Category: Death Education

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When a Worker Is Grieving: How to Handle Everything from Condolences to Time Off

By Dana Wilkie

[W]hen someone loses a loved one, it’s not only friends and neighbors who may not know what to do or say—it can also be that person’s employer and colleagues.

From whether to send a sympathy card or flowers to whether to offer bereavement leave or ask an employee when she’ll be back at work, it can be difficult for managers to know how best to support someone who’s grieving.

One common reason people grieve is because they’ve lost a close relative or friend. But people also grieve over divorces, catastrophic illnesses or accidents, and even the passing of a beloved pet.

“Death is, by far, the biggest [cause for grieving], especially if it’s untimely or unexpected,” said Andrew Shatte, a clinical psychologist and co-founder of meQuilibrium, a Boston–based company that helps people and organizations navigate change. “Sudden, cataclysmic loss shakes the very foundation of our beliefs about control and therefore shakes our resilience. There are big individual differences in how people respond to grief and what they need. For some, they need time away from the world, while others need to reimmerse themselves in it. The manager can start the discussion with the grieving employee by asking, ‘What can we do for you?’ ”

Bereavement Leave
There is no federal law requiring that companies offer bereavement leave. Oregon requires employers in the state with at least 25 workers to offer up to two weeks of bereavement leave, while Illinois requires employers with 50 or more workers to grant up to 10 workdays off for the death of a child.

While bereavement leave is not generally covered by the Family and Medical Leave Act (FMLA), the law mandates leave to address issues that arise when an employee’s covered family member (spouse, child or parent) dies on active military duty. A bill recently introduced in Congress would, under the FMLA, allow a grieving parent up to 12 weeks of unpaid leave off from work to cope with the loss of a child.

However, many companies do offer bereavement leave. The time off varies from a few days to a few weeks, said Robin E. Shea, a partner with Constangy, Brooks, Smith & Prophete LLP in
Winston-Salem, N.C.

“Most bereavement policies provide only a few days—about enough time to make arrangements, fly out of town if necessary, attend the funeral and return home,” Shea said. “But that doesn’t mean that employees cannot be given more time. If the employer offers personal leave, or if the employee has paid time off or vacation available, the employer of course should allow the employee to take it.”

In cases involving a particularly devastating loss, Shea said, her experience is that companies give the employee time off with pay, even if there’s no specific policy addressing such a situation. “If they do this” in one instance, she advised, “they would have to do the same for other employees, to avoid discrimination claims.”

How Much Time?
Are there certain types of events that should require more bereavement leave than others? For instance, if an employee loses a child, as opposed to a sister, should an employer be more lenient about time off?

“There are differences,” Shatte said. “Typically the closeness of the relationship matters. We grieve more for siblings than for cousins. Also, the level of unexpectedness, for instance, whether [the loss] involved an accident or a long, prolonged illness. And nothing is more debilitating than the death of a spouse or child.”

Shea suggests that the time off afforded a grieving worker should depend on the size of the employer, the nature of the employee’s job and the loss the employee has suffered.

“My quick answer would be [to allow] as much [time off] as the employee needs and the employer can afford to allow,” she said. “In the case of the death of a spouse or child, or in the case of a very traumatic death, like a murder, accident or suicide, I would seriously consider giving the employee as much as a month off if he or she wanted that much time.”

Returning to Work
It can be tricky for an employer to inquire when a grieving employee plans to return to work.

One way to handle this is to check in periodically with the employee to see how he or she is doing.

“Let the employee know that he or she is missed,” Shea said. Hopefully, the employee will volunteer details about her plans to return during these conversations. Another way is to tell the employee how much paid leave he or she has available and then offer to extend that with unpaid leave, if the employee chooses. In most cases, the employee will need to return to work when the paid leave runs out, Shea said.

Shatte suggests that about a week after the employee has taken bereavement leave, a manager—after consulting with HR and company attorneys—should reach out to the employee and ask what the company can do for him or her. “At that point, they can ask how much time they think they might need, with an offer to touch base periodically to see if anything has changed,” he said.

If an employee is too devastated to return to work, he or she may benefit from counseling. An employer might steer the worker to an employee assistance program or even suggest short-term disability benefits.

“I would never ask an employee to return before he or she felt ready to do so, but at some point, the employer may have to tell the employee that the job cannot be held open indefinitely,” Shatte said.

Expressions of Sympathy
Also tricky is knowing how to extend condolences to a grieving employee. Should the company send a card? Flowers? Provide meals? Should company colleagues attend a memorial service?

“These decisions need to be made by weighing the individual,” Shatte said. “How long have they been with the organization? How close is the manager to the employee? This is a sensitive time, and every outreach should be made only after consulting with HR.”

Shea said that if the memorial or funeral is in town, anyone personally acquainted with the grieving employee should try to find out if their attendance is desired. This includes the employee’s direct supervisor, she said, and possibly others further up the chain of command.

The HR department, she said, can coordinate expressions of sympathy on behalf of the company, including flowers or cards.

Complete Article HERE!

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Pathologist Carla Valentine Will Teach You How to Die Fearlessly

“The people who think about mortality tend to have the highest happiness rate.”

By Sarah Sloat

[A]mbitious technocrats may predict a deathless future, but as the world stands now, we’re all going to die. This leaves us humans with the same two options we’ve had since we emerged from the evolutionary mire: Fear the final shuffling of our mortal coils, or embrace the inevitability that we’ll all be one with the dirt.

Fortunately, there are people out there who can help ease your mind about the whole “one day you’ll be dead” thing. One of those people is Carla Valentine, whose job as an anatomical pathologist, technical curator at Barts Pathology Museum, and author of The Chick and the Dead, has more than prepared her to come face to face with the inevitable end. In her book, which will be released in the United States in June, she weaves together corpse science and her intimate involvement with the “death industry” with the vital lesson about dying she’s learned over the years: Everyone wants to learn more about death whether they admit it to themselves or not, and accepting that education is the best preparation for their final days.

Valentine, whose book will be released in the United States in June, recently spoke to Inverse about the CSI effect, the future of “soul midwives,” and urban legends that just won’t go to the grave.

Carla Valentine.

>Why was now the right time to write this book?
There are two reasons, really. There is definitely more of a desire at the moment for people to speak about death and learn more about it. That’s been on an upward trajectory. That just happened to coincide with when I left my career as a full-time pathology technician and I began to work at the museum, which gave me more free time to actually start to write.

What do you think has driven that increased interest in talking about death and learning about it?
When I first studied forensic science, which was 15 years ago, there were barely any courses. Those courses began to increase with what we call the “CSI effect”. That’s an actual academic term now for the interest in death and autopsies that has emerged from the increase in books and TV shows on the topic.

I think another issue is just the cost of funerals, like many things, is rising. People want to be a bit more informed and demystify the process around death so that they can plan properly and just dispel a lot of the myths before the time comes. There have always been a lot of myths around autopsies and how we conduct them. I think people just want to know the truth and it’s a good time for it.

What do you think people gain when from learning about what happens to their body after they die?
Personally, I think that when people face this idea of their mortality, the reality of it, and the reality of what may happen to their family members, for example, they tend to live a better life. They tend to understand how quickly it can be taken away. They can appreciate their own mortality and their own health. That was always what I felt and that’s been backed up by psychological studies, as well, which I reference in the book. The people who think about mortality tend to have the highest happiness rate. I think it’s because it demystifies it. People say that you’re afraid of the unknown. Sometimes it’s better to face the reality of it. Then it’s not so scary anymore.

Fracture of a mandible at the Pathology Museum.

Do you get consistently the same sort of questions from people when they learn about your job?
I get consistently the same sort of questions and I get consistently told the same myths. Those absolutely drive me insane. I took as much opportunity as I could to answer all of the questions that I always get asked in the book. A lot of these myths have been doing the rounds since I was a child. For example, I was at the hairdresser’s yesterday, and the girl in the chair next to me overheard that we were talking about my job, and she said, “It’s true, isn’t it, that the fingernails grow and the hair grows after death?” I was like, “No it’s not like that.” I’ve heard the same things for 20 years.

What else do people get wrong about death?
People also think the deceased sit upright because of their gases, which is not true at all. Some deceased people are possibly in a state of rigor mortis, where they’ve passed away in a chair and so that means for a while they’ll still be in a bent-over position. They’ll look slightly like they’re sitting up when they’re on the slab. But they don’t sit up because of the gases. There are the odd groans or burps or farts. That is true.

The most annoying urban legend is the one where someone tells me, “A friend of mine knows someone who got a rash and when she went to the doctors she found out that it can only be caught from a corpse.” Basically insinuating that the guy that she’d had sex with or whatever has had sex with a corpse. That always drives me insane because there’s nothing on a deceased individual that isn’t on a live individual. We have the flora and fauna. There is no such thing as a parasite or a fungus that you can get from the dead.

It just goes to show how fascinated people are by those subjects. I’m doing my MA on the relationship between the sexualized gaze and anatomical displays. When I blog about sex and death and people go, “Really?” I think, look, you’re all interested in sex and death, just look at this one urban legend that’s nearly outlived me. Clearly, people are far more interested in sex and death than they’d like to let on.

A broken cervical spine.

What is it about that intersection that people keep on coming back to?
They’ve had similar periods in time where they’ve been sort of considered taboos. But the simple fact is sex is what begins our lives and death is what ends it. They’re two sides of the same coin. They’ve always been connected to each other psychoanalytically because everything you do, according to Freud, you do with either the death drive, the morbido, or a life drive, which is libido.

Inside Barts Pathology Museum.

Are there any new modern trends you’ve noticed, when it comes to what people want immediately before and after they die?
There are definitely newer trends towards much more environmentally friendly funerals. A lot of people are moving away from the traditional funeral, and opting for a green burial. That means that they wouldn’t be embalmed. Embalming was never as big over in the United Kingdom as it is in the U.S. anyway, but it’s still definitely dwindling. Natural burials where people are placed into wicker, cardboard coffins, or linen and buried into an actual burial ground. There’s definitely an increase in people who want that, while we never really would hear of that request a few years ago.

And then there’s death doulas and end of life doulas. They’re just like midwives, but for death. I met one the other night and he actually called himself a “soul midwife.” Death doulas are usually brought in when the person is in hospice. It can also be as soon as a person discovers that they’re terminally ill. In the same way that a midwife is there for the mother as she’s becoming dilated and then she delivers the baby, the doula helps the person through the process of death. It’s a similar process, I suppose, just the other way around.

Complete Article HERE!

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Do-Not-Hospitalize Orders Reduce Resident Transfers, Says New Study

By Patrick Connole

[A] fresh look at how Do-Not-Hospitalize (DNH) orders affect the movement of skilled nursing care residents shows those residents with such directives experienced significantly fewer transfers to hospitals or emergency departments (EDs). Report authors said long term and post-acute care providers may see the information as evidence that considering DNH orders in end-of-life care plans could benefit residents and the nursing center in which they live.

“Residents with DNH orders had significantly fewer transfers. This suggests that residents’ end-of-life care decisions were respected and honored,” the authors said. “Efforts should be made to encourage nursing home residents to complete DNH orders to promote integration of the resident’s values and goals in guiding care provision toward the end of life.”

Results of the new study are in the May issue of The Journal of Post-Acute and Long-Term Care Medicine (JAMDA) in an article titled, “Are Hospital/ED Transfers Less Likely Among Nursing Home Residents with Do-Not-Hospitalize Orders?” JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine.

The design of the study saw researchers examine Minimum Data Set 2.0 information from more than 43,000 New York state skilled nursing care residents. Of that number, 61 percent of residents had do-not-resuscitate orders, 12 percent had feeding restrictions, and 6 percent had DNH orders.

“Residents with DNH orders had significantly fewer hospital stays (3.0 percent vs 6.8 percent) and ED visits (2.8 percent vs 3.6 percent) in their last 90 days than those without DNH orders,” the report said. “Dementia residents with DNH orders had significantly fewer hospital stays (2.7 percent vs 6.3 percent) but not ED visits (2.8 percent vs 3.5 percent) than those without DNH orders.”

After adjusting for statistical variables, researchers said the results show that for residents without DNH orders, the odds of being transferred to a hospital was significantly higher than those with DNH orders.

One of the report’s authors, Taeko Nakashima, PhD, visiting assistant professor, State University of New York (SUNY) at Albany and adjunct assistant professor at Rutgers University, stresses that preparing DNH orders requires collaborative efforts and thorough discussion among the residents, health care proxy, and the attending physician about the goals of the resident and the resident’s prognosis and treatment options.

“Ethical end-of-life care in nursing homes must respect the resident’s autonomy and advance directive,” she says.

Complete Article HERE!

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Plan for your death; be wise like Wally was

Linda Norlander is one of six reader columnists for The News Tribune.

By Linda Norlander

We sat at the kitchen table with coffee and the forms. My father-in-law, Wally, had summoned me to help him fill out one of those “living will things.” We talked about what was important to him, now that he was in his 80s.

He was clear. “I’ve had a good life. I’ve never buried a child or a grandchild. When it’s time for me to go, I don’t want one of those young doctors trying to save me.” His main wish for health care at the end of his life was to be pain-free.

However, Wally’s gift to his family was not just the paper we filled out that day. His larger gift was the conversation he had many times with the family about his wishes.

When the time came that he was unable to speak for himself, and the doctors wanted to place a feeding tube to prolong his life, we were all on the same page. As my mother-in-law said, “Wally wouldn’t want that.”

With the support of hospice, he was able to say good-bye to his children and grandchildren and dispense a few words of wisdom. I remember that he advised our son with a chuckle, “You go to college. That’s good. But someday you need to get a job.” He died peacefully with all of us at the bedside.

When I meet people and tell them that I’ve worked in hospice and end-of-life care for many years, they often open up with their own stories. Unfortunately, too many of them do not end with, “I was able to carry out Mom’s wishes.” Instead, they are descriptions of having to make harrowing decisions for a loved one in the moment of crisis. I think about the son whose mother had a major stroke and was in a coma. He was told by the neurosurgeon that they would have to do surgery or she would die. What child wants to say, “No, let Mom die.”

They did the surgery and she died six weeks later, among the tubes and medical apparatus of an intensive care unit. To this day, he second-guesses whether he made the right decision. “Her last weeks of life were horrific.” When I’d asked him if he had ever talked with her about what she might want, he’d shrugged and said, “It never came up.”

We live in an era of incredible medical advances. We can replace kidneys, hearts, knees and hips. We have pacemakers, effective heart medications and all sorts of treatments for failing systems. What we usually don’t have are honest conversations about the treatments and what they might mean for the quality of life. To the son whose mother died in the intensive care unit, no one said, “If your mother survives she will likely be bedridden and comatose for the rest of her life.”

I am a proponent of doing four things regarding end-of-life care. First, sit down at the kitchen table with your family and have an honest conversation about what quality would mean for you if you weren’t able to speak for yourself. Second, name your health care power of attorney — the person who would speak for you — and give them your blessing that you will trust their decisions. Third, fill out an advance directive (the living will.) And fourth, do this now rather than waiting for a health care crisis.

I know, from years of working in the medical system, that in the moment when difficult decisions have to be made, very few doctors will seek out the health care directive document and say, “This is what your loved one wanted.” More likely, they will look at the family members and ask, “What do you want to do?”

In fact, when it came time to make decisions for Wally, we couldn’t find the health care directive. But the family knew what he wanted and we provided a united front regarding his wishes. Two weeks after he died, we finally found the form — in my mother-in-law’s underwear drawer. By then, though, Wally had already given us his gift.

Complete Article HERE!

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Why Your Fear Of Dying Alone Means You’re Not Really Living

By Kendra Syrdal

[E]verywhere around me even in modern day 2017, it seems like as a single person I’m confronted with the same message

“Here’s how to find the real love of your life!” Some old guy in a tuxedo exclaims at me from an eHarmony commercial.

“You’re totally like Carrie Bradshaw,” my friends say over drinks when I talk about my job and how I’ve gone out on dates with a few different guys this month. “Now you just need your Big.”

We just don’t want to be alone the countless submissions I read every day proclaim in their honest, heartsick words and in their desperate and painfully lonely headlines.

I’m afraid of a lot of things. I hate driving and am always convinced a semi-truck will run me off of the interstate and send me plummeting to my death. I love paddle boarding but have a weird anxiety about going too far out where the water is a certain level of deep because realistically – who knows what’s down there. The idea of my dog dying when I’m not home makes my eyes start watering just typing it out.

I’m afraid of a lot of things, but dying alone isn’t one of them.

One of my best friends told me a story about how her dad always used to tell her that no matter what, she had to like herself because she was the only person who ever really would ALWAYS be there. And that’s the truth. Some people would say that’s cynical and glass-half-empty, but I say it’s simply honest.

Think about it. Even if you do fall in love, madly in love, the kind of love that people write sonnets about and songs about and paint all over a building as a mural – eventually you’re going to die. And even if that person has been there day in and day out, holding your hand and kissing you despite your morning breath, the only person who you’ll have in those final moments is yourself. All you really have, is you.

So you’d better like you.

I think what we’re really not saying when we say we’re afraid of dying alone is that we’re really not afraid of the alone part, we’re afraid of only having ourselves to hold onto. We’re afraid that somehow, we won’t measure up. We won’t be enough. That somehow, we’re an incomplete puzzle without some else’s edge pieces.

When we say we’re afraid of dying alone we’re really saying we’re afraid that we’ll never be happy with just ourselves, and that we need someone else to dictate that level of completeness to our lives.

But you know what? The little secret that no one wants you to figure out – that the man in the suit hopes you never realize, and anyone writing a “Here Is How You Find The Love Of Your Life And Never Eat Alone Again” book hopes you don’t come to terms with?

A fear of dying alone is really just a fear of not living a life you love. A life you’re excited about. A life that makes you feel enough.

And they never want you to know that crushing that fear is simple. All you have to do is refuse to let it in.

So when you’re worried about eating alone, grab a book that swallows you with its characters and its story and go treat yourself to some Alfredo and wine and give it no second thoughts. If you’re scared of your life being empty, make friends with people who never cease to make you smile and challenge you in the ways you need. Fill your days with a job you love, with travels that blow your mind, and create a life that bears no need for another person other than yourself.

That way, if someone comes alone, they’re just and enhancement, not a requirement.

Your fear of dying alone isn’t sign of being an incomplete or unlovable person — it’s simply a sign that you just need to love yourself enough to stop being so afraid.

Complete Article HERE!

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Med schools to teach how to discuss patients’ goals for care — and for life

How patients answer questions about overall life goals can inform treatment decisions, especially near the end of life.

By Felice J. Freyer

The four medical schools in Massachusetts have jointly agreed to teach students and residents how to talk with patients about what they want from life, so future doctors will know how far to go in keeping gravely ill patients alive.

How patients answer questions about their overall life goals can inform treatment decisions, especially as people near the end of life.

“We’ve trained all doctors to ask people, ‘Do you smoke?’” said Dr. Harris A. Berman, dean of the Tufts University School of Medicine, who met with colleagues last week from the medical schools at Tufts, Harvard, Boston University, and the University of Massachusetts. “We’ve trained people to ask about sexual preference. That used to be a difficult discussion to have.”

Now, Berman said, doctors need to learn how to ask even more deeply personal questions, such as: What most matters to you? What do you need to make life worth living? In what circumstances would you rather not be alive?

The medical schools’ plans to change their curriculums stem from the work of the Massachusetts Coalition for Serious Illness Care, a year-old consortium working to ensure that every resident receives the medical care they want — no more, no less. Dr. Atul Ga-wande, the surgeon and author who helped found the coalition, approached Berman about coordinating an effort among the medical schools.

Meanwhile, on Tuesday, the coalition will mark its first anniversary with the release of a survey of 346 adults who live in Massachusetts, conducted this year. Nearly all residents surveyed said it’s important to talk about their wishes for medical care if seriously ill or near the end of life, but 35 percent had not had that conversation with anyone.

When end-of-life conversations with a health care provider did take place, they were initiated by the patient two-thirds of the time. But three-quarters of those surveyed who said they had spoken with a health care provider about their wishes found that the talk was not difficult.

“People think having the conversation is scary,” said Maureen Bisognano, the coalition’s cochairwoman and senior fellow at the Institute for Healthcare Improvement. “What we’re finding is, when people actually do it, there’s a sense of relief, a sense of peace that you have expressed your wishes to someone.”

Doctors should have this conversation with patients, Berman said, when asking about their medical and family history, before they become ill. And the conversation needs to continue throughout life as circumstances and attitudes change.

Berman said that the schools’ academic deans will collaborate on the best way to incorporate this philosophy throughout medical school and residency training. It can’t be taught in a single class, he said. He expects the curriculum changes to be adopted within a year.

In collaborating on a curriculum change, the medical schools will be building on a successful effort in 2015 to add instruction about prescription painkillers and opioid addiction.

The Massachusetts Coalition for Serious Illness Care started last year, when Blue Cross Blue Shield of Massachusetts brought together leaders in end-of-life care and dozens of organizations concerned with health care and aging. It is funded with $200,000 a year from Blue Cross and the Rx Foundation, which works to improve the quality of hospital care.

With 58 members a year ago, the group has now grown to more than 70. Each organization commits to promoting the coalition’s goals: that all adults have designated a health care decision-maker and have spoken with that person about their wishes; that all clinicians are trained to discuss advance care planning and serious illness care; and that systems are in place to make sure patients’ wishes are documented and honored.

Many of the coalition members had already been working on those issues for years. But they say the coalition bolsters those efforts. “Having to talk about it, being held accountable to a group of our peers — that makes you want to achieve things and achieve them faster. . . . It’s also really a way to hold people’s feet to the fire,” said Anna Gosline, senior director of health policy and strategic initiatives at Blue Cross, which offers workshops in advance care planning for its employees.

Dr. Diane E. Meier, director of the Center to Advance Palliative Care in New York, has been watching the Massachusetts coalition and praised it as “the kind of social movement we need.” Meier, who received a MacArthur “genius” fellowship for promoting palliative care — medical care focused on relieving the stress and symptoms of serious illness — said the coalition is on the right track in focusing on what is valuable in life rather than planning for death.

“The public knows we can’t plan for end of life,” she said. “You can’t know what’s going to happen. Asking us to make decisions about an unknown future is irrational.”

Elaine Seidenberg learned how complicated such decisions can be when she moved into Orchard Cove, a housing community in Canton that offers elders an array of social and medical services.

Seidenberg thought she had everything in order. She had a folder for each of her two children with all the legal forms laying out her end-of-life wishes. But a woman from an Orchard Cove wellness program threw her for a loop when she asked, “What are your goals?”

Seidenberg realized that she had not provided enough information for her children. “Usually when you’re doing end-of-life planning . . . it revolves around things that you don’t want done to you,” she said. “I never really thought about what made my life worth living, what I would be willing to tolerate, and what I wouldn’t.”

After a lot of thought, she realized she most values “giving back to the community, being able to communicate freely and effectively with other people.”

Last year, for the coalition’s launch, Blue Cross commissioned a survey of 1,851 Massachusetts adults. It found that more than half had not named a representative to make health care decisions if they were incapacitated, often because they weren’t sick and didn’t think it was necessary.

This year, surveyors reached out to 860 people from the original survey, and 346 completed a follow-up. The survey was conducted in February and March by the research firm SSRS and the University of Massachusetts Medical School.

Among those who reported a loved one’s death in the past two years, only half rated the care received at end of life as excellent or very good, and a little more than half said their loved’s wishes were followed and honored.

Gawande said those responses represent a “very poor” showing for end-of-life care. When asked about other types of care, such as surgery or cancer care, nearly all patients rate their care as excellent or good, he said.

“This an ambitious agenda,” Gawande said of the coalition’s work. “It’s going to take years to move the needle.”

Complete Article HERE!

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The Life of a Death Midwife

Helping people through the dying process

By Claire Fordham

Olivia Bareham

[O]livia Bareham wants to change people’s perception about death. “I want to break the taboo where we are excited about birth but dread death,” the death midwife said. “What if they were both explosive, incredible events?”

Part of a death midwife’s job is to sit with the dying at the end of their life. “To be able to bear witness to their dying process,” said Bareham. “The midwife is also looking beyond the last breath. We hold the space, not just for dying but for the funeral, burial or cremation rituals and even beyond that, to help the family and friends grieve.”

It’s hard to accept a terminal diagnosis.

“Some people can’t believe they are dying,” Bareham said. “It is unbelievable. It’s unbelievable that we’re even here. Once you play with the idea of the unbelievable-ness of everything, it’s not so unbelievable that you’re dying.”

Bareham believes a funeral or celebration of life service and properly grieving are important parts of the process.

“It’s declaring that the lost loved one counted and mattered and meant something to those left behind,” she said. “If you miss that, it’s sad, but perhaps it’s even more sad for the family and friends who have lost an opportunity to lean into their own mortality.”


Loved ones decorate a simple casket for a home funeral. Wooden caskets are also available. This cardboard one holds up to 200 lbs. weight.

Bareham has this advice for the living and dying: “Build a relationship with death. Befriend death. Be open to every little nuance of what it means to be alive — which includes pain, sorrow and loss — so you’re not thrown off by a catastrophe. Write your healthcare directive and death care directive because you never know when the end will come. And make peace with anyone with whom you have had conflict.”

All passings are different and not everyone gets a terminal diagnosis where they have time to plan their final moments. Having helped more than 200 people in and around Malibu as they die, or arranged their home funeral, Bareham has an idea how she’d like her own death to be.


Learning to lay a body in honor on a Death Midwife course. One of the attendees plays the body here.

“Some people want to be left alone at the moment of death. I wouldn’t mind having people in the room with me, but I wouldn’t want them touching me and close to the bed. Having a dear friend who totally gets me sitting vigil and holding the space is an anchoring that makes the dying feel safe.”

Just as there’s a popular movement toward natural childbirth, Bareham prefers the idea of a natural death. She isn’t saying don’t ever take morphine to help ease any pain, but suggests not taking so much that you aren’t aware of what’s going on. She may not want someone holding her hand or stroking her head at the end, “or telling me it’s OK to go,” she said, but is happy to do that for others, if that’s what they want.

For Bareham, a good death would be where she is aware of what is happening, where she is prepared and feels a sense of completion and fulfillment of the life lived — “so my dying is just another breath. I am ready and excited for what’s next.”

Bareham advises against waiting until you know you’re dying to forgive people who have hurt you or ask forgiveness of those you might have hurt. “It happens so quickly, and then you’re lost and scrambling. Try to stay in a state of consciousness that if death came, if a massive earthquake hit right now, you’d have a level of excitement,” she said.

People from all walks of life complete Bareham’s death midwifery course. “More young people in their 20s are doing it because they feel something is missing in our culture regarding death,” she described. “Some have been volunteering at a hospice, or are social workers. Others are intrigued with the idea that after the last breath, you can keep the body at home for three days and arrange a home funeral. Or they’ve had a horrible experience of death and are looking for healing.”

Bareham, who is fighting fit and looking forward to a long life, doesn’t find her career depressing.

“Death is just another chapter in life’s journey,” she said

Complete Article HERE!