Why We All Need To Better Recognize Our Grief

By Sarah Regan

When we hear the word “grief,” our minds typically jump right to death. We grieve family and friends who have passed, yes—but what about all the other little things in life we grieve that don’t involve a literal death?

Here’s what clinical psychologist Nicole Beurkens, Ph.D., CNS, had to say about this oft-misunderstood emotion, in a recent conversation with mindbodygreen.

What we get wrong about grief.

According to Beurkens, only thinking about grief in the context of death keeps us from properly grieving other endings or metaphorical “deaths” in our lives. This limited definition then inhibits us from actually honoring, processing, and moving through those endings.

“Grief is a pretty intense emotion that we experience in lots of ways,” Beurkens explains.

As she explains, we can grieve any type of loss, from losing a job to losing a relationship to losing a former version of yourself as you grow into your next evolution or chapter of life. She notes that feelings of nostalgia could even fall under grief’s umbrella, too.

You can even grieve for a future you never had, which you might experience when going through a breakup, for example. Suddenly, the future you’d imagined with this person will never happen, even though you’d been planning for it—and that’s a loss that will certainly bring up feelings of grief.

“We can grieve change—any kind of change. So I think people don’t realize that a lot of what we attribute to sadness is actually more accurately labeled as grief,” Beurkens tells us. “They don’t think about it because no one died—but a lot of the sadness, a lot of the melancholy—a lot of that stems from grieving in some way.”

How to make room for grief in your life—because it deserves the space.

The first step to working through any of the more difficult emotions is, of course, identifying it in the first place.

In the case of grief, locate that feeling in your body. What does it actually feel like? (Note: We’re not asking you to intellectualize what, or why, you’re grieving—just feel the feeling!)

From there, Beurkens says, remember that emotions do come and go with time. Sometimes we lean away from grieving because it feels too painful to face, but this only results in stifling those emotions, forcing them to pile up inside you. Trust that by dealing with your emotions now, you’ll be better able to move forward.

“That’s one of the things in Cognitive Behavioral Therapy (CBT) that we really work on with people, is this understanding that you are not your feelings,” Beurkens explains, adding, “Your feelings are happening to you in the moment, but they don’t define you—and what you’re feeling now is not the same way that you’re going to be feeling an hour from now or a week from now.”

With this understanding, we can move away from over-identifying with our emotions. Because if you become too preoccupied with grief, or if you never even honor the fact that you’re grieving something, it can start to impact the way you’re operating, from your mental landscape to your behaviors, Beurkens says.

The takeaway.

Grief is primarily reserved for instances of a loved one passing away, but the truth is, we may actually grieve different things all the time, as we’re constantly changing, growing, and evolving. Nostalgia is real, and grief is too—and when we honor it as such, we don’t have to be weighed down by the past and can move through our emotions with more grace and compassion for ourselves.

Complete Article HERE!

End-of-life planning is a blessing

By John Lurain

In my career as a physician, I witnessed, firsthand, both good and bad end-of-life decision-making by patients and their families. Those who had prepared for the inevitability of death by advance planning and had hope for their life’s meaning beyond the pain and distress of death were able to better accept and handle the realities of dying.

On the other hand, the dying process was often chaotic and resulted in prolonged suffering for those who had not embraced the joy of their lives and had not undertaken discussions or steps to ensure their dying wishes would be carried out.

When my wife, Nell, was diagnosed with incurable, advanced cancer at age 74 in 2021, we were blessed that we had discussed our dying wishes with each other and our daughters and had made plans for the transition to end-of-life well before Nell’s illness. Nell had also found a spiritual peace and meaning in her life through her family, her career as a scientist, and as a teacher, which provided comfort in her final days.

Steps we took to facilitate end-of-life decisions:

1) Moving into an apartment after our retirement, which made it much easier to care for Nell and avoided the hassle of disposing of our house after her death

2) Setting up estate-planning documents, including a healthcare power of attorney if we were unable to serve as our own advocates

3) Discussing with family our priorities for quality of life

As a result of these advance planning measures, our entire family was in agreement about Nell’s end-of-life care. We engaged hospice and home care services early, allowing us to provide comfort care in our apartment without need for hospitalization. Nell passed away peacefully on Aug. 31, 2021. I miss her every day, but I receive solace knowing that we provided Nell with the type of dying experience she wished.

Compassion & Choices, the national nonprofit organization dedicated to end-of-life choices, provides free, comprehensive planning tools available online at: candc.org/endoflifeplanning. I encourage everyone to take advantage of this valuable resource.

Complete Article HERE!

What being a hospice volunteer taught me about death and life

— When Anna Tims volunteered at a hospice, she learned, by helping patients in their final days, not to fear illness and death. Here, she writes movingly on her experience – and explains why dying matters

‘I live in wonder at the power of a held hand.’

By

My introduction to death came in a traffic jam. I turned on the radio and heard a woman describe her father’s final days in a hospice. His end, she said, was a strangely warming memory because of the hospice volunteers who entered the pain of strangers and held their hands as they faced the unknown. In her grief, she explained, she’d encountered humanity at its best. I forgot my frustration at the static traffic as I listened. The prospect of a missed train and crowding deadlines was unimportant, seen through the lens of loss. It was an instant realisation that I wanted to be where life matters most, which is when it is ending. I wanted to be one of those hospice volunteers.

My experience of death had been at a distance. I’d lost grandparents and cats. As a clergyman’s wife, I’d attended funerals of parishioners, tidied tombstones in the churchyard and contemplated my mortality from the pews during Lent. I had never seen a body. I’m frightened of the raw grief of others and I’m squeamish about blood. My volunteering roles have always been with children. I’m used to beginnings, not endings.

I ignored my deadlines that morning. Instead, I Googled hospices. A hospice in the next county was seeking a volunteer to write the life stories of patients in its day centre. This felt reassuringly familiar ground. I applied. Within a month, I was listening to strangers recounting their loves and their losses. Their trust took my breath away. So did the intimacy of hearing memories that had never been shared and regrets that had never been expressed.

Each interview would start the same way: with an apology. The patients apologised for having led boring lives that were not worth recording. Then, as they rewound the years, I realised they were discovering for the first time that they were a pivotal part of a story; that they had made an imprint on the world. A life recounted can make sense in a way that life lived does not. I heard the anguish of a Second World War pilot haunted by the bombs he’d dropped on Germany. I recorded the childhood of a German woman who had grown up beneath those bombs. An ex-convict confided his years of alcohol addiction in the hope that his story of redemption might be shared to help others. I accompanied octogenarians through the hopes of their youth to the resignation of their ending, and, when each story was printed and handed over, those strangers felt almost as familiar to me as family.

Writer Anna Tims in a green tunic and jeans at the Cottage Hospice in East Sussex.
‘I saw people differently’: writer Anna Tims volunteering at the Cottage Hospice in East Sussex.

People were admitted to the day centre if they had less than two years to live. It was a cheerful space full of light, cake and chatter. There was time for friendships to form and flourish. Death felt remote. Occasionally I’d be summoned to the ward of rooms where patients were in their final weeks. It felt a hallowed place. Mysteries beyond my comprehension were unfolding behind the closed doors. Ashamed of my own health, I hovered at bedsides and marvelled as people wrested their remaining shreds of energy to share their lives. One woman could barely speak and her memories were scrambled by a brain tumour. I suggested she rest. “Let’s crack on!” she whispered. Her memoir was for her young children. Through her story, she hoped to live on. We only met the once. She died before she could get past her childhood, but that childhood lives with me as vividly as my own.

I began to see life differently. Chores and routines I’d thought tedious have a sanctity on a deathbed. Everything I took for granted – the school run, the weekly shop, an unexpected soaking in a rainstorm – seemed a gift to those no longer able to experience it. The details the patients recalled of their past were so small, but so precious. I saw people differently, too. Instead of anonymous faces of strangers in the street, I saw protagonists of untold stories; the quiet heroism of ordinary life.

The day centre closed temporarily when Covid struck and most volunteers were stood down. I agonised over all the tales that would never be told. In spring 2021, an SOS came from the Cottage Hospice in East Sussex. They needed volunteers to work shifts with nursing staff. This was not familiar ground; it combined my fears of wounds and body fluids and unleashed emotion. I was uncertain that I could cope with the death of people I had tended. Then I realised that I will one day have to cope with the death of people I have loved. Perhaps to immerse yourself fully in life, you have to confront mortality. So, in fear, I signed up.

The Cottage Hospice is offered free to families and paid for by fundraising. It was established by Hospice in the Weald in 2019 to be a home-from-home rather than a hospital, for those who don’t want to be parted by visiting hours and ward rules. Relatives move in with the patients and care for them with the support, if they want it, of nursing staff and visiting doctors. There are en suite bedrooms with sofas and private verandas, a family kitchen stocked with food, guest rooms for visitors or carers who need a break and stylish lounge areas. Patients can personalise their rooms, which overlook hills and meadows, and host guests in a free café. Some of them bring their pets. The idea is to remove some of the pressure on families so they can make the most of the time they have left.

“Celebrating life, dignifying death” is the philosophy. It feels more like a boutique hotel, and what struck me the first time I entered, was the pervading peace. Not silence, although there is a great quiet, but a tranquillity. It baffled me. Anguish beyond my imagining is endured in those rooms. Some patients were leading active lives until a recent diagnosis and arrive in shock. Some have suffered long illness and are resigned. Family caregivers know that when they leave, they will go home alone.

Over the months, I think I’ve started to understand. The cottage is a pause, a bubble, and in that pause families, in coming to terms with death, can make sense of their life together before the agonising step into the future.

In the outside world, death is hidden, unmentionable. In the hospice, it’s what unites all those there, and, in being acknowledged, it is dignified. It can be a relief for relatives to talk openly about their fears and grief. It is an honour for staff and volunteers to be there to listen. “I feel this place has wrapped its arms round me,” a young wife told me after terrifying weeks of waiting in hospitals.

Instead of collecting memories, I found myself bathing patients, feeding them, talking to families and, occasionally, helping the staff performing last offices for those who had died. To my surprise, I found death in the abstract more frightening than death personified in individuals who can squeeze your hand and share a joke and who, while losing their life, radiate their humanity.

It takes a special grace to accept dependence. In the outside world, we feel humbled by the status and success of others. In a hospice, I’m humbled by figures in the beds, trustingly accepting the ministrations of a stranger and whispering, even when barely conscious, a thank you. Dignity is not what I thought it was. I was hot with embarrassment when I washed my first patient, until I saw she was smiling at me. In her acceptance, she had dignity. In my fumbling confusion, I did not.

Drugs manage the physical pain and some of the mental torment. They can’t remove the dread of loss and the fear of the unknown, but most of those I met have arrived at the same acceptance. Dignity of spirit overcomes the indignity of helplessness. Small gestures – a wiped face, a plumped pillow – feel like tributes. They are all I can offer as they face what I can’t fathom.

My fears were dissolved by the calm of the nursing assistants. Many are young, but have learned more of life in that building than I have done in twice their years. Formal staging posts to friendship are bypassed and staff, volunteers and families are plunged straight into a relational deep end. Some patients and carers want the release of a laugh. Some want to confess fears, share memories or talk of anything but sickness. Some require silence. You have to try to intuit what they need without blundering. I live in terror of an ill-judged word and in wonder at the power of a held hand.

It’s in the kitchen that the hospice’s vision is enacted most powerfully. Caregivers from different families mingle at the table, preparing meals or making tea. We may never have met before, but sometimes the chatter is so lively, the vibe so domestic, that I feel we’re in a house share. A patient’s husband reminded me how to use the microwave each time I forgot and we joked at my culinary incompetence. A pair of young siblings concocted a banquet for their dying father. They’d bought his favourite foods and a bottle of champagne. They decorated the trays with flowers and had hired a band he’d admired. He’d loved to party, they said.

At quieter times, that intimate domestic setting is where relatives let their guard down, confide their struggles and invite a hug. There’s a connectedness in shared crisis that can make you feel more human. Life seems more real sometimes inside the hospice than it does back in the world of deadlines and small talk.

You’re supposed to leave their pain at the door when you clock off from a shift, but some people’s pain comes home with you. The hard part is the absences when you clock on a week later. Families you grew close to are suddenly not there any more and you never got to say goodbye.

Six months after I’d started at the Cottage Hospice, my father was taken ill. He died 10 days later. His sickness was sudden, but the hospice had prepared me. I dread loss more keenly, perhaps, than I ever did, having witnessed families watch their lives fall apart, but death itself has seemed less frightening since I confronted it there.

It was my encounters with patients and relatives that enabled me to accept my father’s diagnosis without terror and to face his body on the bed. My hospice shifts haven’t made my grief any less, but they’ve made it seem less isolating. Loss is the one certainty we all face, but, in the outside world, it tends to be borne out of sight and earshot. Accompanying relatives on part of that agonising journey has helped me come to terms with my own emotions and to root my personal bereavement in the wider human story.

Hospice volunteering has changed my understanding of life and death. There are no happy endings in the conventional sense. The patients won’t get better. One has to accept one can’t save them. There is no counsel or comfort one can offer strangers facing the inevitable. That’s been hard to learn. I like to fix things; I’m prone to impose advice. I’m discovering that it’s essential to recognise that we can’t control life in the way we assume. The existence we take for granted is as frail as dreams and it can dissolve in a heartbeat.

Sharing with families the most private moments at a deathbed is an inexpressible privilege. Social barriers break down. In that limbo, away from daily schedules, relationships are prioritised.

In my head these days is a procession of faces of those I briefly knew. So many of them had craved more time. Now, when a new day breaks, I try to see it from their perspective and cherish the humdrum as a gift. And when I finish a hospice shift, I want to take back into the outside world that sense of life stripped back to its essentials, where what ultimately matters is love.

Complete Article HERE!

Voluntary stopping eating and drinking

By

Sometimes conversations with other elders are about how we want our deaths to be. We want them gentle, peaceful, surrounded by loved ones (or not). Many friends of mine have died recently. One had a beautiful and loving end surrounded by family. Another, a sudden heart attack at home with no warning. One, in a hospital with a long, drawn out, excruciating yet courageous, few weeks. Another, from taking his own life – he was ready.

We have accidents, illnesses and our bodies just wear out.

A 2018 Stanford University School of Medicine study found that 80% of us prefer to die at home. However, about three-quarters of older Americans die in nursing homes or hospitals. Leading causes of death for people over age 65 are: 1) heart disease, 2) cancer, and 3) lower respiratory disease. We can see that the hospital scenario is obvious for many of us.

Another choice we have has recently come to my attention. If we get to a place that is unacceptable to us as far as pain, quality of life issues and never-ending suffering, there is something called Voluntary Stopping Eating and Drinking – VSED. It is a way to end suffering in a fairly gentle, peaceful and predictable way. Animals sometimes wander off and die this way.

This choice has been used by terminally ill people throughout modern history. Many on the verge of death come naturally to this process – they no longer want to eat, although they do desire water. One of my friends died recently in this manner and it was all just so instinctive and spontaneous.

I’ve just read “The VSED Handbook,” by Kate Christie. Her mother had early onset Alzheimer’s and was determined not to end up in a memory care facility. They worked together while she was still lucid, along with others in her family, a care team headed by a death doula, a doctor and a lawyer to enable her to go through this process smoothly, and avoid the horrors of late-stage Alzheimer’s.

This book offers an actionable plan emphasizing the importance of planning, palliative care and a network of support. It is a fascinating account of how one person stayed out of a memory care center. Christie also describes what to expect from each stage of the VSED process, and the highlights and challenges, and unexpected gifts of accompanying her dying mother on her final journey.

Some acquaintances have mentioned wanting “something in the closet” in case they need it eventually, depending on how their later years go. VSED seems to be it. While Medical Aid in Dying is the law in Colorado if you have a six-month fatal diagnosis, VSED is not authorized by state statue or by court ruling. But that doesn’t mean it’s illegal.

VSED is legal nationwide. The U.S. Supreme Court, in Cruzan v. Missouri, 1990, said a “competent person would have the right to refuse lifesaving hydration and nutrition.” Therefore, VSED is legal for a person nearing the end of life who has the mental capacity to make their own medical decisions. This shows how important it is to have Advance Directives, and to make them early while we’re competent, so in case something happens, we’re set!

This differs from SED (stopping eating or drinking), which is governed by different laws that authorize withdrawal by health care professionals of fluids and nutrition, authorized by the patient’s advance directives. (CompassionandChoices.org)

It may be more difficult for people who are not terminally ill to receive health care support through the VSED process. However, Hospice assures me that they would support someone midway through the dying process or if they are comatose, with a doctor’s order. They have always been on the compassionate side of the dying and have assisted with many cases similar to this.

More information about all this can be found at CompassionandChoices.org and vsedresources.com.

Shouldn’t elders who feel they’ve lived a completed life have this choice, no matter what the circumstance? And with no criticism, or shame? It’s about dying the same as living – making conscious decisions that work for us. And, having a death with some grace and dignity.

Complete Article HERE!

Moving Photos Capture People’s Final Moments with Their Pets

By Pesala Bandara

A photographer has set up a nonprofit which offers free end-of-life photo shoots for pet owners.

The Tilly Project was created by Portland-based photographer Lauren Smith-Kennedy in 2021 and began as a small Facebook group.

Now, the international non-profit has a database of over 1,400 photographers around the world who offer their services to grieving pet owners and capture the tender moments families share with their beloved animal companions as they say goodbye for the final time.

Lauren Smith-Kennedy | The Tilly Project
Lauren Smith-Kennedy | The Tilly Project
Lauren Smith-Kennedy | The Tilly Project

“This photography acts as a tool to allow families to navigate through their own grief journey while having tangible memories of their pet’s final stages of life,” Smith-Kennedy tells PetaPixel.

“Many times, scheduling this type of session can also allow the families to come to terms with anticipatory grief.”

Alexpressions Photography | The Tilly Project
2 Girls & Their Cameras | The Tilly Project
2 Girls & Their Cameras | The Tilly Project
Linked Hearts Photography | The Tilly Project
Mandy Houston Photography | The Tilly Project
Emma Beth Photography | The Tilly Project
Emma Beth Photography | The Tilly Project

Smith-Kennedy has shared some of the beautiful and moving images that The Tilly Project’s photographers have captured for pet owners across the globe.

Smith-Kennedy, who works as a director at a wildlife center, began The Tilly Project after she experienced her own loss when her cat Tilly passed away in a freak accident.

The traumatic experience inspired her to use her photography skills for a good cause and help others who were experiencing the loss of a pet.

Smith-Kennedy began offering free end-of-life photo shoots to other pet owners as a way to always remember their animals. She also began collecting the names and information of other photographers who were willing to offer the same service.

Tasha Sport Photography | The Tilly Project
Belay’s Paws In Motion | The Tilly Project
Kristin Cole Photography | The Tilly Project
Sweet Camellia Photography | The Tilly Project
Geli Visions | The Tilly Project
Lauren Smith-Kennedy | The Tilly Project

In less than two years, The Tilly Project went from being a Facebook group to a nonprofit and valuable end-of-life pet photography network that provides resources for pet loss and bereavement. It also serves as a support system for those who have lost or are about to lose a pet.

“There is a high demand for end-of-life pet photography — many families want that chance to celebrate and honor the lives of their pets who mean the world to them. Some weeks I will receive hundreds of inquiries,” Smith-Kennedy says.

“When I am doing my end-of-life sessions, I give lots of prompts instead of poses. I love to encourage those authentic, real moments that will then be turned into precious memories.”

Lauren Smith-Kennedy | The Tilly Project[/caption]

Individuals can sign up to become an affiliate photographer with The Tilly Project on the nonprofit’s website.

“We welcome photographers of all skill levels,” Smith-Kennedy explains. “We do require photographers to have an online gallery that displays their work so families are able to see this portfolio prior to connecting.”

She adds: “We have a mix of photographers who offer this service for free, and those who charge as they have a photography business.”

More information on The Tilly Project can be found on the non-profit’s website, Facebook group, and Facebook page.

Complete Article HERE!

Is severe illness a ‘battle’?

— Some experts are rethinking the phrase.

When talking about individuals experiencing severe illness, people often say that they are engaged in a “battle” with a disease. Writing for NPR’s “Shots,” Marc Silver explains why this language should be avoided and suggests different ways to frame these conversations.

Why you should avoid saying people are in a ‘battle’ with severe illness

In conversations in the media, or with friends, family, and coworkers, it is common to hear people refer to an experience with severe illness as a “battle.”

Countless obituaries of both celebrities and noncelebrities contain language like, “lost the battle with cancer.”

Last month, the family of Bruce Willis revealed that the actor has been diagnosed with dementia. Following the announcement, media outlets circulated headlines like, “After a ‘battle’ with aphasia Willis is now in a ‘battle’ against dementia,” Silver notes.

“We all know that in a battle there are winners and losers,” Silver writes. “But how do you defeat a disease like dementia? It is a relentless, persistent thief, robbing a person of memory and cognitive abilities.”

For some cancers, there are effective treatments that help some patients go into remission. Others, however, die from the disease. But that does not mean they failed to “fight a good fight,” Silver writes. In some cases, none of the available interventions, including drugs, surgery, and other therapies can stop the disease’s progression.

Still, “people cling to the language of battle,” Silver writes. “They want to be a fighter, to do all they can to beat a disease.”

How to rethink conversations about severe illness

When asked how people can discuss illness without including battle metaphors, Sunita Puri, the director of the hospice and palliative medicine fellowship at the University of Massachusetts, proposes that we think about illness as we would other life experiences. “It really is an experience,” Puri said. “We don’t always know what’s going to happen next.”

If a patient tells Puri they are a fighter, she asks them to elaborate. “I will ask people to tell me what being a fighter means to them, what’s been hard about it? Has it been empowering?” she said.

Ultimately, Puri does not want people to set themselves up to feel like they have failed — regardless of their outcome. “I tell people that the strength you bring to this situation is not necessarily the strength your body can bring.”

Separately, Lillie Shockney, the University Distinguished Service Professor of Breast Cancer at Johns Hopkins University School of Medicine, offers that we use the word “advocate” to replace fighter.

Shockney, who is a two-time breast cancer survivor, says that someone with breast cancer “is taking on the challenge to advocate for the right treatment at any given time.”

“She also must have goals of care defined for herself. These goals need to be realistic too. So, if the goal is a miracle and she is doing aggressive treatment toward the end of life, then she [may] not just be disappointed but [may] die sooner and in a miserable way. Twenty-three percent of patients with solid organ tumors die in an ICU on a ventilator,” she says, typically because “there was no thoughtful, honest discussion between the doctor and the patient.”

According to Silver, patients with severe illness and their families can still find “moments of joy, large and small.”

After Silver’s mother-in-law was diagnosed with pancreatic cancer, she found out her tumor was inoperable. Her doctors informed her she could undergo a yearlong regimen of chemotherapy. However, when she asked about the potential result, they told her she could feel terrible from the treatment and would likely die despite their efforts.

Ultimately, she opted out of chemotherapy. At the time, their family questioned her choice. “Maybe she wasn’t fighting her battle with the best arsenal of weapons,” Silver writes. “But she was a realist. And she didn’t want a year of feeling like crap with little to no chance of living longer than she’d live without the chemo.”

While she did not receive any treatment, the pain from the cancer temporarily eased. For the next year, she was able to spend time with family, take classes, and enjoy her new hobby of painting.

Then, her symptoms returned, bringing pain along with them. After spending a few weeks “barely conscious, she died peacefully,” Silver writes.

“And you know what?” he adds. “I think she won her battle against her cancer.”

Complete Article HERE!

How to talk about dying

— ‘Having things in place can help the people grieving the loss’

by Eva-Maria Bobbert

  • Death can be a touchy subject – one that many refrain from until they reach the point where they absolutely must discuss it.
  • But experts say it’s important to make more effort to talk about death for everyone’s benefit.
  • Tackling the subject head-on and making its discussion a normal part of your life, could strengthen bonds, alleviate family tensions and help ensure the wishes of the deceased are met when the time comes.

As far as dealing with death goes, Lisa Gallate inadvertently became an expert early in life.

By the age of 31 she’d lost her sister in a car accident, her first husband had committed suicide, and her fit and seemingly healthy brother was diagnosed with terminal brain cancer.

As we speak, she breaks the interview to take a call from New Zealand where her elderly father is being rushed to hospital in an ambulance after a sudden fall.

“To be honest, I feel like I’ve been dealing with death all my life,” says Lisa, who tackles the subject with admirable eloquence and down-to-earth pragmatism.

“I’d much rather not have had the experience of the loss of so many loved ones, but maybe that’s why talking about end of life doesn’t feel confronting to me. In fact, I’ve learned that it’s the greatest gift that you can give those close to you.”

It’s not a gift many of us are giving.

Research shows although 90% of Australians say talking to their loved ones about their end-of-life wishes is important, only 27% have the conversation.

Given almost three-quarters of deaths are expected, experts say we should all make more effort to talk about death for everyone’s benefit.

“Preparing for death is complex as it includes cognitive, practical and emotional preparedness,” says Professor Lauren Breen, who researches the psychology of grief and loss at Curtin University.

“Knowing someone is dying doesn’t mean we’re automatically prepared for death. It’s hard to be prepared emotionally when we don’t know exactly what will happen, when it will happen, or what the loss will mean for us.”

All the more reason to tackle the topic head-on, according to Dr Breen, because that way you are able to honour someone’s wishes when the time comes.

For Lisa, who has authored a book on grief, the end-of-life discussions she had with her mother offered a comforting sense of certainty when faced with sudden medical decisions.

“The enormity and finality of death feels brutal when it happens, even if you’re expecting it,” she says. “You’re in such a state of heightened emotion that it’s at least a relief to know that you’re not second-guessing their wishes.”

According to Breen, although these conversations can be awkward and upsetting, they are vital.

“Make this a topic of conversation with family and friends before it needs to be, or before it’s too late,” she says. “Having things in place can help the people grieving the loss.”

Recording and updating those plans regularly is also important.

When her mum died, Lisa discovered her mother’s will stated she wanted to be buried.

“That was contrary to our many conversations where she said she wanted her ashes scattered in her homeland, in Ireland,” says Lisa.

“My dad firmly believes you need to be buried within the Christian faith to go to heaven and so we had to have that tough conversation right there and then.

“The nurses were waiting on our decision, so they’d know how to prepare mum’s body. It’s really so much better if families can avoid having those conversations at that moment because emotions are already heightened.”

The reality is facing mortality, our own included, is confronting.

How long is too long to grieve?

In a post-pandemic world where daily death tallies were the norm, it’s easy to imagine that discussing dying with loved ones might have become less taboo, but recent research suggests we still prefer to avoid the short-term discomfort it brings, even if it leads to long-term pain.

“Death may feel too scary, sad or devastating to be raised for fear of opening up emotions that can’t be contained or supported,” says Melissa Reader, the CEO of The Violet Initiative, a not-for-profit organisation that offers free advice and support to carers, friends and family of those facing end of life.

“We might worry it will upset other family or friends, that talking about it might somehow make it happen, or it’s a sign we’ve given up hope for them. But if we plan together, then everyone involved understands how to make the experience the best it can be. This reduces regret after someone has died.”

So, how do you start the conversation?

Breen suggests using films and books dealing with death as a prompt for discussion.

“Family photos can be another way. It doesn’t all have to be discussed in one day,” she says. “In fact, it’s better if death and dying are part of the ongoing conversation we have with people close to us.”

You may even discover death can be a life-affirming topic.

For Lisa, discussing her parents’ end-of-life plans got her thinking about what was meaningful in her own life, and prompted her to set goals to achieve these dreams.

“I love [rabbi and author] Harold Kushner’s idea that not only do we inherit someone’s assets, we also inherit their unlived years. It’s a precious legacy, a reminder to live life to the fullest.”

Even now, amid arranging to see her father for what would turn out to be the last time, Lisa acknowledges it’s reassuring to answer questions about his medical intervention wishes and have instructions for his funeral so his preferences can be honoured.

“Dad had a hand in his farewell as if he was with us,” she says of his funeral. “It’s extraordinary, being human, because when love runs deep, it becomes very real when someone passes. You can’t escape grief, it’s the price for love.”

Here are a few reasons why end of life conversations are important:

Heart-to-heart

Open, honest conversations about death can improve end of life for everyone.

Stronger bonds

Share your feelings of fear and sadness as this brings people together in an intimate way. It encourages rich and valuable discussions about what really matters in life and will also deepen your relationships.

No regrets

Honesty and kindness are not mutually exclusive. End-of-life conversations are an opportunity to express gratitude, love, appreciation, and forgiveness, and can bring a sense of peace, reducing the potential for regret.

Quality time

Discussing what matters most and how people wish to spend their time can help maximise someone’s quality of life. Some people want to be surrounded by family and friends, some want to take the trip of a lifetime and others may just want to be kept comfortable and pain-free.

Honour the individual

Planning for and discussing death can be the difference between having an end-of-life experience that aligns with your values and preferences or one that doesn’t.

Five simple steps to take right now

Diane Young, an addiction and trauma specialist at South Pacific Private, says family conflicts often arise during grief or crisis. To avoid them, she recommends we:

1 – Draft a living will

It not only states how your assets should be distributed, it also states your wishes for end-of-life medical care. Discuss it openly with loved ones.

2 – Write a testament

Appoint an executor to carry out your wishes. Let your family know what your will says, with everyone in the same room, if possible, to save heartache later.

3 – Make funeral plans

Discuss your funeral, who should speak and anything else you’d like in the celebration of your life. Being clear about your wishes can help alleviate disputes after you have died.

4 – Speak from the heart

Fear of death can often be related to events that have happened in our lives. Speaking about death will often free family members from carrying any resentment or shame from the past.

5 – Get expert help

If you feel unable to speak freely and frankly about worries, it can be overwhelming. Speaking with a professional about grief, fear or conflict can help to find a solution in a safe environment.

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