Bereavement Practices of Growing U.S. Latino Population Have Been Ignored Too Long, Study Finds

‘The funeral industry wants to serve this community, but it doesn’t know how,’ Baylor researcher says

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By Terry Goodrich

Death research in the United States mostly overlooks bereavement customs of those who are not Anglo-Protestants, says a Baylor University researcher. She hopes to correct that — beginning with a study of Catholic Latino communities, who often hold overnight wakes and present food to the deceased.

Candi K. Cann, Ph.D., who teaches courses on death and dying, took a group of her students in 2015 to a Latino funeral home in a Central Texas city in which nearly 30 percent of the total population identifies as Hispanic or Latino, according to U.S. Census statistics.

“My students — nearly all Anglo — were fascinated,” said Cann, assistant professor in Baylor Interdisciplinary Core of the Honors College. While the Latino population is burgeoning, “this world was entirely foreign to them. The idea of eating and serving food at a wake was one that my students found not only foreign, but repelling, and they couldn’t imagine eating in the presence of the dead.

“I realized that these practices reflect a central part of Latina/o identity formation, yet seem invisible to many, because the death industry in the United States remains so segregated.”

But change is coming, Cann predicts. Hispanics are the country’s largest minority — approximately 17 percent of the population — and expected to double to 106 million residents in 2050, according to the U.S. Census Bureau. Funeral directors are seeing a need to expand their services, she said.

Cann’s study — “Contemporary Death Practices in the Catholic Latina/o Community” — is published in the journal Thanatos. At the request of the Funeral Service Academy, a national education organization for funeral directors and embalmers, she has prepared training modules about Latino grieving and funeral practices.

The hallmark of the Latino funeral is the extended wake, which often lasts overnight, Cann said. Mourners bring their children with them, and it is common for families to set up card tables so that they can play dominoes and other games and exchange stories about the deceased loved one. Flowers and candles are placed near the body when the visitation begins.

“The wake is not a quiet affair, but often loud and emotional,” Cann said. “Generally, from the time the deceased is brought to the funeral home, the person is not left on his or her own.” Family members often help with washing, dressing and applying makeup to the deceased after they are embalmed, she said.

That is in marked contrast to most modern Anglo practices, in which the body is usually taken from the hospital, or much less frequently, the home, and then prepared by the funeral home, not to be seen again until visitation, Cann said.

In her article, Cann cited a researcher’s previous study quoting two Cuban-American women in Florida — a mother and grandmother — about spending the entire night at a Cuban mortuary, setting up recliners and drinking espresso.

“It’s not like (Anglo) Americans . . . Once the body is there, we would stay with that body until it is buried,” one woman said. When mourners were hungry, “we would go in shifts — like Grandma was going anywhere! But we couldn’t leave her alone. Somebody was always there to keep her company.”

While families sit and eat in the presence of their loved ones, even within the Latino segment of the United States population, those practices vary, Cann said.

Catered services for Mexican-American funerals are likely to include enchiladas, burritos, tacos, rice and beans; at Columbian visitations, empanadas and plantains are common. In funeral homes that are not equipped to offer catering, food will be shared as offerings to the deceased, with others gathering for meals at the church after services or at the deceased’s home after burial, Cann said.

Many U.S. Latinos are Roman Catholic, but even among Protestant Latinos, Catholicism has a cultural influence, Cann said. Each Latin American country tends to favor certain saints, martyrs and icons, and immigrants carry those preferences into the United States and to subsequent generations, Cann said.

Statues and prayer cards with the pictures of these saints are often placed in the room of the deceased, as well as at funerals and anniversary Mass. The cards often display picture of the deceased, with birth and death dates, and a written prayer of intercession.

“These cards are portable and meaningful memorials,” Cann said. “They operate as a sort of souvenir — evidence of the relationship between the bereaved and the deceased and an assertion of the right of the bereaved to grieve.”

But everyday items, as well as religious ones, play a role in Latino funerals, she said. Many family members and friends also purchase caskets that come with memory drawers or insert panels to hold photos, letters, jewelry and keepsakes.

“The casket, candles, pictures, making a plate and offering it to the dead and saying a prayer . . . Those things recognize the deceased person’s role in your life and continuing your bond. But they are also a way of saying, ‘We’ll continue without you,’” Cann said.

In her research, Cann found that while the need for ethnic funeral services is growing, many funeral homes are not familiar with other cultures.

“The industry wants to serve this community, but it doesn’t know how,” she said.

Establishment of ethnic funeral homes with bilingual staff is on the rise, and some traditional funeral homes are actively recruiting bilingual staff, Cann said. Some also are making adjustments so that catered food can be served during wakes.

Cann said that her research is “an introduction. There is much more work to be done. Death practices in the contemporary United States are one of the few remaining places in which ethnic identity is emphasized and even solidified.

“I wanted to at least attempt to counter the myth of death in the United States as uniform and analogous,” Cann said.

Candi Cann is the author of “Virtual Afterlives: Grieving the Dead in the Twenty-First Century.” In her book, she explores how mourning the dead in the 21st century has become a virtual phenomenon, with the dead living on through social media profiles, memorial websites and saved voicemails that can be accessed at any time. Those practices make the physical presence of death secondary to the psychological experience of mourning for many, Cann writes.

Complete Article HERE!

A touching and humorous look at death in ‘Last Rights’

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From left, Sharon Ohrenstein, Ana Maria Larson and Ann Gundersheimer in “Last Rights,” a documentary play about death and dying with dignity at Florida Studio Theatre.

At some point, most of us give at least a little thought to the concept of death, whether our own or a loved one’s. Though we may not want to think about the end of life, it is inevitable, hopefully later rather than sooner.

With a mix of famous quotes, quick sound bites and a few touching stories, the new play “Last Rights” encourages audiences to think and talk about death a lot more. In fact, the point of this original Florida Studio Theatre documentary theater production is to stimulate conversation as part of its ongoing “For the Ages” project exploring issues surrounding aging.

As one character says, we know a lot about the birthing process, but few of us actually know what happens at death. There’s a lot to learn, and you get some lessons in “Last Rights.”

Assembled and directed by Jason Cannon from more than 100 interviews with area residents, including caregivers, hospice workers, journalists and loved ones of those who died, the production is presented in Bowne’s Lab as a reading of sorts. The six cast members stand with scripts in hand ((and)) when it’s their turn ((they)) ((delete-to)) share a story or offer one-line thoughts.

“People breathe much longer than they’re alive,” one man notes, while another says, “If we understood death better, we’d be less afraid.”

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From left, Michael Kinsey, Mark Konrad and Bob Mowry share stories from area residents in the Florida Studio Theatre production of “Last Rights.”

Considering the subject, the play is surprisingly humorous, as it touches on everything from the many euphemisms for death to famous last words, fear of death, dying with a sense of dignity during treatment for an illness, what we expect after death, grieving, and how survivors learn to move on in their lives.

Three widows complain about how their friends avoid them because they don’t have the words to express their sympathy and other feelings.

Get over it, and call.

The actors generally play recurring characters, like Bob Mowry’s compassionate, well-informed and experienced hospice worker who shares some personal stories and important legal information about patients’ rights to refuse care. Ann Gundersheimer is grounded and moving as a gerentologist ((sp?)) providing insights into aging and death. Mark Konrad plays a man who has one year left to live and wants to make the most of it. (Did the year end before the show ((?)) ((B))ecause the character disappears after a while) Sharon Ohrenstein plays an enthusiastic home health aide and Ana Maria Larson is extremely moving as she talks about taking care of her grandfather((,))who wasn’t ready to give up on life.

Michael Kinsey has the strongest through line as a gay man who shares memories of his late first husband and how they mesh into the life he has with his second. But he worries about what happens in the afterlife. Husband No. 1 told him, “I’ll see you on the other side.” ((W))hat happens when he shows up with husband No. 2 ((?))

The play is divided into five sections over two acts that run longer than needed without more compelling story arcs, like the stories Kinsey shares. There is no real narrative, just groupings of ideas and thoughts built around specific topics. There’s a nicely staged moment at the end of the “Any Last Words” section that ((would have provided ((Delete-provides)) a nice finale to the first act, but there’s still another section to go.

The cast, however, keeps us interested, and the play raises a lot of issues that are certainly of concern to the older FST audience and should be of interest and thought for those decades younger. “Last Rights” does have the ability, in an easily digestible way, to make you consider the possibilities of how you want to go.

Complete Article HERE!

Dying Mother’s Lost Letter To Daughter Is Returned 12 Years After Her Death

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If Blanche DuBois’ words about the kindness of strangers have ever been truly applicable, that time is now.

A letter written to a 4-year-old girl by her dying mother was found by a kind stranger and returned to the grown woman 12 years later.

Gordon Draper – the owner of Bondgate Books in Bishop Auckland, England – found the letter in a stack of secondhand books. He instantly recognized that it was extremely special.

The letter was folded with an old photograph of a woman with short hair and glasses. She had a young girl on her knee, who was undoubtedly her young child.

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“Bethany (my little treasure),” the letter begins. “If your dad is reading this to you, it is because I have died and gone to heaven to live with the angels.”

The letter goes on to explain,

My chest was very poorly, and I had an operation to make it better, but it didn’t work. I will always be in the sky making sure you are alright and watching over you.

The dying mother tells her daughter that it’s OK to grieve, and that she will always be with her.

I will always love you and don’t let anyone tell you it’s wrong to talk about me because it’s not. I hope you don’t forget me because I’ll always be your mam.

“I’ll always be your mam.”

Draper realized the importance of this letter, and decided that he must return it.

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Here’s what the letter said in its entirety:

Bethany (My little treasure)
If your dad is reading this to you It is because I have died and gone to heaven to live with the angels. My chest was very poorly and I had an operation to make it better but it didn’t work. I will always be in the sky making sure you are alright and watching over you.
So when you see a bright star like in the nursery rhyme Twinkle Twinkle Little Star that’s me. Be a good girl and live a long happy life your dad and Granda will look after you and take you to school.
I will always love you and don’t let anyone tell you its wrong to talk about me because its not. I hope you dont forget me because I’ll always me your mam. Lots of hugs and kisses.
Goodbye
Mam
PS I’m depending on you to look after Rosie for me now. Don’t forget her will you not.

Draper wrote into the local newspaper, The Northern Echo. They ran the story on their front page last weekend.

Bethany Gash – who is now 21 years old with a child of her own – was sent the article by a friend. The letter had gotten lost five years after the death of her mother, when the family moved house.

Bethany was overwhelmed.

I thought it could never be found. I really can’t describe it because I never thought that the day would come.

When Bethany and Draper got in contact, he realized that they had already met. Draper had met Bethany’s mother when she had come into his shop to buy books for her young child.

“She was really poorly when she came in, but she bought lots of books for the kiddie who was just a little girl,” he said.

Bethany’s mother had been battling cystic fibrosis. She died in 1999, at just 36 years old.

“She really spoiled her with all the ‘Beatrix Potter’ sets and ‘Paddington Bear’ books, and could not have emphasized more that books meant a lot and she wanted to leave her something,” Draper added.

But after the move, Bethany never expected to see the letter ever again. “The length which these two gentlemen have gone to reunite me with it is just amazing,” she said.

To honor the memory of Bethany’s mother, Draper presented Bethany with a set of “Winnie the Pooh” books for her son, Oliver, just as he had done for her mother more than a decade earlier .

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“It’s so lovely seeing her again,” he said. “She looks like the same little girl I saw in her pram when she was in my shop before.”

Complete Article HERE!

What It Feels Like to Die

Science is just beginning to understand the experience of life’s end.

By Jennie Dear

“Do you want to know what will happen as your body starts shutting down?”

My mother and I sat across from the hospice nurse in my parents’ Colorado home. It was 2005, and my mother had reached the end of treatments for metastatic breast cancer. A month or two earlier, she’d been able to take the dog for daily walks in the mountains and travel to Australia with my father. Now, she was weak, exhausted from the disease and chemotherapy and pain medication.

My mother had been the one to decide, with her doctor’s blessing, to stop pursuing the dwindling chemo options, and she had been the one to ask her doctor to call hospice. Still,  we weren’t prepared for the nurse’s question. My mother and I exchanged glances, a little shocked. But what we felt most was a sense of relief.

During six-and-a-half years of treatment, although my mother saw two general practitioners, six oncologists, a cardiologist, several radiation technicians, nurses at two chemotherapy facilities, and surgeons at three different clinics—not once, to my knowledge, had anyone talked to her about what would happen as she died.

There’s good reason. “Roughly from the last two weeks until the last breath, somewhere in that interval, people become too sick, or too drowsy, or too unconscious, to tell us what they’re experiencing,” says Margaret Campbell, a professor of nursing at Wayne State University who has worked in palliative care for decades. The way death is talked about tends to be based on what family, friends, and medical professionals see, rather than accounts of what dying actually feels like.

James Hallenbeck, a palliative-care specialist at Stanford University, often compares dying to black holes. “We can see the effect of black holes, but it is extremely difficult, if not impossible, to look inside them. They exert an increasingly strong gravitational pull the closer one gets to them. As one passes the ‘event horizon,’ apparently the laws of physics begin to change.”

What does dying feel like? Despite a growing body of research about death, the actual, physical experience of dying—the last few days or moments—remains shrouded in mystery. Medicine is just beginning to peek beyond the horizon.

* * *

Until about 100 years ago, almost all dying happened quickly. But modern medicine has radically changed how long the end of life can be stretched. Now, Americans who have access to medical care often die gradually, of lingering diseases like most terminal cancers or complications from diabetes or dementia, rather than quickly from, say, a farm accident or the flu. According to the Centers for Disease Control’s most recent figures, Americans are most likely to die of heart disease, cancer, or chronic pulmonary lung disease.

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For those who do die gradually, there’s often a final, rapid slide that happens in roughly the last few days of life—a phase known as “active dying.” During this time, Hallenbeck writes in Palliative Care Perspectives, his guide to palliative care for physicians, people tend to lose their senses and desires in a certain order. “First hunger and then thirst are lost. Speech is lost next, followed by vision. The last senses to go are usually hearing and touch.”

Whether dying is physically painful, or how painful it is, appears to vary. “There are some kinds of conditions where pain is inevitable,” Campbell says. “There are some patients that just get really, really old and just fade away, and there’s no distress.” Having a disease associated with pain doesn’t mean you’ll necessarily endure a difficult death, either. Most people dying of cancer need pain medication to keep them comfortable, Campbell notes—and the medicine usually works. “If they’re getting a good, comprehensive pain regimen, they can die peacefully,” she says.

When people become too weak to cough or swallow, some start to make a noise in the backs of their throats. The sound can be deeply disturbing, as if the patient is suffering. But that’s not what it feels like to the person dying, as far as doctors can tell. In fact, medical researchers believe that the phenomenon—which is commonly called a death rattleprobably doesn’t hurt.

Ultimately, because most people lose awareness or consciousness in their last few hours or days, it’s hard to know for certain how much patients are suffering. “We generally believe that if your brain is really in a comatose kind of situation, or you’re not really responsive, that your perception—how you feel about things—may also be significantly decreased,” says David Hui, an oncologist and palliative-care specialist who researches the signs of approaching death.  “You may or may not even be aware of what’s happening.”

* * *

A week or two after we spoke to the nurse, my mother sank into a state where she was rarely conscious. When she was awake, it was only the most basic part of her that was there: the part that told her legs to move to get her to the bathroom, the automated steps in brushing her teeth and then wiping the sink afterward. Her mind turned away from her children and husband for the first time.

I wanted to know what she was thinking about. I wanted to know where her mind was. Being at the bedside of an unresponsive dying person can feel like trying to find out whether someone is home by looking through thick-curtained windows. Is the person sleeping, dreaming, experiencing something supernatural? Is her mind gone?

For many dying people, “the brain does the same thing that the body does in that it starts to sacrifice areas which are less critical to survival,” says David Hovda, director of the UCLA Brain Injury Research Center. He compares the breakdown to what happens in aging: People tend to lose their abilities for complex or executive planning, learning motor skills—and, in what turns out to be a very important function, inhibition.

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“As the brain begins to change and start to die, different parts become excited, and one of the parts that becomes excited is the visual system,” Hovda explains. “And so that’s where people begin to see light.”

Recent research points to evidence that the sharpening of the senses some people report also seems to match what we know about the brain’s response to dying. Jimo Borjigin, a neuroscientist at the University of Michigan, first became intrigued by this subject when she noticed something strange in the brains of animals in another experiment: Just before the animals died, neurochemicals in the brain suddenly surged. While scientists had known that brain neurons continued to fire after a person died, this was different. The neurons were secreting new chemicals, and in large amounts.

“A lot of cardiac-arrest survivors describe that during their unconscious period, they have this amazing experience in their brain,” she says. “They see lights and then they describe the experience as ‘realer than real.’” She realized the sudden release of neurochemicals might help to explain this feeling.

Borjigin and her research team tried an experiment. They anesthetized eight rats, and then stopped their hearts. “Suddenly, all the different regions of the brain became synchronized,” she says. The rats’ brains showed higher power in different frequency waves, and also what is known as coherence—the electrical activity from different parts of the brain working together.

“If you’re focusing attention, doing something, trying to figure out a word or trying to remember a face—when you’re doing high-level cognitive activity, these features go up,” Borjigin says. “These are well-used parameters in studying human consciousness in awake humans.  So, we thought, if you’re alert or aroused, similar parameters should also go up in the dying brain. In fact, that was the case.”

* * *

In her last couple of weeks, when my mother’s mind seemed to be floating off somewhere else most of the time, she would sometimes lift her arms into the air, plucking at invisible objects with her fingers. Once, I captured her hands in mine and asked what she’d been doing. “Putting things away,” she answered, smiling dreamily.

This half-dreaming, half-waking state is common in dying people. In fact, researchers led by Christopher Kerr at a hospice center outside Buffalo, New York, conducted a study of dying people’s dreams. Most of the patients interviewed, 88 percent, had at least one dream or vision. And those dreams usually felt different to them from normal dreams. For one thing, the dreams seemed clearer, more real. The “patients’ pre-death dreams were frequently so intense that the dream carried into wakefulness and the dying often experienced them as waking reality,” the researchers write in the Journal of Palliative Medicine.

Seventy-two percent of the patients dreamed about reuniting with people who had already died. Fifty-nine percent said they dreamed about getting ready to travel somewhere. Twenty-eight percent dreamed about meaningful experiences in the past. (Patients were interviewed every day, so the same people often reported dreams about multiple subjects.)

For most of the patients, the dreams were comforting and positive. The researchers say the dreams often helped decrease the fear of death. “The predominant quality of pre-death dreams/visions was a sense of personal meaning, which frequently carried emotional significance for the patient,” they report.

In patients’ final hours, after they’ve stopped eating and drinking, after they’ve lost their vision, “most dying people then close their eyes and appear to be asleep,” says Hallenbeck, the Stanford palliative-care specialist. “From this point on … we can only infer what is actually happening. My impression is that this is not a coma, a state of unconsciousness, as many families and clinicians think, but something like a dream state.”

The exact moment at which this happens—when a person enters a dream state, or even when a person starts dying—is hard to pinpoint.

That was true in my mother’s case. In the early hours one morning after it snowed, I was keeping watch with two of my mother’s friends in her library, the room where we’d moved her to accommodate a hospital bed. She seemed peaceful, and in the dim light of the morning, we stood at different points around the bed, listening to her raspy breathing.

She made no dramatic moves or indications that she was about to leave us. She didn’t open her eyes or sit up suddenly. She took a last, slightly louder breath, and died.

“It’s like a storm coming in,” Hallenbeck says. “The waves started coming up. But you can never say, well, when did the waves start coming up? … The waves get higher and higher, and eventually, they carry the person out to sea.”

Complete Article HERE!

Early Palliative Care Improves Patients’ Quality of Life

Also increases chances of having end-of-life discussions, study shows

By Robert Preidt

The key to helping our patients die with dignity is improving the palliative care we provide, writes Priya Sayal.

Starting palliative care shortly after a person is diagnosed with incurable cancer helps patients cope and improves their quality of life, a new study shows.

It also leads to more discussions about patients’ end-of-life care preferences, the researchers added.

Palliative care, also called comfort care, is given to improve the quality of life for patients who have a life-threatening disease or terminal illness, such as cancer. The goal is not to cure the patient, but to manage the symptoms of the disease, according to the U.S. National Cancer Institute.

The new study included 350 people recently diagnosed with incurable lung or gastrointestinal cancer. They were randomly assigned to one of two care groups. One group received early palliative care integrated with cancer care. The other received cancer care alone.

The patients were evaluated at 12 and 24 weeks after diagnosis. At 24 weeks, the early palliative care patients were much more likely to report using active and engaged coping styles than the standard cancer care patients.

Early palliative care patients also had much higher quality of life and lower levels of depression at 24 weeks, but not at 12 weeks, the study found.

Thirty percent of early palliative care patients said they had discussed end-of-life care preferences. Just 14 percent of standard care patients had similar talks.

The study was presented recently at an American Society of Clinical Oncology (ASCO) meeting in San Francisco. Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

“What we found was the patients who received early palliative care were more likely to use adaptive coping strategies — meaning they were more likely to take some action to make their lives better as well as to accept their diagnosis,” lead author Joseph Andrew Greer said in an ASCO news release.

“Palliative care is a key ingredient to improving a quality of life, which is important to both patients and their families,” said Greer. He’s clinical director of psychology and a research scientist at Massachusetts General Hospital.

ASCO spokesman Dr. Andrew Epstein said these findings help show the benefits of integrating palliative care into cancer care.

“A diagnosis of cancer is never easy for patients, so it is promising that we now have a strategy of early palliative care that can help patients cope while improving their quality of life,” Epstein said.

More information

The Center to Advance Palliative Care has more on palliative care.

Complete Article HERE!

Designer Thinks About Death Every Hour: Why Do We Dwell on Dying?

By Ashley P. Taylor,

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Fashion-designer-turned-director Tom Ford said he thinks a lot about death. “Death is all I think about. There is not a day or really an hour that goes by that I don’t think about death,” he recently told Hollywood Reporter.

Many people probably share Ford’s morbid tendencies, at least to some extent, Pelin Kesebir, an assistant scientist and psychologist at the Center for Healthy Minds at the University of Wisconsin-Madison, told Live Science.

“To be preoccupied with death is very common and very natural,” Kesebir said. This preoccupation can cause psychological problems, but it doesn’t always do so, she said.

It’s rare that people have a pathological fear of death, she said. Further, although “thoughts of death can be a source of anxiety and dread for someone,” they can instead be “a source of immense clarity and wisdom for others,” she said. [10 Things That Make Humans Special]

However, psychologists in one school of thought — those who are “existentially oriented,” or who study the way that concerns about the meaning and value of existence affect human behavior— say that the roots of many common psychological problems can be traced back to people’s anxiety about death, Kesebir said. More specifically, these problems relate to anxiety about failing to live a good life, Kesebir said.

“People are usually not afraid of death per se, but of not having lived a worthwhile life,” she said.

People may have frequent thoughts about death because of humans’ sophisticated mental abilities, she said. Our minds “make us painfully aware of inevitable mortality, and this awareness clashes with our biologically wired desire for life,” she said.

The result of this clash is a very understandable and normal anxiety, Kesebir said.

If people are bothered by thoughts of death, Kesebir suggested engaging in thought experiments about what it would be like to live forever and the problems immortality could bring. She noted that although such thought experiments can leave people intellectually convinced that death is actually a good and necessary thing, it may be difficult to feel that way, emotionally.

The best way “to accept death gracefully is living a good life — a life that is true to your values,” she said. People who do this may stave off a fear of not having lived well.

It’s also possible that a preoccupation with death can actually lead to a relief from anxiety about that final event, she said. Some people who have had near-death experiences “report an increased appreciation and zest for life, closer, more meaningful interpersonal relationships, an increased belief in themselves, changed priorities,” and other positive changes in their lives and outlooks, she said. [After Death: 8 Burial Alternatives That Are Going Mainstream]

In other words, after brushes with death, some people tend to live better approximations of what they consider to be good lives, which can in turn can relieve anxiety about death.

So according to Kesebir, thoughts of death, like Tom Ford’s, are normal and might even help people to live better.

Complete Article HERE!

Musings on Mortality: Difference between suicide, medical aid in dying

By Deborah Alecson

There is a profound difference between suicide and medical aid in dying, otherwise known as death with dignity. It is not a matter of semantics.

Death with Dignity Campaign

In a death-phobic culture such as ours, one in which we prevent ourselves from projecting into our dying time, we cannot grasp the distinction. True, both result in the taking of one’s own life, but one is an act of desperation and self-destruction, while the other is an act of self-love. How can choosing death over life be motivated by self-love, you are wondering. We will explore this later in the column.

People commit suicide often in the prime of their lives because living for them is unbearable. Unlike the terminally ill who choose medical aid in dying, people who seek to commit suicide are not in their dying time but in their living time. More often than not, there are underlying and unresolvable emotional and psychological torments. There is depression or a psychiatric illness that has not been or cannot be treated. For the elderly, suicide can be motivated by the suffering that comes from living a compromised life without the support of family, friends, or community. Loneliness and feelings of abandonment are factors in suicide, especially for the elderly.

Suicide is considered a failure of the person and of our society. Help was needed and not found. In our culture, suicide is to be prevented at all costs including the involuntary psychiatric hospitalization (or incarceration depending on how you view that which is “involuntary”) of the person who discloses his or her suicidal thoughts. There are consequences for a patient in therapy to even talk about suicide: The therapist must report him or her to the authorities. The horrible irony is that the one place a suicidal person can get help to understand his or her own feelings, with a therapist, is the one place where he or she can’t talk about these feelings.

In a death-phobic culture, thoughts of suicide are considered aberrant. But let’s be honest, who hasn’t thought about suicide at least once in their life?

The will to live is an instinct of such force that human beings kill other human beings to stay alive. Human beings accept life-prolonging treatments during what would be their natural dying time that in the end, diminish the quality of time that they had bought with more treatment. People will do unbelievable things to ensure their own survival.

So, choosing to die under the weight of the instinctual and societal will to live is either accomplished out of sheer terror of life itself or incredible courage. Courage to venture into the unknown.

Since most of us have not been around dying people and as I wrote earlier, rarely imagine ourselves in that situation, we have no idea what dying is like. We don’t understand what it asks of us and what it takes out of us. While hospice care can be a possibility for how we live our dying time, it is not for everyone.

Medical aid in dying is now possible in five states. This means that people who are dying of a terminal illness can request a lethal dose of medication to end their own lives. Those few terminally ill patients who request and qualify for medical aid in dying do so to have a dignified death on their own terms. That’s all. This choice is a logical, sound, and deeply compassionate act of relief, not a desperate escape of a circumstantial situation as suicide often can be.

How can choosing death over life be motivated by self-love? When your dying time comes, you may want to spare yourself and your loved ones a prolonged and brutal decline. This to me is self-love. It is not suicide.

Complete Article HERE!