Did you know that death is the second leading fear in the United States? It is second only to public speaking. Talk about something that could scare you to death!

If death is so feared (and many believe that, if we think about it or plan for it, we will jinx ourselves), how do you begin to think about what you would want if you were dying – in fact, at the very end of your life? It may help to look at what you value in your life now, while you are alive. How highly do you value family, community, friendship, pets or the quality of your life (and what that means to you)?

Last month’s blog asked questions about what you would want, whether or not you would survive the medical situation in which you found yourself.

This month, I ask that you ponder what you would want if you were actively dying and there was no hope of surviving. Is this a scary thing to do? Perhaps. But just think about what it would be like to speak in front of a crowd of 500+ people!

BooBooI began my pondering, many years ago, when my wife, Naomi, and I had two geriatric cats. The first cat was BooBoo, who was 22 years old and clearly failing, but did not seem to be in distress. We made the decision that we would not rush to the vet to determine if there were anything that could be done to prolong her life. At first, she stopped eating and slept mostly; then she stopped drinking. Still, she did not seem to be in distress.

One evening, as I was watching television, I held her on my lap as she slowly stopped breathing. I held her as we cried, but we knew that we had made the right decision for her (and, if I may anthropomorphize a bit, I think it is what she would have wanted; to be held and cared for by those she loved in a setting that was comfortable and familiar).

TimmyThe second cat, Timmy, was middle-age/old (it is hard to tell when you adopt them as strays). Timmy had been having difficulty getting up our stairs and was clearly in poor health. We brought him to the vet, were told that we could provide some care, but that, ultimately, there was nothing that could be done.

 

One day, he became quite lethargic and his breathing seemed labored. In this case, we made the difficult choice to bring him to the vet, one final time. We held him and talked to him while he received the final injection that would end his suffering and his life. We cried as he died in our arms, but, again, I think it is what he would have wanted.

But what about me? What are my wishes? How do I make that determination? What do I value most? For instance, above all, I value my relationship with and love for Naomi. I would certainly want to be held in her arms (or at least have her near me) if my death were imminent.

Identifying your values is an ongoing process and so. recently. I continued the journey of clarifying my values by asking myself the following questions:

  • If I have a choice, where do I want to die? Would I prefer to die at home? at hospice facility? in a hospital?
  • Is it more important to me to focus on the length of my life or the quality of my life? What constitutes quality for me?
  • Am I more concerned about not getting enough care or too much care?
  • Which is more difficult to imagine: being in severe physical pain or not being able to say goodbye to my family and friends?
  • Is there anyone to whom I want to make sure that I can say goodbye? Does it need to be in person or would a phone call or letter or email suffice? Is there anyone that I do not want to be present at my death?
  • If it is possible, do I want to be surrounded by my pets or, if I am not at home, at least have a short visit? (Yes, animals have been brought into some hospital and hospice facilities.)

Knowing what you want to happen is only the first step in the process. Writing your wishes down is the second. Telling someone you trust is essential.

Oh, and in relation to jinxing yourself if you think or talk about dying, in the words of my colleague Gail Rubin, CT, pioneering death educator and owner of A Good Goodbye:

A good goodbye

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