AGING & CARING: Ways to help ensure a ‘good death’

BY BARBARA KATE REPA OF CARING.COM

Poets, professors, priests, and plain folks all opine about what makes a “good death.” In truth, deaths are nearly as unique as the lives that came before them — shaped by the attitudes, physical conditions, medical treatments, and mix of people involved.

Still, many have pointed to a few common factors that can help a death seem good — and even inspiring — as opposed to frightening, sad, or tortuous. By most standards, a good death is one in which a person dies on his own terms, relatively free from pain, in a supported and dignified setting. Other things to consider:

Having affairs in order

Not everyone has the luxury of planning for death. But those who take the time and make the effort to think about their deaths during life and plan for some of the details of their final care and comfort are more apt to retain some control and say-so in their final months and days of life.

Legal specifics of such planning can include taking steps to get affairs in order by:

• Having an estate plan, with a will, trust, or other arrangement that sets out who gets property and how it should be divided.
• Specifying final medical care in an advance directive.
• Making final arrangements for body burial or cremation.
• Indicating preferences for a funeral or memorial service. Psychological preparation includes talking about an impending death[5] with caregivers, family members, and others.

Controlling pain and discomfort

Most Americans say they would prefer to die at home, according to recent polls. Yet the reality is that three-quarters of the population dies in some sort of medical institution, many of them after spending time in an intensive care unit.

As life expectancies increase, more people are becoming proactive. A growing number of aging patients are choosing not to have life-prolonging treatments that might ultimately increase pain and suffering — such as invasive surgery or dialysis — and deciding instead to have comfort or palliative care through hospice[7] in their final days.

Ways to help ensure a “good death” on an emotional level

Along with the practical matters of having one’s affairs in order, it’s equally important to prepare for death emotionally, to spend time with loving people toward the end of life, and to have spiritual sustenance.

Having few regrets

Often quoted in the literature on death and dying are the tenets in The Four Things That Matter Most[8], by Ira Byock, a medical doctor who professes the need for a dying person to express four thoughts at the end of life:

• I love you.
• Thank you.
• I forgive you.
• Forgive me.

This supports the idea that, for many people, a good death requires ending life without unfinished business, and after having reconciled damaged or broken relationships when possible.

Receiving mindful care and support

The right company can help aid a “good death.” Although dying may be scary or sad or simply unfamiliar to those who are witnessing it, studies of terminally ill patients underscore one common desire: to be treated as live human beings until the moment they die.

Most also say they don’t want to be alone during their final days and moments. This means that caregivers should find out what kind of medical care the dying person wants administered or withheld and be sure that the medical personnel on duty are fitting in skill and temperament.

Favorite activities or objects can be as important as final medical care. Caregivers should ascertain the tangible and intangible things that would be most pleasing and comforting to the patient in the final days: favorite music or readings, a vase of flowers, a back rub or foot massage, being surrounded by loved ones in quiet or conversation.

Spirituality can help many people find strength and meaning during their final moments. Think about the patient’s preferred spiritual or religious teachings and underpinnings, since ensuring access to this can be especially soothing at the end of life.

  • Atlanta, you’re not alone.

3 comments Add your comment

Lionness

August 27th, 2009
10:25 am

Oh no!!! A page taken right out the Death Panel Book!! Better watch out Barbara Kate Repa & the AJC or the birthers/deathers/teabaggers/Lim-bots of the world will start screaming your name and drawing Nazi symbols on your image at the next Healthcare Town hall meeting!! Care for the elderly… thats socialism to them!! So sad…

Beagle Bailey

August 27th, 2009
11:44 pm

This is a STERILE, ICE COLD article. This author had/has NOTHING invested in this work. Did this author grow up in a Russian orphanage with no human contact for 20 or so years? If this an example of her “Caring”, she needs to get another job.

cate wyckoff

September 1st, 2009
8:27 pm

This is a very practical and useful article. It apparently seemed a little callous to some of those who commented however there are so many aspects of death and dying which are simply “housekeeping” and need to be taken care of so that the process of life and death can go on in a peaceful manner. Pre need funeral arrangements, for instance, insure that the deceased’s desires are carried out. One can see and understand the funeral process ahead of time and take the apprehension out of the act of making funeral arrangements. What a caring act, to make pre-need arrangements in order to take that burden off your family. Plus you get the opportunity to be presented for your friends and family in the way that you choose for them to remember you!