Why the End of Life Matters

Columnist returns with series on life, death and how to handle both well

End of life. Yes, that would be death. And death is the end? No one is sure when it will come, nor what — if anything — comes after. But we are all familiar with the huge realm of possibilities that might precede it.

Will end of life be brief with little suffering and sudden finality? Or will we start paying attention to the subtle signs marking a decline as the body starts to fail us? Maybe there will be illness and lingering. Some will be plagued with pain, difficult medical decisions and stressful treatments. Some will just be plagued by aging. How do we make sense of the sudden loss of a loved one in the prime of their lives while puzzling over the seemingly unfair hand of prolonged suffering dealt to others? Where do we find support — emotional, spiritual, financial, organizational? What else are we missing?

This is a conversation that most of us avoid, or at least put off. It’s easy to put our concerns and fears on the back shelf of our darkest closets because (pick one or more): we’re not sick; we are too busy living life; death will happen no matter what we do; it will be our family’s problem; it’s too scary to consider; [insert your own].

Yet, as a population so focused on goals and quality of life, why would we throw caution to the wind when it comes to the details of how our “decline” might be managed; or how our lives might look if we were suddenly struck by illness or accident; or how our families would be changed if we died unexpectedly? The last phase of our lives should benefit from the same level of thoughtfulness and planning that we assign to all of the most meaningful transitions that happen in a lifetime.

I imagine that most of you reading this column believe that I am about to extoll the virtues of completing a will, filing a medical directive for health and writing down passwords for your online accounts. Yes, I plan to address some of that in future columns, but that’s just scratching the surface.

How about the quality of your care in the event you can’t speak for yourself? Is your house in order? And yes, I mean the place where you live. What will your children or friends encounter when they begin to disassemble your life when you’re gone? What unfinished business will you leave behind? Do your family members or friends know what your wishes are?

I’ve come to an interest in end-of-life planning in a very practical way. At the end of my grandmother’s life, I was 30 years old and privileged to have a life-changing experience in sharing her end-of-life journey with her, from her initial diagnosis of cancer until the moment she died four months later. This was a comfortable role for me because my other life away from writing had been spent as a caregiver. A child developmentalist by education, I have, through more than four decades, supported hundreds of families in the early days following the births of their babies, and with others through all of the additional stages to adulthood.

It took many years after my grandmother’s death and many more experiences with ill, aged or medically-fragile people for me to see that planning and honoring the end of life is just as important as what I had been doing with babies and children in the beginning of their lives. Regrettably, the sudden deaths of friends and loved ones, built on those convictions about the importance of at least addressing the possibilities that await.

My family members mostly roll their eyes with a “here we go again” look when I talk death. If my husband is plagued by a random ache or pain and proclaims that he’s “dying,” I remind him unsympathetically that “we all are.” I don’t mean to sound cavalier but I will not run from this. Nor, I have found, will the people who have taken my class “A Good Death” or those who show up several times a year for the local meetings of the Death Café (more on these soon). Over and over, I am buoyed by others who share a similar intention to “have it our way” in such an important passage and in its preparation.

There is so much to say. This is just the beginning of the conversation. I’m hoping you’ll join me.

 

Laurel Yeates is a daughter, wife, mother, grandmother, doula, nanny, Alameda Sun calendar editor and a nascent thanatologist.