A ‘death doula’ explains how to transcend your fear of dying so you can truly live in the present

Death doula, Tree Carr, explains what she’s learned as an end-of-life guide and how to overcome fear of death so you can live a life with no regrets

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Death doula Tree Carr’s insight into peoples’ final days means that she’s more in touch with mortality than most. Supporting people on their final journey may sound like a grim task, but for Tree, this calling has taught her lessons on how to truly live. Lessons which she has shared with woman&home…

Death is the great unknown and the idea of having to face up to our own mortality and how we’ll be remembered after death can feel more than daunting. However, by learning to interact with this inevitable experience with a positive and supportive lens—you can stop being scared of it. In doing so, you focus on living a far better life, with no regrets.

The word alone can evoke terror, superstition, grief, feelings of loss of control, and existential dread. The sobering reality of death is often kept swept under the carpet and considered taboo for most conversational circles. 

In our long timeline of humanity, we’ve sought to cheat it; delay it; bargain with it; or transcend it. Its great and elusive mystery has captivated the mystics and has raised the eternal question that science has yet to answer—does consciousness carry on after the body expires? No matter what your ontological or epistemological worldview on death is, it’s safe to say that most people are scared to death of dying.

What is a death doula?

A death doula is an end-of-life guide who holds compassionate space for a person journeying through the psychological, emotional, spiritual, and practical terrains of death and dying. The word doula is from ancient Greek, meaning, ‘a woman who serves’—although the role is far from being gender-specific.

I felt the calling to become a death doula in my early forties after a lifetime of synchronistic events all revolving around death. From a near-death experience of nearly drowning in the Atlantic Ocean at the age of four, through to many serendipitous moments involving being at the right place at the right time when strangers on the street have been close to death.

“You can stop being scared of it. In doing so, you focus on living a far better life, with no regrets.”
— Tree Carr

What I’ve learned as a death doula

In my work as a death doula, the most challenging aspect that I witness a dying person go through is surprisingly not the biological deterioration of the body (there is plenty of palliative care pain control for that). In fact, it is the emotional or psychological loss of the sense of ‘self ‘ that appears to be the most painful.

From what I’ve personally observed, at the end of life many people experience a long, slow, and winding loss of who they knew themselves to be. They are thrown into the existential dark night of the soul asking the big questions: What am I? Who was I? What was this all for?

As a result, this can propel the dying person into depression, grief, isolation, and anxiety. This is where the role of a death doula can be very helpful, traversing alongside a person as they lean into the fears and trepidation of the big D!

Certainly, overcoming the fear of death it’s not a ‘one shot’ remedy most of the time and can be a gradual unfolding that combines a mixture of practices and experiences.

How I help people overcome fear of dying

Person contemplating life

Surprisingly enough, my death doula work isn’t always for people who are actively dying. I have folks getting in touch who aren’t dying at all, but they have anxiety around death. Perhaps they are coping with the loss of a parent or struck with grief from experiencing the death of another person they knew.

I guide my client’s through navigating death phobia, tackling grief illiteracy, bereavement catharsis, and reframing the narrative around the topic and therefore moving into a peaceful acceptance of death.

Part of the journey can involve meditations on death, closure techniques, and emotional integration through a variety of creative processes—letter writing, drawing, conversation, and more.

Here are some simple practices I encourage my clients to engage in each day to help overcome the uncomfortable feelings around death…

Observe the ‘little endings’

One way you can start to journey into your fear around death is to have a daily practice where you bear witness to the ’little deaths’ all around you every single day.

It’s a form of mindfulness with a central focus on the theme of endings. When you meet a friend for coffee and then you both say goodbye and they walk away and leave. This is a little ending. When you lose your mobile phone. This is a little ending when the sun sets every evening. This is a little ending.

Allow yourself to hold awareness for these little endings and be with any emotions rising up. Begin to surrender to the process of not holding onto the little endings but allowing them to release. 

Engage the art of non-attachment, seeing that the only constant, is change. Regular meditation practice is also a good habit because it will help to stabilize a conscious state of equanimity through experiencing endings.

Watch the cycles of nature

A pathway through a dark foggy wood

Another helpful tip is to sit and be with nature, observe and be mindfully present. Being closer to nature connects a person to the reality of impermanence. Observing the shifting and changing of the seasons. The growth, decay and return to Spring Equinox. This forever cycle of life, death, and rebirth.

Observe yourself falling asleep

Something else that can help out is sleep. The threshold states of sleep are liminal experiences just as death can be. When one becomes comfortable in these altered sleep states it can help ease the fear of death.

Make space in your bedtime routine for observing this. As you fall asleep every night and you hover on the liminal threshold of the hypnagogic state you can practice and surrender to the idea of your own death. Allowing yourself to relax and surrender to sleep from the cusp of fatigue is a surprisingly easy and transformative technique.

Attend a Death Cafe

Death Cafes are safe spaces to gather and meet to talk with other people about all things death and dying over coffee, tea, and cake. Whether you share your own experiences around losing a loved one or a beloved pet. Or maybe you are navigating your own end-of-life journey, Death Cafes are death-positive, compassionate, non-biased, and non-judgemental events.

In the many Death Cafes that I’ve facilitated worldwide, I see the boundaries of culture, gender, age, race, and religion dissolve as we all come together in solidarity over the one thing we all have in common—the fact that we will all one day die.

Living a life in fear of an inevitability that we all share can prompt or worsen difficult emotions, like anxiety, depression, panic attacks, and conditions like sleep anxiety
and insomnia.

However, by embracing the awareness of this inevitable life process, through positive and supportive ways, can not only help us live a more enriching life—but also help us to live one with no regrets.

Complete Article HERE!

How I learned to talk about death and dying

First step: Acknowledge it, together

By Steven Petrow

A serious illness is many things — terrifying, painful, life-altering. The prospect of losing a loved one, or your own life, becomes an unspeakable agony. It’s also isolating in a way I never could have imagined. I’ve been the one in that sickbed, and I’ve also done some time sitting beside it. I wouldn’t wish either experience on anyone.

Lately, however, I’ve been thinking about what memoirist Meghan O’Rourke has called “the long goodbye” and trying to focus on the one gift it does give us: the gift of time. Time to plan, but mostly time to unearth and process our feelings. And then, if we’re fortunate, to be able to share these deep-seated fears with those we love.

This is not easy. When my mother learned she had lung cancer several years ago, we both turned to humor to help absorb the meaning of her diagnosis and to deflect the pain. One afternoon, many months before she died, Mom said with a wry smile, “I think I’m really dying.” To which I replied, “You mean today? Because I’m going to the market, so if you really think so, I won’t shop for you.” “That’s hilarious,” Mom countered, a hungry smile now on her face. “What’s for dinner?” Very adroitly, pretty much reflexively, we had avoided the elephant in the room.

Mom’s health deteriorated over the next several weeks. Again, she raised the question of her death, but now without the smile. “Will dying be painful?” she asked. In that moment, I knew I needed to confront my own feelings about her mortality and not sidestep the conversation with facile banter.

I took Mom’s hand in mine and said, “Don’t worry, it won’t be painful.” I told her hospice had provided a “comfort kit,” which contained medications for restlessness, confusion, anxiety, sleeplessness, constipation and, of course, pain management. I could feel Mom’s hand relax. Finally, she said, with a palpable sense of relief, “Thank you.”

In the weeks after that, we began a new chapter. I hadn’t realized how much effort had gone into my denial. I thought about the many times I had said, “if you die …,” which denied what we both knew was inevitable. After I dropped the subjunctive and began to talk about when she died, a barrier was eliminated. She knew. I knew. Now, we knew together.

I don’t think Mom suffered in her final days. After she became “unresponsive” (considered part of “active dying”) I returned to that comfort kit at the direction of a nurse. I removed the liquid morphine and gently squeezed one drop, then a second into her mouth. When the end came a few hours later, my sister, brother and I sat on her hospital bed, holding hands with each other and our mother as she died. What a gift, I thought, as we helped her to let go honestly, openly, and — most importantly — together.

Three decades earlier, when I was newly in remission from my own cancer, I had so many worries — about recurrence, additional treatments, more surgery. But at its core the fear was always about dying, which I never acknowledged, which meant no opening for others to broach the topic. I tried hard to keep those anxieties buried away, mostly by taking anti-anxiety medications. I’d pop a Klonopin and for four hours I’d be “fine,” as I often repeated. Still, I felt detached from others, even myself, but in my mind, that was better than feeling. Or worse: talking about feelings with others.

I chose to be alone.

Every time when I returned to the hospital for follow-up labs and scans, I’d medicate. But drugs, it turns out, can do only so much. I’d still taste the fear in my throat, or notice the shallowness of my breathing. A few times I vomited — spontaneously — the associations too strong. No matter how hard I tried, I could not effectively lock away that demon, that fear.

Then I decided to volunteer at the cancer hospital that had given me so much, sharing my cancer “experience” with patients, which invariably included discussions of fear. I realized how helpful these conversations — about hair and weight loss, recurrence and remission, life and death — were to the patients I met in the hospital, either newly diagnosed or undergoing treatment. But these talks changed me, too.

For far too long, my fears had been caged inside me, dense and dark. Laura Wallace, a licensed clinical social worker whose practice focuses on transitions and loss, explained that acknowledging feelings of “loss and longing,” while deeply painful, is a much better alternative than anger, addiction and anxiety. Or denial.

Releasing these fears — into the rooms where I had these conversations, into the air outside the hospital when I would walk away — was liberating. Imagine a vial filled with dark blue worry. Release a drop into a small cup of water and it colors the water. Release another drop, this one into a gallon bucket, and it becomes nearly impossible to detect. By acknowledging and sharing my fears openly, I let them go and they began to dissolve. Eventually, I stopped taking those anti-anxiety medications.

In her recent memoir, “Going There,” journalist Katie Couric, whose husband died of colon cancer in 1998 at age 42, tells of feeling trapped between a rock and a hard place. “I was so worried about letting go of hope because I didn’t want Jay to spend whatever time he had left just waiting to die,” she wrote. “I think it takes extraordinary courage to be able to face death, and I think I was too scared, honestly.”

Couric’s words reverberated with me, especially as I’ve tried to take the lessons learned from my mother’s death, and my own illness: How to be present. How to balance today with tomorrow. How to find the courage to embrace what’s so often unspeakable.

A longtime friend, Barry Owen, succeeded in all three ways.

At 66, he revealed his pancreatic cancer diagnosis in a blog post. He knew, as did his husband, Dan, the unforgiving prognosis. (Stage IV pancreatic cancer has a five-year survival rate of 1 percent, according to Johns Hopkins Medicine.) “I have no illusions about this disease,” Barry wrote on his Caring Bridge blog, which was read by about 30 of his closest friends, including his two brothers.

Three months after his diagnosis, Barry pushed open the door to a conversation about dying. “Dan and I are starting to talk about planning, planning for my death,” he wrote. “This is not easy to write about.”

It was not easy to read about, either. But we joined the conversation with Barry and Dan, I hope, supporting them if not sharing their pain.

Barry did well enough for a while — long enough to celebrate his 67th birthday, to make a farewell tour to friends, and to enjoy the winter holidays. By spring, all that had changed. Eleven months after diagnosis, one of his caregivers posted the sentence everyone expected, yet dreaded. “So, yes, he is dying.” We understood. Barry’s followers made that final journey together with him.

During those final days I thought of “The Mary Tyler Moore Show,” one of Barry’s favorites, specifically the final scene where Mary, Rhoda, Lou, Ted and all the rest huddle, and walk offstage together, as one. It’s a tear-jerker, for sure.

We leaned in, through the Caring Bridge site. One friend acknowledged the heartbreak of losing Barry. His brother, Jamie, posted: “We all know the inevitable result, but it doesn’t keep me from becoming emotional every day.” I wrote that I’d burst into tears upon reading the news, but that I felt so deeply connected to his friends. Amid all this, a friend reminded us that Barry’s mantra had always been “Only connect,” which to him spoke to the importance of our relationships to help defeat “the isolation” — as novelist E.M. Forster put it — that keeps us apart.

I felt privileged to be among all these beautiful souls, so in touch with their feelings and able to express them. I thought then — as I do now — how rare this gift is. When Barry died, we held onto one another, tightly albeit it virtually. One friend posted, “Although I only know a few of all the friends around Barry, I feel part of you and share your grief.” Another wrote, “How terrible our loss.”

Complete Article HERE!

Scared of dying?

Here’s how to beat back the fear and find peace.

Death ‘is life’s change agent,’ Steve Jobs said in a famous 2005 speech.

By Morey Stettner

If you’ve lived a full life, you’re more apt to accept death. You’re able to wrap your mind around your demise without anger, panic or woe.

Yet for many retirees, the prospect of their own passing is immobilizing. A flurry of negative emotions vies for attention, from fear (“I’m afraid of a long, painful decline”) to regret (“I won’t see my grandchildren grow up”).

If you experience what psychologists call death anxiety, you’re not alone. Roughly one in five adults say they’re afraid of dying.

Older people may feel less haunted by death, especially if they’re terminally ill and receive hospice care. Surrounded by nurses and aides who prioritize emotional support and comfort, hospice patients tend to view their impending death with serenity.

On the other hand, some otherwise healthy seniors cannot bear to think about death. Whether it’s the realization that they have fewer years left, to dread that months or years of physical suffering await them, a dark cloud of foreboding invades their everyday life.

What separates those folks who take death in stride from the ones who let it eat away at their wellbeing?

“Part of it is having a more relaxed, flexible attitude and a willingness to rescind control over how we will die,” said Katherine King, an assistant professor of psychology at William James College in Newton, Mass. “A lot of us don’t tolerate uncertainty very well.”

If you have a controlling personality, pondering your death can cause agitation. Coping with such a sweeping, impossible-to-control force can prove crippling.

Another source of death anxiety relates to your overall satisfaction with how you’ve navigated your spiritual, creative and financial life. Generally, those who are fulfilled in these areas accept with equanimity that death is the next stage.

Steve Jobs qualifies as someone who attained a measure of fulfillment. Confronting his pancreatic cancer, he described death as “very likely the single best invention of life.”

Like many terminally ill people, he waxed philosophical about death. While we’ll never know if he cursed his bad luck in private, he took a more reassuring position in public.

“It is life’s change agent,” he said in his now-famous 2005 commencement address to Stanford University graduates. “It clears out the old to make way for the new. Right now the new is you, but someday not too long from now, you will gradually become the old and be cleared away.”

Aging in itself enables some people to accept death. The more funerals we attend, the more we start to see death in a new light.

“Losing people around us like friends and loved ones creates a feeling that it’s time,” King said. “It’s a natural preparatory process. As you get into your 80s and 90s, it can seem like the next task” on your to-do list.

But for those who continue to resist (“I’m not ready to die!”), honest self-reflection can help.

Ask yourself, “Do I have any unfinished business to tend to?”

“People who fear death tend to believe they haven’t completed their lives,” said Connie Zweig, a retired psychotherapist in Los Angeles, Calif. “So the key is to move toward completion, whether it’s completing a relationship where you still feel wounded or a business project that’s important to you. It’s that longing to reach a resolution.”

By taking steps to repair ruptured relationships, reclaim discarded dreams or intensify your search for spiritual or religious affirmation, you can address the nagging feeling that something’s missing. Checking off all the boxes in your life thus reduces death anxiety.

Speaking of religion, it can work for or against you when you’re grappling with the notion of your demise. Naturally, your beliefs about life after death play a big role.

“If you think you’ll be buried and a tree will grow there, that’s enough for some people,” said Zweig, author of “The Inner Work Of Age.” “Others are more religious and their beliefs can either give them solace or dread.”

Regardless of what’s driving your fear or sadness about death, detaching yourself from your inner demons can work wonders. It’s liberating to rise above your anxiety and, like Steve Jobs, take a big-picture view of what life’s all about.

Zweig recalls counseling a 70-year-old woman who was grieving from the loss of her parents, brother and best friend. Unlike some people who grow to accept death as they mourn the passing of loved ones, Zweig’s patient expressed mounting stress as she thought about her end-of-life.

“I suggested that she meditate,” Zweig said. “She learned how to quiet her nervous system and quiet her mind so that she could watch her thoughts about death and let them go. They became less gripping and less overwhelming.”

After a few months of meditation, the woman attained a heightened state of calm in mind and body. Even her breathing gave her comfort.

“Each time I breathe in and out, I’m practicing dying,” she told Zweig. The regularity of her breathing reduced her fear and gave her strength to persevere.

“In that way, she acclimated to those previously disturbing thoughts,” Zweig said. “She found peace of mind.”

Complete Article HERE!

Dying isn’t as bad as you think

The thought of death makes many of us feel frightened, so we barely talk about it. But dying is far gentler than Hollywood would lead us to believe.

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Here’s a delicate truth: we’re all approaching the ends of our lives. Every day counts us down, it’s just that most of us rarely talk, or even think, about it. And when we do, we feel scared of pain and panic and feeling out of control; afraid of sadness and saying goodbye; worried about deaths we’ve seen on TV or in films.

I’ve worked in palliative medicine for over 30 years, helping to improve the conditions of those nearing the ends of their lives. I’ve sat by the bedsides of scores of dying people and it’s taught me a lot about the realities – and misconceptions – of death.

More than half a million people die in the UK each year and almost all of them from a condition that gives at least some warning that death is approaching. If you knew you had limited time left to live, what would you want to do? Who would you want to be with? Are you keen on hospitals? Could your home be suitable? What’s your opinion about being kept alive on a ventilator, even if you’re unlikely ever to regain consciousness? How much treatment is too much? Are you an organ donor?

Here is some good news: death is almost certainly not going to be as bad as you think. Just like birth, death follows a predictable pattern. Initially, illness reduces people’s energy levels. The mechanisms are complex, but the outcome is that they need more sleep. Naps help, but energy is quickly used up, and another snooze is required.

 

At the end of life, there’s an exhalation that just doesn’t get followed by an inhalation. As simple and gentle as that.

As time goes by, those naps last longer and change in character. Although the person doesn’t notice any difference, they dip into unconsciousness for a while, so we’re temporarily unable to wake them. At this point, it’s time to switch any symptom-managing medications to a subcutaneous route like a syringe pump, to stop any symptoms from coming back if we cannot rouse the patient when their medicines are due.

If their illness isn’t affecting their thinking, then a dying person will still appreciate their family and friends when they’re awake, the occasional sip of fluid, perhaps a spoonful of something tasty, although people rarely have much appetite. They may stay in bed. They may appreciate peace and quiet, or their favourite music (I’d prefer BBC Radio 4, by the way). The periods of unconsciousness get longer and, eventually, the dying person is simply unconscious all of the time.

We can change evolution © Scott Balmer

Now, the next change begins: in deep unconsciousness, breathing is driven by the only part of the brain still functioning. This produces an automatic breathing pattern that cycles between deep, sometimes noisy breathing and very shallow breathing. The rate also alternates between fast and slow; there can be gaps that are several seconds long. Saliva may gather in the throat, causing air to bubble through the fluid, which makes a rasping or rattling noise. These noises are a sign of deep unconsciousness, not of distress.

At the end of life, during a phase of slow, shallow breathing, there’s an exhalation that just doesn’t get followed by an inhalation. As simple and gentle as that. Sometimes so gentle that the family around the bed doesn’t notice. No pain or panic; no sense of loss of control. This is what the vast majority of people experience.

By knowing this gentle pattern, dying people can make choices about where and how to be cared for. Their families are often asked to report dying people’s wishes. Do you know the answers? Does your family know yours?

Complete Article HERE!

What Is Thanatophobia?

Understanding prolonged, excessive fear of death

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Thanatophobia is a persistent and irrational fear of death or dying. The fear may focus on your own death or the death of a loved one. In extreme cases, these thoughts may be so terrifying that you end up isolating yourself completely, avoiding leaving the house in case something terrible happens.

In the Greek language, the word “Thanatos” refers to death and “phobos” means fear. Thus, thanatophobia translates to the fear of death.

Many of us will feel scared of death and dying at some point in our lives. If you have a phobia of death or dying that is persistent and longstanding, causes you distress or anxiety, and is so extreme that it interferes with your daily life, you may be suffering from thanatophobia.

This article takes a close look at thanatophobia, or death anxiety, to explore the symptoms, causes, and treatments for this phobia.

While thanatophobia is not specifically listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), there are symptoms of a specific phobia that could be applied in assessing whether someone has a typical fear of death or something more.

  • Unreasonable, excessive fear:The person exhibits excessive or unreasonable, persistent, and intense fear triggered by a specific object or situation.
  • Avoidance of situations in which thinking about death or dying may be necessary: In severe cases, this can lead to the person avoiding leaving home altogether.
  • Life-limiting:The phobia significantly impacts the individual’s work, school, or personal life.
  • Duration:The duration of symptoms must last for at least six months.

The panic you experience with thanatophobia is often attributed to general anxiety, which could produce the following physical symptoms:

  • Sweating
  • Shortness of breath
  • Racing heart
  • Nausea
  • Headache

Death Anxiety in Children

A child’s fear of death may be a healthy part of normal development. Children generally lack the defense mechanisms and understanding of death that help adults cope. Whether the fear qualifies as a phobia depends on its severity and the length of time it has been present.

Diagnosis

Thanatophobia isn’t a clinically recognized condition, so there is no specific test healthcare providers can use to diagnose this phobia. But a list of your symptoms, the length of time you’ve been experiencing the fears, and their severity will give healthcare providers a greater understanding of what’s going on.

It is important that thanatophobia is diagnosed by a trained mental health professional. They will try to determine whether the fear is part of a specific phobia, an anxiety condition, or a related mental health disorder

Thanatophobia may be linked to:

  • Specific phobias: Death anxiety is associated with a range of specific phobias. The most common objects of phobias are things that can cause harm or death, including flying, heights, animals, and blood.
  • Panic disorders: During a panic attack, people may feel a fear of dying or impending doom.
  • Illness anxiety disorders: Death anxiety may be linked to illness anxiety disorders, once known as hypochondriasis. Here, a person has intense fear associated with becoming ill and excessively worries about their health.

A 2019 study linked death anxiety to more severe symptoms across 12 different mental disorders.

Causes

The exact cause of thanatophobia is unclear. However, the condition is a specific phobia with a focus on previous experiences with death.

Some of the risk factors that expose people to a higher risk of thanatophobia include:

  • Age: Studies found death anxiety peaked in people during their 20s and declined significantly thereafter.
  • Sex: Although men and women both experience death anxiety, women experience a secondary spike of thanatophobia in their 50s.
  • Parents nearing the end of life: Children of elderly or sick parents are more likely to fear death. They’re also more likely to say their parents are afraid of dying because of their own feelings.
  • Personality and temperamental factors like being prone to anxiety may increase your risk of death anxiety.
  • Personal health: People with chronic illnesses are more at risk of developing an extreme fear of death.
  • Traumatic event: Those who have experienced death-related, traumatic events are more likely to develop death anxiety.

Prevention

Medical literature on death anxiety is limited and often conflicting, but one study found that fear of death is uncommon in people with:

  • High self-esteem
  • Religious beliefs
  • Good health
  • A sense of fulfillment in life
  • Intimacy with family and friends
  • A fighting spirit

Your healthcare provider may recommend that you receive treatment for an anxiety disorder, phobia, or for a specific underlying cause of your fear of death.

Therapy

Cognitive behavioral therapy (CBT) is an effective treatment for many anxiety conditions and for symptoms of thanatophobia. During a course of CBT, you and your therapist will work together to determine the cause of your anxiety and focus on creating practical solutions to problems.

The goal is to eventually change your pattern of thinking and put your mind at ease when you face talk of death or dying.

Medication

Your healthcare provider may prescribe medication to reduce anxiety and feelings of panic that are common with phobias. Medication is rarely a long-term solution, however. It may be used for a short period of time in combination with therapy.

Coping

Social networks and support groups may help you to deal with death anxiety. Some people may come to terms with feelings of death through religious beliefs, though for some, religion increases feelings of death anxiety.

Self-help techniques include activities that help you feel calmer and more relaxed, such as breathing exercises and guided meditations, as well as other activities that help you improve your overall mental health, such as eating a nutritious diet, getting enough sleep, and regular exercise.

They may not help you overcome your fears in the long term but can help you to reduce the physical symptoms of anxiety you are experiencing and feel better able to cope.

Frequently Asked Questions

How common is thanatophobia?

Everyone will experience a fear of dying at some point in their lives. If you find yourself worrying about death a lot, the first thing to do is to remind yourself that you’re not alone. But if this fear is persistent and is impacting your daily life, seek medical help.

Death anxiety peaks for people in their 20s and seems to get better with age.

Why can’t I stop thinking about death?

Anyone can experience obsessive thoughts about death or dying, and unfortunately they can worsen when a triggering situation arises or can even appear suddenly. While there are many strategies you can try on your own, if you continue to experience unwanted, intrusive thoughts about death, it’s best to reach out to a mental health professional for help.

How do I talk to someone about my fear of dying?

It can be daunting to seek help for death anxiety, but asking for help and learning how to handle these fears in a healthy way can help you manage your condition. It can also keep you from feeling overwhelmed.

A therapist will work with you to examine your thoughts and behaviors and improve how you feel. Your therapist will also give you the tools to help you open up to loved ones about your fears.

Is necrophobia the same as thanatophobia?

Necrophobia is different from thanatophobia. Necrophobia refers to an intense, often irrational, fear people exhibit when confronted with dead “things,” such as the remains of a deceased human being or an animal, or an object typically associated with death, such as a casket, cemetery, funeral home, or tombstone.

A Word From Verywell

Worrying about your own death, or the death of a loved one, is normal but can be distressing and concerning when the feelings linger. If the worry turns to panic or feels too extreme to handle on your own, seek help.

If your worries about death are related to a recent diagnosis or the illness of a friend or family member, talking with someone can be helpful.

Complete Article HERE!

Death-friendly communities ease fear of aging and dying


Improving death-friendliness offers further opportunity to improve social inclusion. A death-friendly approach could lay the groundwork for people to stop fearing getting old or alienating those who have.

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Death looms larger than usual during a global pandemic. An age-friendly community works to make sure people are connected, healthy and active throughout their lives, but it doesn’t pay as much attention to the end of life.

What might a death-friendly community ensure?

In today’s context, the suggestion to become friendly with death may sound strange. But as scholars doing research on age-friendly communities, we wonder what it would mean for a community to be friendly towards death, dying, grief and bereavement.

There’s a lot we can learn from the palliative care movement: it considers death as meaningful and dying as a stage of life to be valued, supported and lived. Welcoming mortality might actually help us live better lives and support communities — rather than relying on medical systems — to care for people at the end of their lives.

 

The medicalization of death

Until the 1950s, most Canadians died in their homes. More recently, death has moved to hospitals, hospices, long-term care homes or other health-care institutions.

The societal implications of this shift are profound: fewer people witness death. The dying process has become less familiar and more frightening because we don’t get a chance to be part of it, until we face our own.

Fear of death, of aging and social inclusion

In western cultures, death is often associated with aging, and vice versa. And a fear of death contributes to a fear of aging. One study found that psychology students with death-anxiety were less willing to work with older adults in their practice. Another study found that worries about death and aging led to ageism. In other words, younger adults push older adults away because they don’t want to think about death.

A clear example of ageism being borne out of a fear of death can be seen through COVID-19; the disease gained the nickname “boomer remover” because it seemed to link aging with death.

Grandparents with masks seen pressing hands against window looking at granddaughter

The World Health Organization’s (WHO) framework for age-friendly communities includes “respect and social inclusion” as one of its eight focuses. The movement fights ageism via educational efforts and intergenerational activities.

Improving death-friendliness offers further opportunities to improve social inclusion. A death-friendly approach could lay the groundwork for people to stop fearing getting old or alienating those who have. Greater openness about mortality also creates more space for grief.

During COVID-19, it’s become clearer than ever that grief is both personal and collective. It’s especially relevant to older adults who outlive many of their peers and experience multiple losses.

The compassionate communities approach

The compassionate communities approach came from the fields of palliative care and critical public health. It focuses on community development related to end-of-life planning, bereavement support and improved understandings about aging, dying, death, loss and care.

The age-friendly and compassionate communities initiatives share several goals, but they don’t yet share practices. We think they should.

Originating with the WHO’s concept of healthy cities, the compassionate communities charter responds to criticisms that public health has fallen short in responding to death and loss. The charter makes recommendations for addressing death and grief in schools, workplaces, trade unions, places of worship, hospices and nursing homes, museums, art galleries and municipal governments. It also accounts for diverse experiences of death and dying — for instance, for those who are unhoused, imprisoned, refugees or experiencing other forms of social marginalization.

The charter calls not only for efforts to raise awareness and improve planning, but also for accountability related to death and grief. It highlights the need to review and test a city’s initiatives (for instance, review of local policy and planning, annual emergency services roundtable, public forums, art exhibits and more). Much like the age-friendly framework, the compassionate communities charter uses a best practice framework, adaptable to any city.

Multigenerational family, walking, holding hands on the beach.

Age-friendly initiatives could converge with the work of compassionate communities in their efforts to make a community a good place to live, age and, ultimately, die.
There’s a lot to like about the compassionate communities approach.

First, it comes from the community, rather than from medicine. It brings death back from the hospitals and into the public eye. It acknowledges that when one person dies, it affects a community. And it offers space and outlets for bereavement.

Second, the compassionate communities approach makes death a normal part of life whether by connecting school children with hospices, integrating end-of-life discussions into workplaces, providing bereavement supports or creating opportunities for creative expression about grief and mortality. This can demystify the dying process and lead to more productive conversations about death and grief.

Third, this approach acknowledges diverse settings and cultural contexts for responding to death. It doesn’t tell us what death rituals or grief practices should be. Instead, it holds space for a variety of approaches and experiences.

Age-friendly compassionate communities

We propose that age-friendly initiatives could converge with the work of compassionate communities in their efforts to make a community a good place to to live, age and, ultimately, die. We envision death-friendly communities including some, or all, of the elements mentioned above. One of the benefits of death-friendly communities is that there isn’t a one-size-fits-all model; they can vary across jurisdictions, allowing each community to imagine and create their own approach to death-friendliness.

Those who are working to build age-friendly communities should reflect on how people prepare for death in their cities: Where do people go to die? Where and how do people grieve? To what extent, and in which ways, does a community prepare for death and bereavement?

If age-friendly initiatives contend with mortality, anticipate diverse end-of-life needs, and seek to understand how communities can indeed become more death-friendly, they could make even more of a difference.

That’s an idea worth exploring.

Complete Article HERE!

End-of-life care: people should have the option of general anaesthesia as they die

By and

Dying patients who are in pain are usually given an analgesic, such as morphine, to ease their final hours and days. And if an analgesic isn’t enough, they can be given a sedative – something to make them more relaxed and less distressed at the end of life. We have recently written about a third approach: using a general anaesthetic to ensure that the dying patient is completely unconscious. This has been described previously, but largely overlooked.

There are two situations when a general anaesthetic might be used in dying patients. The first is when other drugs have not worked and the patient is still distressed or in pain. The second is when a patient has only a short time to live and expresses a clear wish to be unconscious. Some dying patients just want to sleep.

But what type of anaesthesia are we talking about? If you need surgery or a medical procedure, there are three options. First, being fully awake, but having local anaesthesia to block the pain. Second, you could be partly sedated: you would be less stressed or worried about it, but you might remember some of the procedure afterwards. Finally, you could have a general anaesthetic and be out cold, with no memory of the procedure afterwards.

Any of these might be appropriate, depending on the procedure and depending on the person. But the option with the highest chance that you won’t feel anything is, of course, general anaesthesia.

These same three options could be offered to a dying patient. Some people might want to be as awake as possible. (Like the poet Dylan Thomas, they might not wish to “go gentle into that good night”.) Some might want to be sedated, if necessary. Others might want to be completely asleep.

The choice of general anaesthesia at the end of life is potentially popular. Last year, we surveyed more than 500 people in the UK about end-of-life options. Nearly 90% said they would like the option of a general anaesthetic if they were dying.

You might wonder, is this not just euthanasia by another name? Giving someone medicines to ensure that they are unconscious as they die naturally is different from giving someone medicine to end their life. General anaesthesia is legal, whereas in many countries, including the UK, euthanasia is illegal. This means that the option of anaesthesia could be available now for dying patients in the UK without changing the law. France has recently recognised the right for dying patients to be unconscious.

Wouldn’t it be too risky?

There are side-effects with all medicines, but recent advances mean that it is possible to give anaesthetic medicines to patients close to death without affecting their breathing. The medicine is given slowly, and the patient made unconscious gradually over 15 to 20 minutes. The medicine can be slowed or stopped at any point.

Tray of anaesthetic drugs.
Tray of anaesthetic drugs.

Previous studies that have used anaesthesia at the end of life, have continued the medicines for one to 14 days until the patient died naturally.

This will not be for everyone. It may not be possible for those who are dying in their own home. And some people will not want it. But we have the means to offer dying patients a gentle alternative end to their days. We believe that there is a strong ethical case to make the option of general anaesthesia at the end of life more widely available.

Complete Article HERE!