Valley. I’d sit on a folding chair and move in close, so our whispered conversations would not wake others.

She was comforted and calmed by my presence. She was grateful that I had re-arranged my visiting times. (I know because she told me so.) And she also told me that she loved me. Too weak now to even raise her hands to my face, I fulfilled the need for that contact by tenderly kissing her cheek and forehead often. I needed it too. Time was slipping away.

I soon realized her truth, raw honesty and tenderness had created in me a level of introspection and self-examination that had previously been inaccessible. Was this a cause and effect of true love? And I did grow to love her — for her courage, candor and kindness. She was well aware her days were numbered. But for all of her failing health issues, she never expressed bitterness. It was another lesson learned for me.

For the first time in almost two years after I started visiting with E., I was going to be away from her, to make good on a long-planned vacation in the Yucatán. I told her that I’d be gone only a week and during that time there would be a full moon. I suggested that since she was awake at night she should look up for the full moon, and I promised I would too, and maybe we’d do it at the same time. Corny, maybe, but she didn’t think so.

One night during the middle of my trip, I couldn’t sleep and walked outside to where a hammock was strung between two palm trees. I laid back and looked up at a crystal clear moon and said out loud, “See? I told you.”

Upon returning home, it took me a few days to get back into the groove of work and life. But before I could make my next visit, I got a call from the hospice volunteer coordinator. E. had died while I was away. Peacefully, in her sleep, at age 87.

I often think of E., of how a dying old woman helped me to access and express my true, honest feelings about life and love. Not only did I get to learn from my mistakes, but from hers, too. I was able to affect the quality of her life for a time, but not the direction. She did both for me.

In real ways, we set each other free.

Complete Article HERE!

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04/16/18

How to Pay Your Respects when Someone You Know Dies

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Sometimes a death occurs when you aren’t particularly close to the person, but you still want to pay your respects. If a teacher, friend’s parent, or other person in your community dies, it’s nice to express sympathy to the family and honor the deceased. Pay respects by attending any memorial services for the person and offering condolences to their loved ones. Afterwards, it can be helpful to follow a few practices to remember the person.

 

METHOD 1  Attending the Memorial

Get the important information. Find out from family members, close friends, or members of the community when the memorial service will be held. If the person who died was a pillar in the local community, information about their services may be posted in the local newspaper.

  • Make sure you know when and where the service will be held. Review the directions ahead of time to avoid getting lost and arriving late.

Send flowers. Across many cultures and religions, a common way to pay respects is to send flowers. Plus, if you are unable to attend the memorial, sending flowers lets the person’s loved ones know that they are in your thoughts.[1]

  • Look online or visit your local florist to choose a nice arrangement. Have them sent to the funeral home so that they are there prior to the memorial.
  • If you are sending flowers from a long distance, it may be helpful to contact florists in the person’s area to have them send over your flowers.
  • Local and online florists can guide you on choosing and ordering arrangements that are designed specially for memorials.
  • A donation can be an alternative to flowers. Making a donation in the deceased’s name to a cause they cared about is a nice gesture. Check the obituary, as this is sometimes specified there.

Ask someone to join you for support. If you have never attended a funeral, or if you are a bit shaken by the death, it may be a good idea to bring someone with you. A parent, sibling, or friend can accompany you to the memorial and offer comfort if you need it.

  • Another good option is to go with someone who has a similar relationship with the deceased as you. For instance, you might go with another classmate, if a teacher has died. Or, you might attend a friend’s parent’s funeral with another mutual friend.

Arrive on time and dressed appropriately. Be respectful and proper by arriving to the memorial service on time. Aim to arrive at least 15-30 minutes before the service begins. Also, dress appropriately. It used to be common practice to wear black. That’s no longer necessary, but you should wear subdued clothing.[2]

  • Do some research before you dress. If the person followed a certain religion, you might look to see if there are general expectations for clothing in that place of worship.
  • Go for solid-colored clothing choices in mute shades like navy, burgundy, or grey as a rule. Avoid bright colors and busy prints or patterns. Also, try to be modest—don’t wear anything too revealing, such as low-cut tops or mini skirts.
  • If you are attending a wake or viewing, the attire might be more relaxed or casual. Still, stick to subdued colors. Also, if you are going to a viewing, you can arrive at any time and approach the casket. Just make sure you greet the person’s loved ones before viewing the body.

View the body, if you want. It is typical for everyone at the memorial service to pay their respects by viewing the body. This may take place before, during, or after the service. If you want to see the deceased one last time, you may go up when directed and view the body. If you don’t want to take part in this practice, remain seated.[3]

  • In some situations, a viewing, or wake, may be held immediately before the memorial or on a separate day. Wakes are usually more intimate but allow you to come and go as you please. The funeral itself, on the other hand, is more anonymous but requires you to be present for the entire service.

METHOD 2  Showing Sympathy to Their Loved Ones

Offer your condolences. Typically, after the service, mourners may line up to express their condolences to close family and friends of the deceased. When it’s your turn, keep it simple and straightforward. Go for something like “I am so sorry for your loss.”[4]

  • If you are attending a wake or viewing, you will typically greet and console the person’s family before viewing the body.

Skip the empty or religious platitudes. In an attempt to comfort the bereaved, some people communicate phrases like “Everything happens for a reason” or “God makes no mistakes.” Even if they are well-intended, such platitudes may offend close family, especially if they do not share the same religious or spiritual beliefs.[5]

  • Avoid phrases that minimize the person’s experience, like “I know how you feel.” Even if you have lost someone, too, this day is not about your own loss. Focus on the person who has died only instead of comparing their death to someone else’s.
  • If you know the person is religious, it may be appropriate to communicate sincere words, like “I am praying for you and your family.”

Relay a fond memory. If you want to say more, it can be thoughtful to communicate a fond memory you have of the bereaved. This reminds them of the good times the person had, or of their kindness or compassion.[6]

  • For example, you might say, “Ms. Henry, I am truly sorry for your loss. Mr. Henry was such a caring man. I’ll never forget that time he pulled over in the rain to help me with a flat tire. He was one of a kind.”

Offer your help. You can show your sympathy in a practical way by offering to help the family. When people are grieving, basic chores like cooking, cleaning, or picking up groceries may be left undone. They can be overwhelmed and too uncomfortable to ask for help. Offer to come by the family home and help out as needed if you are close to the family, or make an unsolicited gesture of aid like bringing food.[7]

  • Make your intentions to help clear, such as saying, “I’ll come by on Tuesday to help with cleaning or cooking.” Pitching in with housecleaning, chores, or yard work can be helpful during this time.
  • In addition, you might drop off prepared foods like casseroles or sandwiches to ensure the family has food to eat. Other helpful gifts might include plastic or paper utensils, trash bags, paper towels, and household items, since the family may be hosting many guests.
  • You might also ask someone close to the family what holes exist in their needs. Take the initiative.
  • Oftentimes, everyone is supportive of mourners immediately after the death, but this support fades as time goes on. For this reason, stay in touch with the family and continue to help out in the weeks after the funeral.

Be brief. After you have expressed your condolences, said something kind about the deceased, and offered to help, move along. Everyone is hoping to talk to the family, so don’t hold them up for too long.

  • You may leave your number with someone and suggest that they call you later if they’d like to talk more.

Send a card. If you are unable to attend the memorial service, it is appropriate to send a thoughtful card or note in your absence. Choose a card that offers your condolences and then add a brief message telling the family that you will come by for a visit soon.

  • You might write a simple message on your card, such as “I am thinking of you and your family during your time of grief.”
  • You might have your card mailed to the site of the memorial (with flowers) or you might send it to the person’s family home, if you are close to the family.
  • Respect the family’s wishes and space. Some might welcome a personal visit, but others may want to grieve privately and be alone for a time.

METHOD 3 Remembering the Deceased

Visit the burial site. In the days and weeks after the funeral or memorial service, you can pay your respects by visiting the graveyard or crypt where the deceased was laid to rest. It is generally acceptable to bring flowers or other mementos of the dead. This is a great way to privately honor the deceased.[8]

Reminisce with others who knew the person. If you are close to the bereaved, it may be comforting to you and others to talk about the deceased. Do this on a case-by-case basis, as some people may want to talk about the person and others may not.

  • Talk about the great times you had with the person, and relay the qualities about them you will miss. If you want, you may try to keep it upbeat by telling funny stories about experiences you shared with the deceased.

Write down your memories. You might also consider writing down your memories of the deceased or even making a journal of notebook of these remembrances. Include things like their traits and qualities as a person, things you did together, happy memories you have of them, or reminisce about funny stories that involve them.

  • Creating a journal can be a useful grieving technique for people who process things visually rather than verbally. It can also help you explore why you might be so affected by a person’s passing.

Start a new tradition to honor the person. If you want to continue to pay respects to the deceased after their memorial service, you can implement a ritual that helps you keep the person’s memories alive. For instance, if a teacher who loved chocolate chip cookies died, you might bake them each month on the anniversary of their death.[9]

  • You might also ask other mourners to join you. For instance, you might go to lunch every other Friday at the person’s favorite restaurant.

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04/15/18

When do you know you’re old enough to die?

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Barbara Ehrenreich has some answers

Author and journalist Barbara Ehrenreich at her home in Alexandria, Virginia, on 2 March.

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With her latest book, Natural Causes, Barbara Ehrenreich notes that there’s an age at which death no longer requires much explanation

 
Four years ago, Barbara Ehrenreich, 76, reached the realisation that she was old enough to die. Not that the author, journalist and political activist was sick; she just didn’t want to spoil the time she had left undergoing myriad preventive medical tests or restricting her diet in pursuit of a longer life.

While she would seek help for an urgent health issue, she wouldn’t look for problems.

Now Ehrenreich felt free to enjoy herself. “I tend to worry that a lot of my friends who are my age don’t get to that point,” she tells the Guardian. “They’re frantically scrambling for new things that might prolong their lives.”

It is not a suicidal decision, she stresses. Ehrenreich has what she calls “a very keen bullshit detector” and she has done her research.

The results of this are detailed in her latest book, Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer, published on 10 April.

Part polemic, part autobiographical, Ehrenreich – who holds a PhD in cellular immunology – casts a skeptical, sometimes witty, and scientifically rigorous eye over the beliefs we hold that we think will give us longevity.

She targets the medical examinations, screenings and tests we’re subjected to in older age as well as the multibillion-dollar “wellness” industry, the cult of mindfulness and food fads.

These all give us the illusion that we are in control of our bodies. But in the latter part of the book, Ehrenreich argues this is not so. For example, she details how our immune systems can turn on us, promoting rather than preventing the spread of cancer cells.

When Ehrenreich talks of being old enough to die, she does not mean that each of us has an expiration date. It’s more that there’s an age at which death no longer requires much explanation.

“That thought had been forming in my mind for some time,” she says. “I really have no hard evidence about when exactly one gets old enough to die, but I notice in obituaries if the person is over 70 there’s not a big mystery, there’s no investigation called for. It’s usually not called tragic because we do die at some age. I found that rather refreshing.”

In 2000, Ehrenreich was diagnosed with breast cancer (she wrote the critical, award-winning essay Welcome to Cancerland about the pink ribbon culture).

The experience of cancer treatment helped shape her thoughts on ageing, she says.

“Within this last decade, I realised I was not going to go through chemotherapy again. That’s like a year out of your life when you consider the recovery time and everything. I don’t have a year to spare.”

In Natural Causes, Ehrenreich writes about how you receive more calls to screenings and tests in the US – including mammograms, colonoscopies and bone density scans – as you get older. She claims most “fail the evidence-based test” and are at best unnecessary and worst harmful.

Ehrenreich would rather relax with family and friends or take a long walk than sit in a doctor’s waiting room. She lives near her daughter in Alexandria, Virginia, and likes to pick up her 13-year-old granddaughter from school and “hang out with her a while”.

Work is still a passion too. She fizzes with ideas for articles and books on subjects that call for her non-conformist take.

Once a prominent figure in the Democratic Socialists of America, she is also busy with the Economic Hardship Reporting Project she founded, which promotes journalism about inequality and poverty in the US, and gives opportunity to journalists who are struggling financially. (The Guardian often partners with the organisation.)

Ehrenreich, who is divorced, has talked to her children – Rosa, a law professor, and Ben, a journalist and novelist – about her realisation she is old enough to die, but “not in a grim way”. That wouldn’t be her style. While a sombre subject, she chats about it with a matter-of-fact humour.

“I just said: ‘This is bullshit. I’m not going to go through this and that and the other. I’m not going to spend my time, which is very precious, being screened and probed and subjected to various kinds of machine surveillance.’ I think they’re with me. I raised them right,” she laughs.

“The last time I had to get a new primary care doctor I told her straight out: ‘I will come to you if I have a problem, but do not go looking for problems.’”

She pauses: “I think I beat her into submission.”

Natural Causes is Ehrenreich’s 23rd book in 50 years. Much of her work is myth-busting, such as Bright-sided, which looks at the false promises of positive thinking; other work highlights her keen sense of social justice. For her best-selling 2001 book Nickel and Dimed, she went undercover for three months, working in cleaning, waitressing and retail jobs to experience the difficulties of life on a minimum wage.

A recent exchange with a friend summed up what Ehrenreich hoped to achieve with Natural Causes.

“I gave the book to a dear friend of mine a week ago. She’s 86 and she’s a very distinguished social scientist and has had a tremendous career. “She said: ‘I love this, Barbara, it’s making me happy.’ I felt ‘wow’. I want people to read it and relax. I see so many people my age – and this has been going on for a while – who are obsessed, for example, with their diets.

“I’m sorry, I’m not going out of this life without butter on my bread. I’ve had so much grief from people about butter. The most important thing is that food tastes good enough to eat it. I like a glass of wine or a bloody mary, too.”

Barbara Ehrenreich: ‘Cancer is a cellular rebellion.’

Yet despite her thoughts on the “wellness” industry with its expensive health clubs (fitness has become a middle-class signifier, she says) and corporate “wellness” programs (flabby employees are less likely to be promoted, she writes), Ehrenreich won’t be giving up the gym anytime soon. She works out most days because she enjoys cardio and weight training and “lots of stretching”, not because it might make her live longer.

“That is the one way in which I participated in the health craze that set in this country in the 70s,” she says. “I just discovered there was something missing in my life. I don’t understand the people who say, ‘I’m so relieved my workout is over, it was torture, but I did it.’ I’m not like that.”

In Natural Causes, Ehrenreich uses the latest biomedical research to challenge our assumption that we have agency over our bodies and minds. Microscopic cells called macrophages make their own “decisions”, and not always to our benefit – they can aid the growth of tumours and attack other cells, with life-threatening results.

“This was totally shocking to me,” she says. “My research in graduate school was on macrophages and they were heroes [responsible for removing cell corpses and trash – the “garbage collector” of the body]. About 10 years ago I read in Scientific American about the discovery that they enable tumour cells to metastasise. I felt like it was treason!”

She continues: “The really shocking thing is that they can do what they want to do. I kept coming across the phrase in the scientific literature ‘cellular decision-making’.”

This changed her whole sense of her body, she says.

“The old notion of the body was like communist dictatorship – every cell in it was obediently performing its function and in turn was getting nourished by the bloodstream and everything. But no, there are rebels – I mean, cancer is a cellular rebellion.”

Ehrenreich, an atheist, finds comfort in the idea that humans do not live alone in a lifeless universe where the natural world is devoid of agency (which she describes as the ability to initiate an action).

“When you think about some of these issues, like how a cell can make decisions, and a lot of other things I talk about in the book, like an electron deciding whether to go through this place in a grid or that place. When you see there’s agency even in the natural world. When you think about it all being sort of alive like that, it’s very different from dying if you think there’s nothing but your mind in the universe, or your mind and God’s mind.”

Death becomes less a terrifying leap into the abyss and more like an embrace of ongoing life, she believes.

“If you think of the whole thing as potentially thriving and jumping around and having agency at some level, it’s fine to die,” she adds reassuringly.

Complete Article HERE!

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04/14/18

I’m dying, and I’d like D.C.’s Death with Dignity Act to help

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People attend a House Oversight and Government Reform Committee business meeting at the Rayburn House Office Building in February 2017 for a discussion of D.C.’s Death with Dignity Act.

I am dying of ovarian cancer. I do not know how long I have to live. I have endured radical surgery, 65 chemotherapy treatments, countless trips to the emergency room and admissions to the hospital to extend my life. Now, my illness has developed resistance to treatments, and the last two drugs did not slow the growth of my tumors. I can die from a combination of chemotherapy and cancer or from just the cancer itself. I recently decided to cease treatment and pursue palliative care so I can minimize my suffering and maximize the quality of life that I have left with my wife, Stella, and our beloved dog, Adina.

I love my life, but now I need to plan for my death. I would like the option of medical aid in dying, which is authorized under D.C.’s Death with Dignity Act and that took effect in February 2017 for those terminally ill patients who meet strict requirements. The law allows mentally capable terminally ill adults with six months or less to live to get prescription medication they can decide to take if the suffering becomes unbearable, so they can die peacefully in their sleep, at home, surrounded by loved ones.

March 23 was a wonderful day for me and other terminally ill D.C. residents. President Trump signed an omnibus spending bill that did not include a House-passed provision to repeal the law or an administration proposal to thwart funding of its implementation.

Coincidentally, March 23 also was the 20th anniversary of the first prescription for medical aid in dying in the nation, under the Oregon Death With Dignity Act, the model for medical aid-in-dying laws in the District and five other states.

Before the federal spending bill was enacted, I lived in a state of uncertainty. I feared that opponents would be successful at invalidating the law. Fortunately, they were not. The law has been upheld, and the D.C. Department of Health issued rules last June to implement it, but health-care providers have not done the work necessary to allow patients such as me to use it. The threat that the law might be repealed made it unrealistic for doctors, health-care systems and pharmacists to invest the time to develop policies to participate in it. The D.C. Department of Health confirmed at its performance oversight hearing in February before the D.C. Council, at which I testified, that not one resident has obtained a prescription since the law that took effect more than a year ago.

Now, almost two months after the hearing, I still cannot find a physician who is willing to write a prescription for medical aid in dying. I and other terminally ill residents in the District need a compassionate doctor to come forward and embrace this option for dying.

I have been surprised at how many people, including physicians, do not know that medical aid in dying is now legally authorized in the District. Assumptions that congressional opponents would defeat the law brought its full implementation to a standstill.

Now that the immediate threat of the law’s repeal is over, I would like to encourage the D.C. Department of Health to work with health-care advocacy organizations such as Compassion & Choices, which helped implement the Oregon law, to launch an education campaign here and put the law into action. This collective effort would require working with D.C. doctors, health-care systems and pharmacists not only to explain the rules but also to consider any changes to ensure that the law does not discourage participation. Terminally ill patients need to know that medical aid in dying is an option.

It also took five months after the Oregon law went into effect for the first doctor to write a prescription. Once he did, others followed. Oregon now has an end-of-life care system that recognizes this compassionate option for dying.

More than a dozen safeguards in the D.C. law have been time-tested for a combined nearly 40 years in states that have authorized medical aid in dying without a single documented case of abuse or coercion. The D.C. rules are more complicated than those in other states, which might make it harder for terminally ill D.C. residents such as me to access this option to die peacefully in their sleep, at home, surrounded by loved ones. The result would be needless suffering.

It’s time we make compassion the priority of this law.

Complete Article HERE!

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