As a death doula and professor who teaches about dying, I see a need for more conversations about death


Students in a death and dying class have the opportunity to become a ‘death ambassador,’ in recognition of their new level of awareness that could help foster healthy conversations about death and dying.

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A growing number of folks may have heard of the death-positive movement, death cafés or death-friendly communities — each of which are animated by the understanding that welcoming our own mortality could improve the quality of our lives.

There is truth to these claims. Both as a person who has taught courses on death, dying, and spirituality for more than 20 years, and as a death doula, thinking about dying and working closely with the dying has fostered in me a deep appreciation for what it means to live well and meaningfully.

However, my university students have often told a different story. Both informally in class discussions, and also in a public presentation about why death education matters, for the online Lifting The Lid International Festival of Death and Dying, many have expressed how their learning with me signals their first times talking about death.

When I hear this, I am aware of how our society needs to do a better job at nurturing more conversations about death, and building communities that support people navigating questions surrounding death and dying.

Denying death

The easiest way to exile death from our conversations is to label it “morbid,” ensuring we never need speak of it.

My first lecture in every death class begins with a discussion of the pervasiveness of death denial in dominant modern western culture.

I ask my students: “How do people react when you tell them you’re taking a course on death?” Invariably they have heard things like:

“That’s so morbid!”

“How depressing/dark/strange/weird!”

“Why would you want to study that!?”

My courses are designed to introduce students to the study of death through history, culture, religion and spirituality, ritual, literature, ethics and social justice

We explore social and cultural barriers affecting how services are structured and the implications for end-of-life care. For example, racism and inequities in health care and other institutions contributes to dangerous disparities in treatment and life outcomes, influencing Black, Indigenous and racialized communities’ collective trauma surrounding dying and death.

Students read and learn about how humans have understood and interpreted death, as well as some of the pressing social issues that we face in contemporary death care and practices.

Inspired by the work of Dr. Naheed Dosani, palliative care physician and health justice activist, I now include a class on palliative care for people experiencing homelessness and dying in the streets.

Anishinaabe death doula Chrystal Toop, a Member of Pikwàkanagàn First Nation, also visits my class to speak about compounded trauma of death and collective grief experienced by Indigenous Peoples, and why she created her own Indigenous death doula training to reclaim cultural teachings.

I also bring what I have learned as an end-of-life companion from hours sitting with and listening to people who are facing their own death or the death of those they love.

The gentle skills learned there are discernment, attention and compassion. As students reflect on what they will take with them from the course, they perceive the value in this kind of experience I bring to the classroom as much as in an article on palliative care and its history.

Negative consequences of denying death

My courses on dying and death have always drawn students from other humanities programs like English, fine arts and history. But over the years, more students from the professional programs, such as nursing, criminal justice and social work are enrolling.

While students’ professional programs — for example, in nursing or social work — seek to address various topics surrounding aging, trauma, death or end-of-life care in varying ways, students also need opportunities to think about their own mortality and, to cultivate some self-awareness in order to be present for others experiencing death and dying.

Some of my nursing students raise questions like: How do they talk to the loved ones of patients who are dying? What should they say?

These questions are hard enough when death is expected. They are exceptionally difficult when it isn’t, when the death is of a young person, a child or a baby.

New level of awareness

Students also express their disappointment and confusion because what they face in the aftermath of death and loss is often isolation and solitude.

While research about how to support children and young people navigating death amplifies the need for open and sensitive discussion, some students, especially white, middle-class students, speak of experiences of having been shielded from death by those who thought shielding them was the best way to protect them from fear and anxiety.

Simply providing the safe space to begin to have these conversations goes a very long way towards assuaging their fear and grief.

In part this is because supporting the passage of life to death, and supporting grief, is (or should be) a collective experience.

Community death care is everyone’s business, and while awareness of our own mortality is an important part of that, awareness and activism around racism, violence and injustice in end-of-life care is essential.

Image showing cards with a crow that say 'death ambassadors.'
Some of my students have also created their own death-awareness social media accounts as part of being a ‘death ambassador.’

Death ambassadors

Figures like Dosani are making social media outreach part of their teaching and care practices. In recognition of the importance of creating death supportive communities, I also started an Instagram account, @death.ambassadors, to chronicle my death teaching.

At the end of each death course, I offer students the opportunity to be a “death ambassador,” in recognition of their new level of death awareness that could help to foster healthy conversations about death and dying in our culture.

Some of my students have also created their own death-awareness social media accounts, and found themselves supported by a death-positive community of educators, end-of-life companions, funeral directors and death doulas.

It is a universal truth that one day we are all going to die and that means we all have a serious stake in death education.

When it’s your turn, or the turn of someone you love, don’t we all need people who have considered how to support us in navigating dying and death? Let’s do the work to make that a reality for everyone.

Complete Article HERE!

Your Partner Was Diagnosed With Dementia

— What Now?

Dementia can be a devastating diagnosis, but there are steps you can take to plan ahead and care for your partner. Learn about the early warning signs of dementia, what to do if you suspect a diagnosis, and how to create a legal, financial and end-of-life plan.

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Maybe you knew there was a possibility that it could happen. Maybe your partner’s mother or father had dementia, and maybe even their siblings, so you were watching for the signs. Or, maybe, it came out of the blue, and you never thought that dementia would ever impact you or your family. 

When you start to notice changes in memory, behavior and judgment that are not normal with your partner, it gives you a sinking feeling, whether you may have been expecting it or not.

Warning Signs of Dementia

According to the Alzheimer’s Association, there are 10 early warning signs of Alzheimer’s and Dementia that you can be watching for:

1. Memory Loss That Disrupts Daily Life

Forgetting recently learned information, forgetting important dates or events, asking the same questions repeatedly and increasingly needing to rely on memory aids or family and friends for things they used to handle on their own are all signs.

2. Challenges in Planning or Solving Problems

This may involve changes in the ability to follow a plan or work with numbers. For instance, they may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and/or taking longer to do things than they did before.

3. Difficulty Completing Familiar Tasks

Examples include having trouble driving to a familiar location, organizing a grocery list or remembering the rules of a favorite game.

4. Confusion With Time or Place

This may involve losing track of dates, seasons or the passage of time, trouble understanding something if it is not happening immediately and possibly forgetting where they are or how they got there.

5. Trouble Understanding Visual Images and Spatial Relationships

Some people experience vision changes that may lead to difficulty with balance or trouble reading. This may also lead to difficulty judging distance and determining color or contrast, causing issues with driving.

6. New Problems With Words in Speaking or Writing

This often presents as difficulty following or joining a conversation. They may stop during a conversation and have no idea how to continue or repeat themselves. Moreover, they may simply struggle to find the right words.

7. Misplacing Things and Losing the Ability To Retrace Steps

They may put things in unusual places, lose things and be unable to go back over their steps to find them again or accuse others of stealing, especially as the disease progresses.

8. Decreased or Poor Judgment

Experience in changes in judgment or decision-making. For example, when dealing with money or keeping themselves clean.

9. Withdrawal From Work or Social Activities

Because of the changes in the ability to hold or follow a conversation, many people experiencing changes due to dementia may withdraw from hobbies, social activities or other engagements.

10. Changes in Mood and Personality

This shows up as being confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, with friends or when out of their comfort zone.

If You Suspect Your Partner Has Dementia…

Don’t ignore the signs. Schedule an appointment with your partner’s primary care physician immediately to seek a diagnosis and take the next steps.

If there is a dementia diagnosis, you are likely completely overwhelmed. Your world has been turned upside down and it is likely hard to think beyond each day at a time, let alone the next month or year. However, taking steps to plan ahead can help things go more smoothly for you and your entire family. 

As the disease progresses, things are likely to only become more hectic, making it even more difficult to think clearly. Getting your legal, financial and end-of-life planning finalized early on will make it easier for you to make the appropriate decisions needed and to communicate those decisions to the right people before things get even harder.

Legal

Make sure your partner has updated legal documents in place (if they don’t already) before they are designated as being unable to make those designations/decisions for themselves due to their new diagnosis.

  • Patient Advocate/Health Care Durable Power of Attorney: This names someone as a “proxy” to make medical decisions for someone when they are not able to.
  • Living Will: This informs medical professionals of how one wants to be treated at the end of life (dying, permanently unconscious, etc.) and cannot make decisions on their own.
  • A Do Not Intubate, or DNI, order: This lets medical staff know someone does not want to be put on a breathing machine.
  • A Do Not Resuscitate, or DNR, order: This lets medical staff know not to perform CPR or other life-saving procedures in case the heart or breathing stops.
  • General Durable Power of Attorney: This names someone as a “proxy” to make financial decisions and handle financial transactions for someone when they are not able to.
  • Will: This names someone to be the executor to handle their estate after they are deceased.
  • Trust: For some, a Revocable or Irrevocable Trust naming someone to handle assets on their behalf and for their benefit either during their lifetime or after death is appropriate.

Financial Planning

It is important to work with your financial adviser to make sure fiscal affairs are in order for several reasons:

  • Make sure that all of your financial records are accounted for by using a Personal Recording Keeping document. Keep it stored in a safe place before that information is lost or forgotten by either or both partners.
  • Work with your financial adviser to make sure you have planned well to provide for your financial future, including your now more certain long-term care needs including dementia care.
  • Make sure assets are positioned and titled properly to assist with future long-term care needs and any future resources and assistance that may be needed.
  • Research any insurances you may currently hold to make sure you understand how they may be used for future long-term care needs.
  • Talk about how you might want to handle future care needs for your partner with dementia. If that includes you, as the healthy spouse, taking time from work (if you are not yet retired), plan for how you will handle that financially. Planning ahead for how care will be funded, if needed, is a key piece of future planning.
  • Research community and professional resources in your area. Put together a team to help you when needed.
  • Communicate your future plan to your family so that they can help you execute it when things are more hectic and the disease is more difficult to deal with.

End-Of-Life

There is currently no cure for Alzheimer’s disease or any other dementia. Some treatments, though, can manage some of the symptoms for a time. 

However, a person who has been diagnosed will gradually decline and the condition itself (or combined with additional health problems) will eventually result in death. For that reason, it is also important to plan ahead and make decisions for end-of-life early on. 

Making sure the important legal documents are in place is the first step. Communicating preferences for end-of-life to important family members is the second step. If there are any preferences for end-of-life services, that should be documented. Using a Letter of Last instruction document is a good idea.

When your partner is diagnosed with dementia, it can be a shock. For many, it can be so overwhelming that it can be hard to breathe, let alone get your head around doing anything. But once the numbness wears off, lean on your financial adviser and professional team of advisers to get a plan in place so that the legal, financial and end-of-life pieces are in order so that you can concentrate on caring for your partner and their ongoing needs.

Complete Article HERE!

In my 40s I’ve started decluttering my house in preparation for my death

– Everyone should

Swedish death cleaning, basically throwing out your crap so that others don’t have to do it when you’re gone, is truly comforting, says Sophie Morris

By Sophie Morris

I have a stash of travel guides that take up two shelves in my home. They’re all completely useless, of course – out of date and pre-smartphone. But while clearing out my house before letting the builders in a few years ago, I struggled to get rid of them. The vintage guidebooks to foreign countries and capitals remind me of the places I’ve been and the life I once had. My youth. Does getting rid of them mean accepting I will never live in Spain?

But when I factor in my daughter, and think about how she’d feel if I left her with a stack of pointless books, saying goodbye becomes much easier. I’d far rather she has some online photo albums of my travels to flick through when I’m gone than break her back lugging books to the tip. We’ve started to feed them to the fire together, reading pages as we go and dreaming about future holidays and real-life experiences that I’d love to share with my family instead of clinging onto bulky possessions.

I have begun, inadvertently, döstädning – Swedish death cleaning. I’m in my 40s and I’m not ill, unless you count my fear of clutter as an ailment. Nor am I a Marie Kondo-obsessed minimalist. I’m happy to have stacks of books and toys around the house, and shoes and coats piling up in the hallway.

Think of döstädning as a gentle, considerate Kondo. It’s an approach to organising your life – which the Swedes apparently have always done as they age – to prepare for death. It has been translated and popularised for the rest of us by the author Margareta Magnusson, whose book The Gentle Art of Swedish Death Cleaning was an international hit, spawning a TV show (out on Peacock earlier this year) and Magnusson’s 2023 follow-up, The Swedish Art of Ageing Well.

What is Swedish death cleaning? “Basically throwing out your crap so that others don’t have to do it when you’re gone,” says Amy Poelher, who produces and narrates the TV show. But it leaves people feeling enriched rather than robbed, which I know more than a few KonMari acolytes felt once the seasons changed and they had only three pairs of pants and one coat to see them through the winter.

Magnusson came to death cleaning after losing her own mother and husband. She realised that having to sort through housefuls of clutter and useless possessions makes the grieving process even harder. When done properly, according to Swedish folklore, döstädning means taking a gap year after you retire to declutter and organise your home and belongings. While cleaning, we’re forced to think about the stuff we own and our attachment to it, which brings with it a natural emotional cleansing.

Perhaps more importantly, the aim is to consider whether these items will hold value for those we leave behind. If not, they are simply a burden. Therefore, as you consider and confront mortality – something British people are notoriously squeamish about – you also enhance the time you have left and let your loved ones know they have been thought about too.

“Death cleaning isn’t the story of death and its slow, ungainly inevitability,” writes Magnusson. “But rather the story of life, your life, the good memories and the bad. The good ones you keep. The bad you expunge. A loved one wishes to inherit nice things from you. Not all things.”

As the children of boomers who, it sometimes seems, remain in possession of most items they’ve acquired during their long years, my husband and I are both hyper alert to not hanging onto stuff. If we’re putting something in the loft, we’ve always paused to ask if it’s for future use, or just because we can’t face sorting through it. Shows about hoarding on TV typically present extreme examples, which are often health and fire risks. But when you look at most people’s homes, hoarding seems to be the norm rather than the exception.

When my great-aunt died in 2019, my parents were left to sort through her house. Luckily, they are both retired, but they spent months driving back and forth to her modest two-bedroom house to sift through her and my great-uncle’s lives well-lived. So when my Dad later sent me a box of my own school reports and certificates (every piece of paper from the age of three to 18!), I realised he was saving me and my sisters a job and was grateful.

Over the past two years, I’ve become much more ruthless and begun conscientiously Swedish death cleaning. Prompted by the travel guide saga in 2021, I began to see the incredible volume of unused, unloved and, often, useless stuff a family of three in a modest semi was holding on to. We went through the döstädning process then, when we moved out for renovation works to begin, and we did it again when we moved back in a few months’ later.

Most weekends since have involved trips to charity shops, posting items for sale on Facebook Marketplace, eBay, Vinted or local resale WhatsApp groups, or seeking out younger children who might benefit from our daughter’s old clothes and books. Everyone else is at it, too. My – exceedingly lucky – seven-year-old has recently received Jill Murphy’s Worst Witch series, a whole stack of Pamela Butchart books and a complete winter wardrobe, all for free, from our kind neighbours.

One particular sticking point for me has been books. My collection feels a bit like a sourdough starter: alive, always growing, demanding to be fed, prone to surprises and unmanageable. I have made the (extremely conservative) estimate that a minimum of 20 new books enter the house for me each year for work and pleasure. Therefore, I must identify and pass on at least 20. This is not easy, but I plough on, making slow but steady progress. (Don’t worry, I’m not turning them all into fuel. They’re going to keen readers and charity shops.)

Another area of my life where I think about döstädning, and I think this is the most important one, is when I am buying something. If it never gets into my house in the first place, I won’t have to waste time wondering how to get rid of it.

So what have I got from all this death cleaning? I’ve found plenty of comfort in Scandinavian lifestyle trends in recent years: I was a shoo-in for hygge, the Danish concept of building yourself a cosy and comfortable lifestyle, and was born to embrace fika, the Swedish concept of taking time each day to relax and connect over coffee and a cinnamon bun. But death cleaning feels so much more significant and truly comforting, compared to cosiness and cake.

How to Swedish death clean

  • If you are genuinely preparing for death because of illness, or feel old enough, it can be wise to tell loved ones that you are Swedish death cleaning. It’s not meant to be bleak, but an act of kindness created with survivors in mind.
  • Work top to bottom – from your loft down to your everyday living spaces
  • Don’t force people to take items they do not want to save your own guilt. This is a chance for open and honest dialogue about what family members might want now and when you are no longer here.
  • Leave sentimental items, letters and photos till last. Keep your own memory box. This is also your chance to dispose of or hide anything embarrassing!

Complete Article HERE!

Anticipatory Grief

— It’s Not Just Stress

By KATE FAVARO

When we know something is going to happen, we try to prepare ourselves. If the timer is about to go off, we grab the oven mitts lest we burn the chocolate chip cookies. When there’s a new baby expected in the family, we rush to check our phones each time they ring. If we’ve somehow found ourselves in the front row of a roller coaster, we silently curse the friends who talked us into it and grip the bar before that big drop at the beginning. When we find out someone we care about is sick and likely to die soon, we grieve even before they are dead.

Anticipatory grief is the period of time prior to an expected death (or other loss.) It is filled with many emotions and can easily be written off as “just stress” but it should be seen as its own unique grief experience. It provides an opportunity for you to make plans of how to care for the person, to have conversations you’ve been putting off and spend meaningful time with the person who is dying. At its core, anticipatory grief allows you a chance to imagine a world without the person who is going to die; a terrifically sad prospect. Not each death allows for the experience of anticipatory grief but if you do experience it, Hospice of St. Lawrence Valley offers the following suggestions:

Consider secondary losses. Not only are you grieving the loss of a person but you’re grieving what will (or won’t) happen because of their death. Things like a change in financial security or in living arrangements. When the person dies your role in the family, and perhaps even your purpose, may change. You will also be grieving the future you thought you’d have with them. They won’t be at that wedding, graduation or next big family get together.

Remember your whole body will grieve. Just like with traditional grief (after the person dies), anticipatory grief impacts your whole body not just your emotions. People frequently experience headaches, changes in eating habits, and feeling as though they’re always on the verge of tears. For me it was the sensation of holding my breath, for months, while the person I loved was on Hospice.

Your emotions will be conflicting. Anticipatory grief can be confusing. On one hand you are sad this person will die, on the other you want to focus on the good memories you have and can still make with them. At times you may feel grieving or imagining a world without the person who is dying is “giving up.” It’s not, it’s a natural part of the grieving process. It is important to note going through anticipatory grief does not give you a head start on the traditional grieving process after a death.

Anticipatory grief can be overwhelming. No matter how long the person was sick, no matter how long it’s been since they were “themselves” you will still grieve their physical absence.

Complete Article HERE!

Choosing a dignified death

— Stratford woman shares medical assistance in dying journey

Stratford resident and journalist Diane Sims, who is living with end-stage multiple sclerosis, recently received approval for medical assistance in dying (MAiD). She spoke with the Beacon Herald about that process and why she is choosing to end her life.

Approved for medical assistance in dying last year, Stratford’s Diane Sims recently spoke with the Beacon Herald about her journey and her choice to die with dignity.

By Galen Simmons

In making the decision on how and when she will die, Diane Sims is also choosing how she will live the rest of her life.Last year, the Stratford journalist and writer, who was diagnosed with multiple sclerosis in 1975 when she was just 17 and declared palliative two years ago, qualified and was approved for medical assistance in dying (MAiD).

“I never want to end up in a nursing home, especially after what we saw coming out of COVID,” Sims told the Beacon Herald in a recent interview. “My whole experience with nursing homes is they’re just places where you’re waiting for God. It was the lack of independence and privacy, and I worried about care because my care needs are high. I never wanted that.“And I’m a communicator, so when my hands stop working completely and my voice stops working, I don’t feel I have myself left anymore. MAiD is such a dignified way to go,MAiD and there’s no purchase in people giving me lectures about God because the divine and I are at peace with this.”

A nuanced decision

In Canada, qualifying and being approved for medical assistance in dying is a strictly regulated, yet nuanced, process. Dr. Stefanie Green, a MAiD practitioner and founding president of the Canadian Association of MAiD Assessors and Providers, said there are five criteria a patient must meet to qualify as eligible.

The patient must be 18 years of age or older and eligible for government-funded health care in Canada. The patient also needs to make a voluntary, written request free of any kind of coercion. The patient must have the capacity to make that decision, which means they understand what’s wrong with them, as well as their pros and cons of their treatment options. Finally, the patient must understand that an assisted death is irreversible.

Finally, the patient needs to have what Canadian law refers to as a grievous and irremediable condition.

“A grievous and irremediable condition is a term that is defined in the Criminal Code of Canada,” Green said. “It is the only medical practice I’m aware of that’s defined in the Criminal Code … so we know exactly what the law says about it. … It means there are three things that need to be true all at the same time. … The patient needs to have a serious, incurable illness, disease or disability. The patient needs to be in an advanced state of decline and capability. Capability really means function, so they’re no longer functioning the way they were before they had their serious and incurable illness, disease or disability.

“The third and final thing that needs to be true is that the patient has intolerable and unendurable suffering that cannot be relieved in any way they find acceptable, and that is a subjective criteria that the patient really gets to decide. It’s not for me to decide how much someone is suffering or how much they can endure.”

Once a patient meets those criteria as determined by two independent clinician assessors, there are two paths their MAiD journey can follow, Green said. The first is more straightforward. If doctors determine the patient’s natural death is reasonably foreseeable, meaning the patient is on a trajectory toward death based on their illness, disease or disability, and not that they will die within a specific time period, they are put on track one.

“The procedural safeguards (for track one patients) are some of the things I already mentioned,” Green said. “There needs to be a written request. It needs to be signed and dated. It needs to be witnessed. The patient needs to give consent at the time of their request and also immediately prior to administration of medications.

“A track two patient,” Green added, “is someone whose natural death is not reasonably foreseeable. Typically, they’re people with chronic pain syndromes that are less understood and more complex, or a patient who a clinician is just not comfortable saying their death is reasonably foreseeable. Track two patients have to meet all the track one eligibility requirements and procedural safeguards … and they have five extra procedural safeguards on top of that, (including) there has to be the input of someone with expertise in the condition that’s causing the patient’s suffering … (and) patients need to be made aware of all the reasonable and available means to reduce their suffering. … They need to be offered those means of reducing their suffering and they need to give serious consideration to accepting those means of reducing their suffering.”

A considered decision

Sims said she and her husband spent the year between her prognosis as palliative and her decision to apply for MAiD considering these alternatives and evaluating her quality of life.

While she was still getting some enjoyment out of life, her disease has confined her to an electric wheelchair and severely restricted the food she can eat. In recent years, she’s endured numerous hospitalizations and invasive surgeries, required round-the-clock care, and has suffered chronic pain, declining speech, jerky arms, spastic legs, shaky hands, a compressed lung and a dying colon.

Though she still finds enjoyment when she writes and paints, Sims knows there will soon be a time when that enjoyment will only be a memory.

“I know what’s coming and yet I look around at all this colour and I think, ‘How am I going to leave all this colour and close my eyes for the last time,’” she said. “I’m not there yet because I’m still working. I can’t keyboard very well anymore – my hands are really going – so that worries me. I notice it day by day almost.

“It is scary.”

Not everyone in her life understands or is willing to confront Sims’ decision. In a piece she wrote for Maclean’s magazine at the end of June, ‘How I Plan to Die’, Sims said her husband, Dennis, was initially horrified by the notion his wife was considering ending her life.

“Dennis was absolutely against it. I remember being outside on the terrace last summer telling him that’s what I wanted to do, and I knew his reaction because I’d known what it would be all along. He hated the idea. He felt it was a cop out. He felt it was suicide,” Sims said.

That summer, Sims and Dennis worked their way through a bucket list of day trips close to home before travel became too burdensome and painful for her. After seeing his wife struggle with pain and discomfort on those trips, Dennis finally accepted his wife’s decision.

“All of the sudden in the car he said, ‘I understand.’ I was sort of shocked into silence and had to ask him to repeat what he meant. He said, ‘I understand why you want to do it now,’ so now he understands and is supportive. All my friends have been supportive. I’ve had some family members … tell me that it’s basically suicide and I should wait for God’s timing to take me, and I’ve said, ‘You want me to suffer?’  … It’s not just the communication. It’s when the pain reaches a certain point where I won’t want to carry on with it anymore.”

A conversation with the patient

Ultimately, control over when, where and how she dies remains firmly in Sims’ hands. When she reaches the point where she knows she simply can’t carry on, she will call her MAiD practitioner and they will be ready to carry out the final stage of her journey within 48 hours. Even on the day of her planned death, Sims has the right to back out of the process until that point of no return when the medications are administered.

According to Green, a patient and their practitioner have that conversation about how the medically assisted death will be carried out as soon as it is approved.

“It’s a conversation with the patient about what’s meaningful to you. What would be a meaningful event for you? Who do you want there? The word that we tend to use … is choreograph. We choreograph their event,” Green said. “Do they want music? Do they want people there? Do they not want any of those things? Do they want a spiritual guide? Do they want prayer? Basically, anything we can accommodate, we will. Any sort of ceremony or ritual that they wish, we can do.”

For Sims, she will be surrounded by her friends when she decides to go.

“And they’ll be there to support (my husband) Dennis. … I plan to have friends and bubbly and music – all the things that I love,” Sims said. “You have to explore your soul and be at peace with yourself first (before considering MAiD). You can’t put too much purchase in what other people say because those that love you and understand what you’re going through should support you. … Don’t be afraid of the process. … You’re in the driver’s seat. Nobody is pushing you as to the time. It’s totally up to you.

“You are making the choice and it’s your last act of independence.”

According to the most recent data published by Statistics Canada, there were 12,689 written requests for MAiD in 2021,  a 31 per cent jump from 2020. These requests resulted in 10,029 medically assisted deaths in Canada in 2021, an increase of 34.7 per cent from the year before. MAiD accounted for 3.3 per cent of all deaths in Canada in 2021, up from 2.4 per cent of all reported deaths in the previous year. In 2021, slightly more than half of those receiving MAiD were men, and the small percentage difference between men and women had not changed significantly since 2020.

Complete Article HERE!

Does Someone Know When They’re About To Die?

By Jennifer Anandanayagam

Death is an uncomfortable topic for most of us but it is also one of the few universal experiences everyone will have. Scientists and doctors have long been investigating what happens to someone as they slowly slip away from this world, and while we don’t have all the answers, there are a few physical and behavioral changes you might be able to observe in someone who’s dying.

The person’s level of activity and movements might decrease significantly, noted the Hospice Foundation of America. They might spend most of their time sleeping. You might also observe that they’ve detached from what’s going on around them — interests, conversations, etc. They may also experience a loss of appetite and mental confusion. Physically speaking, someone who’s dying will experience a slowing down of their breathing and a drop in their blood pressure, per Everyday Health. “The fingers may get cold or turn blue. If you feel the pulse, it will be weak, then they start to develop an irregular type of breathing, and that’s a sign that things are pretty ominous,” added the medical director of the Hebrew Home at Riverdale in New York, Dr. Zachary Palace. A person in the last stages of life may also lose control of their bodily functions like urinating and defecating.

While these are the changes you’ll see in someone who’s close to death, what about them? Do they know they’re dying? According to certified hospice nurse Penny Smith, who goes by the name Hospice Nurse Penny on YouTube, they do, mainly because of what most people say before they die.

Dying people talk of having to ‘go away’

Penny Smith, who’spassionate about end-of-life advocacy and normalization of death, thinks that people who are close to death sometimes tell us that their time on earth has come to an end. “They might say, in no uncertain terms, ‘I’m dying soon,’ but often they tell us in metaphors,” she added.

They might say things like, “‘I need to pack my things,’ ‘I’m getting ready to leave,’ ‘I’m going on a trip,’ ‘I want to go home,’ or even just, ‘I’m tired,'” shared Smith. For the loved ones who are watching the process, it’s a matter of leaning into and listening to what they’re saying. By following their cues, you’ll really have the chance to say goodbye and express your feelings before they no longer understand, explained the hospice nurse.

People on their deathbeds are often concerned with mending relationships, navigating regrets, and spending time with loved ones. In fact, according to Fellow of the American Academy of Hospice and Palliative Medicine, palliative care physician, and author, Dr. Ira Byock, the words, “Please forgive me,” “I forgive you,” “Thank you,” and “I love you,” become even more meaningful when death is near. As a loved one who’s close to someone nearing their end, facilitating these important conversations could be the biggest gift you can give them.

Someone near death may feel peace

According to a 2014 study published in Resuscitation, people close to death sense being separated from their bodies and feel peaceful. The research involved interviewing 140 cardiac arrest survivors with near death experiences from the U.S., U.K., and Austria.

Neuroanatomist and author of the book, “My Stroke of Insight,” Dr. Jill Bolte Taylor, who experienced a sense of bliss when she had a stroke, per Forbes, thinks her euphoric sensations when close to death may have had to do with what part of your brain dies first. The left brain is often credited with all that’s logical, mathematical, and factual in our thinking, while the right brain is where creativity, imagination, and feelings thrive (via Healthline). Dr. Taylor thinks that when we’re close to death, it’s the right side of our brain that endures.

“When we’re on our deathbed, the left brain begins to dissipate. We shift out of all the accumulation and the external world because it’s no longer valuable. What is valuable is who we are as human beings and what we did with our lives to help others,” she told Forbes. Perhaps this is another explanation as to why someone who is about to die is concerned with mending relationships. Even if we don’t have all the answers about what people see and hear before they die, we do know that they want to spend their last moments in peace and love. Maybe this will help us do the best we can to make the experience of their passing meaningful for them.

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Why Do We Always Want To Know How Someone Died?

— Mental health experts weigh in on this common impulse to find out the cause of death.

It’s natural to feel curious about death, especially in unexpected circumstances.

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When we learn that someone has died ― especially at an earlier age than expected ― there’s often a flood of painful emotions and difficult questions. Chief among them: How did this happen?

Whether we knew the deceased well or they were a complete stranger, some of us have a tendency to fixate on finding out the cause of death, perhaps devoting hours to internet research as we desperately search for clues that might provide an reason. Others might reach out to express condolences to their loved ones … followed by the blunt question. Though the approach to finding answers can vary, the underlying impulse is not uncommon.

“I think when we hear about someone passing away at a young age, it rocks our sense of normalcy and the way we conceptualize the world,” said Rachel Thomasian, a licensed therapist and owner of Playa Vista Counseling in Los Angeles. “We operate with the general belief that people live until they are older and, barring a major catastrophe, will die well after they retire. Believing this is our brain’s way of keeping us psychologically safe from worrying about all the bad things that actually could happen.”

She added that not knowing the cause of death can lead us to think about all the possible ways a person can die. This need to have the reason a relatively young person died is about giving us some sense of meaning as to why this could happen.

“People have a natural fear of their own death, so when they hear of an untimely death, it might give them a sense of control to know how they died so they can try to prevent that,” Thomasian said. “So when we hear about someone who dies at a young age, it reminds us not only of our own mortality but that we too are not immune from dying much sooner than our 100th birthday.”

Because most of us don’t enjoy actively thinking about our own mortality, we tend to counter such thoughts with the assumption or hope that we’ll die peacefully in our sleep of old age, as will our loved ones.

“So when we have to confront the reality that someone died young, it creates a conflict with this assumption and we try to resolve it by getting more information,” said Zainab Delawalla, a clinical psychologist in Atlanta, Georgia. “Ultimately, we want to reinforce for ourselves the idea ‘that [dying young] won’t happen to me.’”

This impulse to want to know the cause of death also stems from our natural curiosity as people. In the age of the internet and social media, those in younger generations particularly pride themselves on their ability to quickly find information about other people. So not knowing how someone died can feel like a frustratingly incomplete puzzle, which compounds the difficult emotions surrounding a tragic and shocking loss.

“This neurological need to understand how and why someone died relates to a concept that social psychologists call ‘cognitive closure,’ which refers to the motivation to find answers to ambiguous situations,” said Becky Stuempfig, a Southern California-based therapist. “All of us have different levels of need for cognitive closure, and this need often increases during stressful events such as a death. Our brains struggle with the unknown, and it brings us peace when we can answer the ‘why’ and dispel the mystery surrounding the loss. Even if we do not have accurate information, our minds may hold on to any answers we can gather.”

Is this impulse a bad thing?

“Generally speaking, I think trying to resolve internal conflicts by seeking more information is not a bad thing,” Delawalla said. “The impulse to figure out the exact cause of death when someone dies at a young age is likely rooted in us trying to desperately hold on to the assumption that we might still die peacefully of old age. More information on one specific case would allow us to figure out why these circumstances are different and how they don’t apply to us.”

There’s nothing inherently wrong with wanting details that allow us to put order to things that feel chaotic, and the unknown process of death and what happens after we die certainly fall into that category.

“For some, the attempt to understand how and why someone died stems from a desire to delay the frightening concept of death by prolonging life and avoiding whatever caused the death,” Stuempfig said. “This is often seen when children pass away. The loss of a child feels so unnatural and traumatic that others sometimes feel a desperate need to understand the cause of death in an attempt to avoid a similar loss and to place some kind of reason to a situation that feels like it should never happen.”

However, this impulse can become problematic in certain situations, she added. For example, you might need to take a step back if your desire to learn the cause of someone’s death becomes obsessive and interferes with your daily functioning. Don’t let it impact your sleep or ability to complete work or other tasks.

“On the extreme alternative end, those who fixate on all the alternative ways one could die young are usually dealing with some form of anxiety,” Thomasian noted.

Ask yourself if your desire for this information is related to a deeper problem you should work through with a professional therapist.

“I think the impulse can be bad if it influences you to cross boundaries or disrespect what a person or family has lost,” added Racine Henry, a licensed marriage and family therapist in New York City. “It’s not always appropriate to ask ‘what happened?’ ― especially when the loss is new and people are trying to figure out how to grieve.”

Show respect for the deceased person’s loved ones and their desire for privacy.

How can you avoid feeling consumed by your need to know?

If you’re feeling consumed by your need to know someone’s cause of death, try to shift your mindset. Examine the source of your frustration and ask what you see as the benefits to gain from knowing how they died and harms from not knowing.

“If the desire stems from concern over personal health or wanting to safeguard family members from potentially dangerous situations, open discussions and proactive steps can empower the individual to regain a sense of control,” Stuempfig said.

“For example, if someone feels preoccupied by a death that they suspect was caused by suicide, it could be therapeutic to have open discussions with people in their lives about how they can take care of their mental health. This can help give people a sense of control, counteracting the prevailing feelings of helplessness.”

Try to determine whether your feelings around wanting this information are related to something in your own life.

“Most often there’s a judgment attached to a manner of death ― i.e., if someone died from an overdose, you may feel they deserve less empathy vs. someone who died from a car accident or plane crash,” Henry said. “What does that judgment say about you, and why is it necessary to attach meaning to how someone passes away? Spend time thinking about how that informs the way you treat others.”

Focus on showing empathy for how their loved ones might feel about the cause of death as well.

“Remember that many times the cause of death is not revealed openly because of the family members’ fears about how others will respond and judge them,” Steumpfig said. “In the case of substance abuse overdose or death by suicide, family members are often reluctant to share the cause of death out of fear of judgment or blame.”

Give yourself grace as you process the uncertainty and difficulty of death as well. Stop the “what if” questions from turning into intrusive thoughts and feelings by labeling them without self-judgment.

“Instead of feeling shame for wanting to know the cause of death, recognize the need as a natural function of the human brain,” Stuempfig said. “It can be useful to alter our inner dialogue from ‘What’s wrong with me? Why am I so morbidly obsessed with finding out how this person died?’ to ‘OK, I’m having an intrusive thought about wanting to know the cause of death and that’s just my brain doing its job.’”

Shifting our negative self-talk helps reduce judgment, anxiety and shame ― which thereby decreases the frequency of potentially harmful impulses. So rather than judging yourself for having them (and thus helping them grow stronger), focus on awareness to avoid feeling consumed by intrusive thoughts.

“Discussing these impulses with trusted family and friends can also help reduce isolation and self-criticism as it is a universal human need to seek answers in such situations,” Stuempfig added.

If you didn’t know the person who died well, consider how you might channel your fixation into something more positive.

“Try to refocus on how you can honor what those who are impacted are going through,” she said. “Maybe you can drop off a meal or help with the funeral arrangements. How can that energy be used to benefit those grieving?”

The finality of death can prompt serious anxiety and fear, but no piece of information will make it feel less uncertain.

“Instead of frantically looking for information to confirm ‘that won’t happen to me,’ let us work on accepting that none of us knows how or when we will confront death,” Delawalla emphasized. “We do, however, know and have many more choices around how we confront life. Let us spend more energy on that.”

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