End of Life

by Jeffrey Markel

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How do we communicate in our culture about the end of life?

A leading Hospice Society – “Hospice is about living. Hospice strives to bring quality of life and comfort to each patient and their family. Our successes are in helping a patient and family live fully until the end. Often patients will feel better with good pain and symptom management. Hospice is an experience of care and support, different from any other type of care.”

A leading Cancer Society – “Learning that you have advanced disease growing and not responding to treatment – may make you feel lost and afraid. At this point, you know that the cancer is not going away and the time you have left to live probably is limited. But knowing what to expect and being prepared to deal with it can enable you to get the support and care you need so you can have the very best quality of life possible.”

These expressions of how to be supportive at the end of life from both organizations are very closely aligned.  At the Conscious Dying Institute, we recognize that the end of life is a special time whose depth can transcend all involved regardless of training and approach.  Unfortunately there are many situations where feelings and sensitivity are not included in the end of life experience. This is sometimes driven by beliefs, money, family support and societal approaches.  But when consciousness of choice and best care and practices are considered, the end of life experience is more likely to be infused with heart and connection.

As we age our contact with death becomes more prevalent. Our friends and family die. We see the generations who precede us pass. We have a more intimate connection with our sense of mortality knowing we too will die.

When we finally grasp the depth of the truth of the inevitable death of ourselves and everyone we love, this can be the impetus to train in all that is important in being part of the death experience.  When we can be supportive, loving and knowledgeable, we are giving ourselves, our loved ones and our community a necessary resource. 

The Conscious Dying Institute was formed because education in the art of presence and skills needed during the dying time is essential.  We utilize a curriculum in the End Of Life Doula Certification that is holistic and palliative in nature, increasing caregivers' capacity to give spiritual, emotional, physical, and practical care to anyone, regardless of diagnosis or care setting. It illuminates our capacity to be an authentic caring healing presence, restores our true purpose and power as healing agents, and is appropriate for clinical professionals, home and family caregivers, and staff in hospitals and senior health care systems.

This approach aligns with the organizations mentioned above, but even more importantly with what is necessary to celebrate life and honor death. In my own life I am compelled to be present, offer appropriate support, be aware of choices and to be a clear-minded listener in times when a friend or loved one is passing.  I feel honored to be present at one of the ultimate rites of passage.  

The reason I write a monthly blog for the Conscious Dying Institute is because death has been an important part of my life. From the time my father passed away when I was a teenager, I understood there is always a need for someone to be strong when someone passes. Strength that includes compassion, how to be there for the person passing as well as for family and loved ones, and an understanding of the necessary actions to be taken before, during and after a passing. The people who have provided that presence during my life have made an indelible impression on me.  I think of them often as models for how I can be present in everyday occurrences.  Am I being compassionate, present, a good listener and asking for people to express their needs?

Historically this role at the dying time has been filled by a member of the clergy but in today’s world it is up to all of us to fill that role. The more we know, the more we are experienced, the more we contribute.  This contribution is for others and yet we benefit so greatly because we are changed each time we experience death.

This change is the true gift of being present at the End of Life.  When someone close to us dies, something is born within us. We end of one phase of life and begin a new one.  We may become the matriarch or patriarch of the family; the dynamics of relationships shift; financial responsibilities and wealth are altered; and perhaps--at any ag--we realize we could be next.

I am saddened when life is ending. I offer my intention to be my most present. From experience I know I will be changed. However, even within the sadness, I have learned to treasure the experience and the inevitability of living and dying.