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End-Of-Life Planning Makes It Easier To Say Goodbye

This is a guest post by Dr. Barbara Okun and Dr. Joseph Nowinski.


End-Of-Life Planning Makes It Easier To Say Goodbye

Saying goodbye as the end of life approaches can be difficult, even for those with a gift for words. In a moving account in a recent issue of The New Yorker, writer Joyce Carol Oates describes the last week of her 49-year marriage, as her husband was dying from complications of pneumonia. Like A Year of Magical Thinking, Joan Didion’s poignant memoir of her husband’s sudden death and its aftermath, Oates’ essay highlights the need for each of us to think about death and dying — and discuss them with loved ones — long before they become a likelihood.

In our work with individuals and families facing death, we have seen too many people miss the opportunity to say goodbye because they avoid what feels like a scary or taboo topic: What do I want to happen when I die? Beginning this discussion early, preferably while you are in good health, can help pave the way for a “good death.” In our new book, Saying Goodbye: How Families Can Find Renewal Through Loss, we offer a guide to help individuals facing a terminal illness and their families navigate the realities of death and dying. Planning ahead is essential. Here are some suggestions for doing that:

Choose your team. Identify support people and specialists (legal, medical, financial, religious) you can count on to advocate for you and help you make decisions. Designate these people to act for you by signing advance medical directives. Read more »

*This blog post was originally published at Harvard Health Blog*

May We All Die So Well

Everyone liked him. Though his later years (the only ones in which I knew him) took away his ability to do most things, and though he was in great pain every day, it was easy to see the mischief in his eyes. The subtle humor was still there, coming out of a man who was weak, in pain, dying.

She lived for him. She was always telling me of his pain, frustrated with the fact that he didn’t tell me enough. She was anxious about each complaint of his, wondering if this was the one that would take him away from her. Many of her problems were driven by this anxiety and fears, and she spent many hours in my office giving witness to them through her tears.

As his health failed, I wondered about her future. He was the center of her life, the source of her energy, joy, purpose. How could she manage life without him? How could she, who had so much lived off of the care of this wonderful man, find meaning and purpose in a life without his calming presence?

Then he died. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Is There A Rule Book On Grief?

She looked down toward her feet at the end of her visit. “I’ve got one more question, doctor,” she said, hesitating. I turned toward her and waited for her, letting her ask on her own time. Clearly this was something difficult for her to ask.

“When will I get over the death of my husband? It’s been ten years, and I still wake up each morning thinking he’s there. I still come home wanting him to be there. Am I crazy?”

Her face showed the shame that was so clear in her words. I had been along with her during the death of her husband, and she handled that period with much grace and strength. Now the silence at home is deafening. People around her, on the other hand, are far too quick to tell her how to grieve. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

The Right To Mourn

Grief and lossI seem to have had a run on bereavement recently, in that I’ve had several patients who have lost loved ones. Some have wound up in my office for unrelated complaints, only to have the grief spill out. I’ve become aware of the struggles of others via Facebook.

I’ve found this handout (from Family Practice Management several years ago) to be very useful. I keep copies in my office and hand them out when needed, but it occurs to me that having another way to disseminate this helpful information would be a good idea. Read more »

*This blog post was originally published at Musings of a Dinosaur*

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