Disclaimer: This is copied from a pamphlet I found at the hospital. My brother-in-law has terminal brain cancer and I found this quite informative and helpful and wanted to share it.
by the Rev. Daniel H. Grossoehme, BCC
Juan was in his mid-30s and sitting up in his hospital bed when I met him. His wife and mother were on either side, holding his hands and sobbing. His cardiologist paged for a chaplain, and I arrived to learn that Juan understood he was dying and wanted to make arrangements to die at home. He was having trouble helping his wife and mother understand this, and the doctor asked me to help the family talk about what the end of Juan’s life would be like. Over time, we moved from this scene of helplessness and grief to a scene of story telling, laughter and tears, and for Juan, a quiet and holy death.
my own religious tradition has a Lenten prayer which used to trouble me, because we prayed that we might be delivered, “…from dying suddenly and unprepared.”A quick, painless death is exactly what many of us have in mind and hope for, but the reality is that, for most of us, our death and those of our loved ones will be much more like Juan’s. My experience experience with him brought out the truth of that prayer for me, for the time of preparation for his death brought the possibility of choice and intimate conversations with his family.
This is what Mother Teresa meant, in part, when she said, “The highest goal of human life is to die in the peace of God.” Part of that sense of peace is having closure with all of our relationships. It is in the relationships we have with one another that we can glimpse the love of our Ultimate Lover and Creator.
Facilitate the Process: Just as we believe the Creator of all of us cares for us, so we are to care for one another. Sometimes care demands that we work toward curing but at some point, cure is no longer possible. Caring then becomes a matter of comfort- physical, emotional and spiritual.
Many people have the ability to sense when their bodies actively begin to die. Children and adolescents are especially good at this, though they sometimes lack the vocabulary to express themselves the same way that adults do. If the dying person is able to sense this and talk about it, we can respond at the same level. It’s one way we care for those we love at this stage of their lives.
Statements like, “I don’t think I’ll make it till Christmas,” or, “I don’t think I’m going to be better,” are signals that someone is aware that they are dying, and is willing and able to talk about it. Sometimes we can even test the waters with gentle questions such as, “How do you think this is going?” which may invite someone to begin to talk about their sense of impending death.
Open-ended responses such as “How would you like to spend the time then?” or, “What frightens you the most about that? invite the dying person to talk about how they envision their own dying. Such questions and conversations allow the dying person to be empowered at a time when many fear being helpless and powerless. They signal that the dying person can have some control over the dying process.
Encourage Conversations: Once the topic has been raised, a caregiver might wonder aloud “Who else would you like to join us in this conversation?” and arrange for a future time when those people can be present.
For a person who is dying, the question becomes a matter of saying, “I’d like to talk more about this, but I’d like to be able to talk with everyone at once. Let’s find time when they can be here with us.” The dying person should be in control of the conversation, but family caregivers may urge them to reconsider a decision if they seem to be omitting significant people. One might gently wonder if the omission implies that there is some anger or other unresolved issue—and suggest dying provides a time to work through those feelings.
In an ideal situation, this conversation would include one’s spouse and children (including adolescents, and spouses of married children) as well as a religious leader. Every family is different, and the dying person should be empowered to make the best choice for them-self. It may also be the case that the dying person doesn’t want to have the discussion, and well-meaning caregivers should not attempt to force the issue. This, too, is the dying person’s choice to make.
There are many issues to face other than whether medical treatment has reached the stage of “enough is enough.” Frequently, more than one group conversation may be called for. There are decisions about continuing treatment; about whether to spend one’s last days at home, in a hospice, or in a hospital; about bringing closure to one’s relationships; and about planning one’s funeral. It would be almost impossible for any family group to discuss all of these at one time—indeed, it would wear out everyone involved to even try.
Instead, the family caregiver can encourage the conversation by providing the dying person with resources that help a person move through the variety of choices that can be made: everything from whether to die at home or in a hospital, to setting down the details of one;s funeral, to creating memory books for the dying person’s family. A number of guidebooks are available that can help with these tasks.
Sources of Additional Help:
Books: Chrysalis, by Val Hillsdon-Hutton, rev. ed. 1998
Dying We Live, by Edward S. Gleason, 1990
Last Wishes, by Lucinda Page Knox and Michael Knox, 1995
Saying Goodbye With Love, by Sheila Martin, 1999