California assisted suicide patients are mostly white, well-educated

Amanda Friedland, left, adjusts her friend Betsy Davis’ sash as Davis lies on a bed during her “Right To Die Party” surrounded by friends and family, in Ojai. At the end of the party, the 41-year-old woman diagnosed with ALS took a cocktail of lethal drugs and died, becoming one of the first California residents to take life-ending drugs under a new law that gave such an option to the terminally ill.

[C]alifornia residents choosing legal assisted suicide are disproportionately white and well-educated, new figures show.

Since California’s End of Life Option Act went into effect on June 9, 2016, hundreds of terminally ill patients have weighed the decision to end their own lives.

In 2016, 111 individuals died from ingesting aid-in-dying drugs, according to the California Department of Public Health. Ninety more had been prescribed drugs but ultimately did not take them, while a total of 258 individuals had begun the end-of-life option process.

Over half of the participants had cancer, with the most common type being lung cancer. Participants also suffered from neuromuscular diseases, heart disease and non-cancer lung respiratory disease, among others. At least 84 percent were already enrolled in hospice or palliative care.

Of the 111 individuals, 87 percent were at least 60 years old and 44 percent relied solely on Medicare for health insurance. Participants were also overwhelmingly – 89 percent – white. Additionally, 58 percent had attained an associate degree or higher level of education. Highly educated whites tend to have higher household incomes.

While these proportions are similar to those in Oregon’s 2016 Death with Dignity Act report, they do not reflect the demographics of California’s population. This is a sign of a deeper sociological and anthropological cause, said Lael Duncan, medical director of consulting services for the Coalition of Compassionate Care of California, an advocacy group for quality end-of-life care.

“I suspect it has to do with cultural and community norms and higher acceptance of this practice among that demographic,” Duncan said, though she hopes future research will shed more light on the situation.

To be eligible for participation, patients must have a terminal diagnosis, defined in the bill as an “incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, result in death in six months,” according to the bill. They must be determined to be able to make their own medical decisions and self-administer the aid-in-dying drug.

Patients begin the process by orally requesting an aid-in-dying drug two times at least 15 days apart and submitting a written request to their doctors. After discussing alternative options for care with their attending physician, they must also consult another doctor who can confirm the terminal diagnosis and their medical decision-making capacity.

Drugs used to aid in dying have changed throughout the years as more states have authorized the procedure, Duncan said. Common prescriptions are for mixes of various drugs, such as narcotics, benzodiazepines and cardiac medications, that can be taken orally. The exact combination and dosages of these drugs are adjusted to the patient, as individual tolerances and metabolisms vary. This multi-drug regimen costs several hundred dollars depending on the drugs used. Medicare does not cover these costs, so many patients must pay out-of-pocket for the procedure.

After ingesting the drugs, patients enter a deep comatose state in roughly 15 minutes and die about 30 minutes to a few hours later, Duncan said.

Physicians are not mandated to participate in aid-in-dying, and facilities can also opt out of the practice. But a list of participating doctors does not currently exist, according to the Coalition of Compassionate Care of California’s website. Only a small proportion of all physicians in California are willing to prescribe aid-in-dying drugs, complicating patient access to the procedure, Duncan said.

“The first year, it’s been a bumpy road,” Duncan said. “Access has been incredibly challenging even for patients who are being cared for in organizations and institutions where they are participating.”

Complete Article HERE!

On dealing with grief

Methods for coping with the noise

By Douglas Redd

[W]hen you are grieving, it may seem instinctual to build a wall around yourself. Or you might want to bottle your emotions and disguise what you really feel. It is important, however, to realize that there are other ways to heal that keep you and your relationships healthy. The American Psychological Association recommends several methods for dealing with loss including acceptance, self-care, and support system building.

Loss, failure, or separation can cause pain that may never go away and, in my experience, this pain comes in waves. At times, I would convince myself that I was OK, but something small, like a song or smell, would consume the peace of mind I thought I had. At times, the grief may not seem all that bad while at other times the anger, sadness, or denial may swallow you whole.

It is human to feel this pain, and it is human to let yourself express the heartache that comes with loss.

It is crucial to remember that it’s OK to hurt. The first step to moving on is allowing yourself to be sad. Denial will only prolong the pain you’re feeling. During the initial stages of grief, surround yourself with others. Do not allow the pain to make you forget about the people that you still have. Your friends and family understand what you are going through, and shutting them out will only further your misery.

While you may not want to open up about what you are experiencing inside, realize that talking about what you are feeling will make it better. Talking is believed to reduce stress, and during times of grief, it could be useful to help create a support network. Loved ones want to support you during times of grief, so let yourself lean into that support rather than resisting it. You have people to talk to, so use them to ease your pain. Talking will let you realize that you cannot and should not depend solely on yourself, and it could allow others to find different ways to help you heal.

Grief won’t only affect you mentally, but it will also seep into your daily life and could begin to affect your lifestyle, routine, and health habits. To cope with loss, it is important to maintain your health and wellness.

To make this easier, it may be useful to understand the five stages of grief.

The five stages of grief are denial and isolation, anger, bargaining, depression, and acceptance. Those who are grieving experience these stages differently; they might experience all of these stages in this order, skip some of them, or they may appear in a completely different order. While everyone may find that some coping mechanisms are better than others, there are a few health-related tips to make the process easier.

Firstly, make sure that you are able to get an ample amount of sleep. The process of grieving may tire the body, and a lack of sleep could cause you to feel worse.

To properly nourish your body, do not forget to maintain healthy eating habits. This also applies to the use of substances to alleviate the pain. While alcohol and other drugs may seem like they numb the pain, they ultimately will only bring more trouble.

Taking care of yourself is an essential part of living well, especially in times of struggle. When grief has the potential to not only affect your mental health, but your physical health too, you need to take additional measures to ensure your well-being. These measures also include returning to things that made you happy before.

Do not forget about the little things in life that you previously enjoyed. I am not telling you to distract yourself from the pain that accompanies grief, but to indulge in the activities that made life worthwhile to begin with. It is not over yet — enjoy what there is left to love.

Complete Article HERE!

The deaths that changed my life

A palliative care specialist reveals what she’s learnt

[W]ith two decades of experience in helping people approach their final days in the best way possible, Adrienne Betteley shares her most touching and disturbing moments

 
First as a nurse, and then working with Macmillan Cancer Support, I have spent nearly 20 years helping people during the final months of their lives – and making sure that as many as possible have a “good” death is a great privilege.

If my experience of end-of-life care has taught me anything, it’s that there is indeed such a thing as dying “well”. Of course, the way we die varies depending on the cause of death, as well as the individual needs of the person, but there is also a tragic variation in the care and choice that people have as they approach their end.

At Macmillan, we believe the first step in achieving a “good” death is talking about it more – as we set out in our recent report, No Regrets. We looked at the taboo around discussing death, and how planning ahead can help people to die in a place of their choice and to have more control over their treatment.

So, in the spirit of talking more, and being honest, I’m sharing some of my experiences. I hope that it inspires others to do the same.

Dennis’ late wife, with her son (Adrienne’s husband) and grandchildren.

Closure is important

The first time I encountered death was when I was seven years old and living in Australia in the 1970s. My best friend, Stephen, died of leukaemia at the age of 11. He was the son of some close friends of my parents and was like a big brother to me. He was so kind-hearted, and I really looked up to him.

Death wasn’t seen as something children should know about, so I never visited him at hospital or went to his funeral. No one talked about Stephen dying, and I had recurring nightmares about it. I feel that I never had closure, and still think about it now sometimes.

Adrienne Betteley

Don’t let fear stop you

When I was 25, and living in Cheshire, my maternal grandmother Eileen was diagnosed with oesophageal cancer. Her reaction to finding out she was dying was calm; she began talking about her memories and writing them down.

I was pregnant and my granny “held on” until my daughter, Jasmine, was born. I took my daughter to hospital to meet her great-grandmother, a few weeks before she was moved to a hospice.

The experience with Stephen had scarred me, and I didn’t visit her in the hospice. I was too afraid. I thought it would be like a Victorian sanatorium, with people wailing and crying out.

Years later, while I was a student nurse, I realised a hospice can be a place of joy and peace – somewhere to treasure the end of life, rather than focus on death.
I regretted that I had let fear stop me saying goodbye to someone I loved dearly.

Adrienne Betteley couldn’t face visiting her grandmother in a hospice

Trust a professional

My first career was in architectural stained glass, but I also had a part-time job at a nursing home. One of the nurses asked me to help her lay out a woman who had just died. I was very nervous, but it turned out to be an amazing experience.

I had never seen anyone treat another person with such gentleness and respect. As the nurse washed her and did her hair as though she were still alive, I was in awe. She made her look lovely, in her favourite clothes and make-up.

I understood the huge value that this nurse placed on another person’s life. It was this moment that helped me choose my own future in caring for people at the end of their lives.

Focus on pain relief

While waiting for my nursing training to start, I worked in a different nursing home, where I had an awful experience.

I was looking after an elderly woman who was dying of uterine cancer and had become bedbound. One day, the nursing sister on duty told me to get her out of bed to use the commode. I went to do as I was told, but as soon I touched the woman she dug her nails into me and screamed out in pain. I had never witnessed such agony.

Filled with rage, I went straight to the nurse and shouted at her that nobody in this day and age should be allowed to experience such pain. Why were we moving her when it was clear she needed to be catheterised?

She listened to me and sorted out a catheter and a syringe driver for the pain. But it made me determined that no one should have to experience pain like that.

Communication is key

My father-in-law Dennis had been employed on the Crewe railway works, and after years of exposure to asbestos he was diagnosed with terminal lung cancer.

It was the poor communication we encountered that was really upsetting. He was never told his prognosis by a medical professional; in fact a hospital doctor, knowing my nursing background, asked me to tell him instead. I couldn’t believe they would put that kind of pressure on me. But I went ahead and did it; I felt that at least I would do a better job than this doctor.

Adrienne Betteley’s late father-in-law, Dennis

As soon as I’d told my father-in-law, I felt like the grim reaper. The whole experience blurred the boundaries between my professional life and my private relationship with him – it was damaging and I felt a mixture of guilt and anger.

Dennis was encouraged to have palliative chemotherapy, without being warned of the side effects. Any extra time the chemo bought him was overshadowed by painful mouth ulcers, nausea and fatigue. The treatment destroyed any quality of life, and barely extended it: he died within six months.

If he had been given an informed choice about treatment, I’m sure things could have been different.

Say goodbye the right way

A few years ago, my mother died of oesophageal cancer, like her own mum. My dad and I were at her side, and I’d spent the last week in a camp bed next to her, mopping her forehead as we shared memories.

On the night she died, she put her arm around me and said: “Adrienne, I have to thank you for being the most wonderful daughter.” What a privilege to be able to use my knowledge and experience to support my mum and make her death easier.

Adrienne Betteley’s late mother

A Macmillan occupational therapist had transformed mum’s quality of life, making it possible to fulfil her wish of dying at home. As a nurse, I could advocate for her, and demand the right pain relief – but it really brought home how hard it would be for people without my professional background.

Knowing I’d done everything possible to fulfil her wishes made the grieving process easier, but I still had frustrations about what could have been better – especially the lack of support available at the very end. It sounds clichéd to say “dying is inevitable” or “death is the only certainty” – of course we all die, everyone knows that. But all too often, it feels like we are hiding from it. The fact that it will affect every one of us should galvanise us into action, so we demand a “good” death that is pain-free and meets our preferences about treatment and location – for ourselves and those we care about.

Complete Article HERE!

This Startup Wants to Make End-of-Life Care Easier and More Compassionate

 

By

[M]aggie Norris endured two significant family deaths just six years apart. First, her stepfather was diagnosed with bladder cancer, which spread to his lungs and his brain. He passed away in 2008. Then, her biological father was diagnosed with lung cancer, which metastasized to his spine. He died in 2014.

Caring for her biological father and her stepfather before their deaths meant that she, her sister and her mother had to put their lives on hold. Caring for them meant everything from bathing and administering medications to planning meals and overseeing care, all of which she said amounted to a full-time job. While her stepfather was more forthcoming about his illness, her father was not as open about his, which led to Norris and her sister not finding out about his prognosis until things had gotten difficult.

In between all of this, Norris said her family conducted research in order to understand the illnesses. It was not clear how these conditions would progress or what they should do to ensure the best care was provided.

“He didn’t openly talk about it with family or his primary oncologist, so by the time we found out he was really in a tough spot,” Norris said, referring to her biological father. “What people don’t understand is death is a process. It doesn’t happen in a day or a week. It is over the course of several months or several years. It’s an emotionally and situationally really complex to navigate.”

An idea emerged in the aftermath of her grief. What if there was a way to making end-of-life planning easier? How can discussing advanced care be simplified in a way that keeps family members, medical professionals and other stakeholders in the loop? Those questions led her to create After, an end-of-life planning software that provides informational healthcare videos, organizes key legal and healthcare-related forms, and coordinates end-of-life care requests with stakeholders involved in patients’ healthcare decisions. Norris founded the company in January 2017 and is preparing for a soft launch this August.

The software features animated videos that walk patients through what to expect with their diagnosis for the most common causes of death including cancer, heart disease, Alzheimer’s, chronic lower respiratory disease, diabetes and stroke. It also allows patients to organize their advance care planning and power of attorney information. But what distinguishes the software, Norris said, is its personalized, compassionate questions regarding how the patient wants to spend their last length of time.

“No one likes talking about death and dying, even if it’s your job to have conversations with patients about death and dying,” Norris said. “A lot of times physicians wait for families and patients to come to them with questions. The problem with that is the first stage of grief is denial.”

Norris is in the process of determining where to best place her software. It’s a natural fit for the healthcare industry, but she said she could also see the software being applied by lawyers and financial planners, or pharmacist. Navigating bureaucratic hospital systems and healthcare laws could also be tough for the company going forward, she added.

Still, Norris is aiming to provide vulnerable patients with a way to regain control over their final moments and initiate the uncomfortable, yet necessary conversations surrounding death.

“How do you make this conversation happen more often and easier and more accessible?” Norris said. “There’s this empty space there, and we’re trying to fill it with software.”

Complete Article HERE!

Navigating the end of the road

Death doulas offer education, support to those seeking alternative options while dying or grieving

A screenshot of a video documenting a home funeral shows family members visiting their deceased loved on in a home setting. The video was produced by Lee Emmert and the University of Oregon’s School of Journalism and Communications Department.

By Courtney Vaughn

[W]hen both of her parents died six weeks apart, Nancy Ward had to confront death in a profound way.

She was lucky, sort of. Her parents had prearranged for their care after their deaths, but Ward recalls being uneasy with the post-mortem process when her father died of congestive heart failure.

“Up until this point, I had never seen a dead body because I was about as death-phobic as they come,” Ward says. “A man came into the room, he looked about 14, and unrolled a black plastic body bag on the gurney. I’m going, ‘Oh my God. This man was just living and breathing and now you’re gonna put him in a black plastic bag and do what?’ Put him out on the curb for waste management to pick up?”

Ward succinctly recalls the emotional sterility of the situation.

Nancy Ward

“This doesn’t feel right, this doesn’t feel good, it doesn’t feel loving, or respectful,” she thought to herself. “He doesn’t know my father. I know my father.”

Six weeks later, her mother died.

“I knew what was coming and didn’t like it, but I had nothing to replace it with,” Ward says.

Afterward, she became a death midwife, or “death doula” as some call it, availing herself to others so they didn’t have to go through the same process she did with her parents.

Ward is now used to confronting death. In fact, she and others have made a living out of it.

A few years ago, Ward and other colleagues in the death directives industry teamed up to form the End of Life Care Collaborative. Members help educate and guide people in their quest for home funerals and other self-directed death practices.

The group focuses on serving those who are dealing with the death of a loved one, or preparing for their own death.

Services range from home funeral preparation and arrangements, to help with navigating the traditional funeral process, to emotional and practical support for those delving into the end of their own lives, and a gamut of other services to serve those confronting death.

The ultimate goal, members say, is to help people achieve greater meaning, or a more comfortable process around dealing with death and accepting loss. To get there, clients must be willing to shake off some of the cultural stigma of death.

“As a society, we aren’t comfortable with dealing with death because it reminds us of our own mortality,” Ward says. “We think everybody should know what their options are and right now, they don’t. We’re trying to reach the people who want it done differently but don’t know what different looks like.”

Ward and the collaborative team help educate people on what their options are for preserving a loved one at home after they’ve died, or bringing the body of a loved one home if they choose.

Ward says most members of the collaborative try to operate on a sliding-scale fee system, to make sure no one is turned away because of finances.

“We all have different areas we like to focus on and that’s what makes the collaborative so important,” she says. “We can do everything from the totally esoteric to the toally practical.”

That means being a listener and helpful guide, or doing a load of laundry or providing a meal for a grieving household.

She points to a recent client she worked with- a woman dying of cancer- who wanted to be prepared when her final moments came, but more importantly, wanted to rely less on her family for her physical and emotional needs.

“She said, ‘my family is having a really hard time with this …I don’t want to burden them with my own questions and expressions, this is what I need you for,'” Ward recalls.

“Their psychological and emotional needs are unmet,” Ward says of many terminally ill patients. “My involvement is just simply working with the person on a psychological, spiritual, emotional level.”

Members of the collaborative are not isolated in their quest to provide resources and support for death directives, but their services aren’t widely available, or even widely culturally accepted.

Asher Wallis

“I have seen a good deal of anxiety arise from family members who are trying, in the midst of disorienting grief, to figure out what their loved ones, who had not planned logistically or financially for the events that would follow their death, would have wanted,'” Asher Wallis, an End of Life Care Collaborative member and grief counselor, explains.

He attributes some of the sources of that unnecessary stress to “culturally sanctioned misinformation about the physiological and psychological nature of dying such that both the family caregivers and the dying person think they are doing it wrong.”

Deborah Threadgill, a collaborative member who is also a certified funeral director, says the End of Life Care Collaborative focuses on making “everything family-directed,” meaning they never suggest or push services on clients. Rather, they try to educate them on their full range of options surrounding death and dying.

“We take something that is very, very traumatic in our society and taboo and make it something natural and beautiful,” she says.

Complete Article HERE!

Deconstructing Death as a Dying Woman

by Mackenzie E. Rockcastle

[N]ext week, I have my second scan since being diagnosed with terminal cancer.

 
The thought of the little white masses glowing brightly on my doctor’s computer monitor leaves my stomach unsettled—leaves my mind unsettled.

As my “scanxiety” builds, I find myself leaning on my own advice to approach my fears of dying. A few weeks ago, I gave my therapist a breakdown of what I thought were my general fears surrounding death. She was surprisingly thankful for my analysis of such an enormous concept and fear that is shared by so many. She told me many of her patients held an irrational fear of dying. Breaking death down into the smaller fears that truly comprise the overall terror for the word makes it a little less intimidating.

She believed this mindset could help some of her other patients get to the root of their obsessions. So I thought to myself, perhaps my breakdown of death—one that has helped me unveil my true fears, befriend my own death, and enhance my life—could help others do the same.

To start the process of grasping my fears surrounding death, I first had to ask: Is it possible to create a good relationship with death? And in order to create a good relationship with it, well, perhaps we need to understand why we have such a bad relationship with it.

I personally see four major reasons to feel uncomfortable about death. All of them associate with fear. Fear of the dying itself, fear of what lays beyond death, fear of the life we will never live, and fear for those we leave behind.

At this point, I believe I’ve come to peace with three out of the four. But I had to ask (and continuously have to ask) myself the following questions:

1. What is dying?

Dying is a physical action. It is momentary. Physical pain may be associated, but it is temporary, not eternal. Dying is generally defined as “to stop living.” This definition causes death to be associated with the opposite of life. I don’t like this association, and I don’t believe it properly does justice to the word death.

As a young child in school, I specifically remember doing worksheets to understand opposites: on/off, black/white, night/day, life/death. Looking at a lot of ancient cultures, many have a book of the dead: The Egyptian Book of the Dead, The Celtic Book of the Dead, The Tibetan Book of the Dead, and so on. The way that most of them describe death is not as the opposite of life, but the opposite of birth. I think this shift in language—this shift in the juxtaposition of life and death—is important.

It is an entirely different concept. It suggests that we walk into a room and we walk out of a room, not that the room disappears.

2. What comes after death?

Since this is the most uncertain part of the equation, this question can bring about the most fear. Do we fear an almighty man in the sky? Burning for all eternity? That, maybe, this is it? Religion, upbringing, what we’ve experienced, what we’ve watched, and what we’ve read all play into what we believe happens after death. But the reality is, no one knows for certain. Beliefs, faith, and religion aside, really no one can say without a shadow of a doubt what happens when we die.

In this thought, some people hold fear, and some people hold peace.

For me, this is the most fun part. As a nonreligious, but spiritual person, this is a playground of opportunity. I personally don’t hold a fear for this. Rather, I see the space beyond death as a a beautiful existence where our beings no longer hold their human form. I acknowledge my brain doesn’t have the capacity to understand this fully, and therefore I don’t try too hard to create an image or definition to coincide, rather just a feeling. This is the part of death I feel to be the most reassuring, warm, and whole. It’s the presence that gives full peace.

3. Are we afraid of the things you will miss out on, the things we never did, or the things we’ll never do?

This fear is actually comprised of regret. These are the things in life we always thought we’d achieve or have the time for. The places we wanted to go. The people we wanted to meet. The food we wanted to eat. The adventures we wanted to take. This is bucket-list stuff, and is constantly shifting. It’s understandable to want more time to do more things, but, in fact, more incentive to live fully while we know we are here. Carpe f*ckin’ Diem, right?

The longer we live, we assume, the more likely we are to achieve our dreams and desires. And sometimes this is true. At 21, my initial diagnosis left me thinking I’d never graduate from college. A year later, I graduated with my class. At 23, just two weeks after finding out my cancer had returned, I stood next to my beautiful sister-in-law as she married my brother. I cried a good amount, most tears were of joy, but some of the salty droplets fell from the thought that I may never live long enough to get married. A year passed, and I did.

I realize some of those things can’t always be attained. I have certainly shed a tear or two over the thought of the empty bedrooms in my home that echo with the cries of babies who are not mine, and are not there. While the thought is sad, it too passes. My perspective goes beyond that. I have a lot of dreams. But if I don’t attain them, I am at peace with that. And I think part of that acceptance is the realization that it isn’t those big “achievements” that were my favorite parts of life thus far.

It’s the nitty gritty. The naughty. The unexpected. The unconventional things that are mine. And if that’s what we enjoy about life—the little things and the uniqueness of the bonds we’ve made—then maybe we can take away the bigness of death. Maybe if we break it down into the little things about it we can start to get on the same level as it. Maybe we can start to repair this broken relationship with death.

4. Do we hold a fear for those we’ll leave behind?

Currently, this is my greatest fear associated with my own death. I fear for the pain inflicted on those who will heavily feel my void. I am trying to remedy this by reminding them that my purpose here may be just that: a reminder. A reminder and an inspiration. And whatever is happening, it’s supposed to. It’s fluid and it will make sense. If I were to die soon, I know the little things people will see and think of me for.

Little jokes that will make them laugh. Spaces, patterns, and songs that will make them smile. And that is what makes us immortal: our essence. I believe that’s what we become when we die. And if I can inspire people to pursue the things that make them smile, laugh, and feel joy—feel love—that is a gift greater than I can take credit for. It gives me peace to know I will, in some way, be with them.

But, I can stare into my mothers eyes and tell her how at peace I am over a bottle of wine at lunch. And I am. But when I swivel around that table and look through her eyes, what do I see? My baby girl dying? F*ck, I can’t imagine. Nor, probably will I ever have to (which adds into the f*cked-up-ness of the thought).

I can physically feel the heaviness of my husband’s sadness as he lays his body on top of mine just to make sure I’m still there. I can run alongside my best friend and no empathy is needed, because the thought of losing her is the exact same weight as her thought of losing me. I can talk bucket-lists with my dad, who is battling Stage 3 cancer, with stipulation on both ends on how things are doing in a few months—a most unusual fate not typically shared between a father and daughter simultaneously. I can go out with my brothers or my friends and share meals, drinks, and laughs.

A big part of the problem is we continue to view death as an end—that we’ll never be able to share those same meals, drinks, and laughs again. But we wouldn’t anyways. That’s how time works. Part of making peace with death is making peace with time. Perhaps it’s the most perfect preserver of time—the relationship we had is exactly the relationship it will always be. We will always have shared that meal. We will always have shared that drink. We will always have shared that laugh. Allowing the fleeting to fleet. And letting life slip into death, in the beautiful, exact way it’s supposed to.

But, still, this is where I find sadness: in the sadness of others. I don’t like being the source of peoples’ pain. It’s the part that hurts the most. So no, this piece I am not yet at peace with. But it is a shared burden. And I believe the more at peace those I love become, the more at peace I’ll become. Which is the point of this whole thought: How do we better our relationship with death?!

I suppose a more complicated question then becomes: How do we better our relationship not only with our own death, but with the death of others? And I’m starting to think this is a full circle concept. If we better our relationship with our own death, we better our relationship with the death of others.

I think the first step is talking about it. Often the conversation is met with: “I can’t bare the thought.” But what if we did? What if we did just f*cking bear the thought? What would we do differently? How would we treat each other differently? How would we live differently? Can being friends with death make us have a better life?

I whole-heartedly believe the answer is yes.

I think as we visit and revisit each of these four major parts of death, we continue to delve deeper and deeper into a peace with it. A peace with our own death, a peace with the death of others, and a life more fully lived.

Complete Article HERE!

Supporting a child when someone dies – Part 1

Talking about death and who can help

[T]he death of someone close is one of the hardest things anyone has to face. It can be especially difficult to help a child manage their grief while you’re dealing with your own. Although you can’t protect a child from the pain that follows a bereavement there are things you can do to help them come to terms with their loss.

Talking about death

Although you may wish to protect your child from unhappiness, avoiding talking about the person who died isn’t helpful and can cause problems in later life. Talking about death can be difficult, even for people who are familiar with it. You may worry that you will frighten your child or say the wrong thing. But it’s important to be open and to answer any questions they have as honestly as you can. What children imagine can be far worse than the reality.

  • Try to avoid telling your child not to worry or be sad. It’s healthy to get attached to people. And, like you, your child might find it hard to control their feelings.
  • Don’t try to hide your pain, either – it’s alright to cry in front of a child. It can help to let them know why you’re crying.
  • Be sure to give the child plenty of reassurance. Let them know they’re loved and that there are still people who will be there for them. A cuddle can make a big difference and make them feel cared for. It’s also a good idea to stick to a routine, if you can. This can help the child feel more secure.

Sometimes it might seem as though they haven’t heard what you’ve said or aren’t affected by it. They could also seem to move in and out of their grief – being upset at some times and not at others. This is just their way of coping and they’ll deal with what they’ve been told in their own time.

Child Bereavement UK   has a useful information sheet (PDF download) for explaining death to children. Here are some other things that may help:

Be honest

Children need to know what happened to the person that died. Try to explain in clear, simple language that’s right for their age and level of experience. You might also try giving them information small amounts at a time, especially young children, as this can help them understand. Once you’ve explained that someone has died, the details can follow.

Use plain language

Talking around the subject doesn’t help and may lead to misunderstandings. Avoid explanations such as ‘the person has ‘gone to sleep’ or ‘gone away’. They may make your child frightened to go to sleep or worry as soon as you leave the house in case you don’t come back. Even if you believe the person who died has gone to heaven this can be confusing and worrying for a small child.

Encourage questions

Be prepared for your child to be curious and to ask the same questions again and again. This can be distressing but remember it’s a part of their need for reassurance and helps them process the information.

It’s not easy, even for adults, to understand death and dying. A child’s understanding will depend on their age, gender, stage of development, family background, personality and previous experience. Think about what to say and give the same answers each time. Be led by what they want to know and don’t be afraid to tell them you don’t know the answer to something.

Reassure them

It’s common for children to feel that the person has died as a result of something they may have said or done. Explain simply how and why they’re not to blame.

Ask them to tell their story

Asking children to tell their story of the death and experience of grief will let them know they are important and that their relationship with the person who died has been recognised. It can help you to understand what they know about what happened and correct anything that’s not quite accurate. It can also help children to discover that the way they see things changes with time.

Listening to their story will also help you better understand the child’s grief. Avoid comparing it to what you think they should be feeling or overusing words like ‘time’ as a way of trying to reassure them.

What people want more than anything, whether child or adult, is control over grief, feelings, and needs. Immediate comfort, the ability to express their feelings about the loved one and stability are all important in helping someone cope.

People who can help

Each person’s grief is as individual as the person who’s been bereaved and it can sometimes be easier to deny feelings than to acknowledge them. How children respond will depend on many things including:

  • their age
  • their stage of development
  • what they’ve read or seen on TV
  • their understanding of death and dying

Sometimes two children from the same family might need completely different types of support. The relationship that the child had with the person who died can also affect how they grieve.

Take things one day at a time. If at any time you feel unable to cope remember you’re not alone. Friends, family, healthcare professionals, teachers at your child’s school and others can all help. There may also be specialist child bereavement services that you can use including Child Bereavement Network  , Cruse Bereavement Care   or Winston’s Wish  .

Alternatively there may be a local children’s bereavement service in your area – ask your GP or search online.

External websites

Care for the Family  

Child Bereavement Network  

Cruse Bereavement Care  

The Child Bereavement Charity  

ChildLine: 0800 1111 (24-hour helpline)  

DadsNet  

Dying Matters  

Grandparents Plus  

Grief Encounter  

Healthtalkonline  

Netmums  

Samaritans: 116 123 (24-hour helpline)  

WAY Foundation  

Winston’s Wish  

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