We've listened, watched and lived as our world becomes saucier, sexier and less inhibited. Except when it comes to death. Medical experts say talking...
We’ve listened, watched and lived as our world becomes saucier, sexier and less inhibited.
Except when it comes to death.
Medical experts say talking about the end of our own lives — and the lives of loved ones — could very well be our last societal taboo.
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“We are a death-denying society,” said Dr. Darrell Owens, founder and director of the Palliative Care Consult Service at Harborview Medical Center. “If you look at people in their 50s, they’re more willing to talk to their kids about safe sex than about their parents’ — or their own — deaths.
While facing our own mortality — and especially that of loved ones — can be particularly uncomfortable, being there for family and friends when they’re about to die can be the most important thing you can do for them — making sure they’re not only ready to go, but satisfied with where they’ve been.
Owens’ palliative practice deals exclusively with that topic.
Points to consider
1. Don’t assume they don’t want to talk. Many times they do.
2. Be sensitive to their sensitivities.
3. Help them be remembered.
4. Encourage them to tell you what they’re afraid of, even if it’s hard to talk about.
5. Don’t dismiss your own fears. They matter, too.
Nathan Hurst, Seattle Times staff reporter
“We have all this medical technology, and we use it to extend our lives as long as possible,” Owens said. “Everyone wants to control when they’re going to die.”
But with an increasingly aged population suffering from a growing number of maladies related to longer lives, we can no longer avoid death — or talking about it with those who matter most.
Trish Emry and Shuko Hashimoto met a few years ago when they were serving on the board of a cooperative school together. The two women came from seemingly different worlds: Emry had become one of Seattle’s many Microsoft moms while Hashimoto had gigs in counseling and graphic design.
But the two women found a common ground in an unlikely — and uncomfortable — circumstance: the death of a loved one.
“During tough times of loss in our own lives, we both felt a need for resources that simply weren’t there,” Emry said.
So, after enterprising a bit and deciding on a direction, mission and a name, the two women opened Four Seasons Oasis, a business that caters to the needs of the terminally ill and their families (On the Web at: www.fourseasonsoasis.com).
In the name is a lesson, one they share with store visitors.
“My therapist … told me that while grieving is really a perpetually ongoing process, I should give myself four seasons to adjust to the loss,” Emery said. “You have to experience all of those yearly firsts — like holidays and vacations — without the person to start adjusting to what life without them is actually like.”
Though decidedly death-focused, the store in Seattle’s Madison Valley has much less to do with death itself than with what happens just before and after.
Preparation — as for so many things in life — can be key to a good death, Emry and Hashimoto say. They echo Owens in saying that helping loved ones navigate the emotional and spiritual minefields surrounding death may be the greatest gift we can give them.
But what do you say? How do you breach the last taboo?
Emry, Hashimoto and Owens offer a number of suggestions:
Don’t assume that the person dying won’t be willing to talk about it. Often, Owens said, his dying patients are more ready to talk about their deaths than their families are.
But be sensitive to personality and cultural differences. Recent medical studies on palliative care have noted significant contrasts in attitudes toward death exhibited by those with differing ethnic and religious backgrounds, Owens said.
For example, he said, some Asian cultures traditionally hold that talking about death will hasten it, and some conservative Muslim sects would regard a prognosis that gives a timeline for death as a challenge to the power of Allah.
“Every culture has its own very important set of beliefs regarding death,” Owens said.
Furthermore, the way people deal with strife during life is likely a strong indicator of how they will approach their own deaths.
“If a person wasn’t very open in life, you can’t expect much to change in death,” Owens said. “People always look for that momentous change right at the end, and while there is some potential for that, the expectation is unrealistic.
Offer ways for the dying person to be remembered. Often, that’s their greatest wish. Emry suggests making oral histories: audio or video recordings of the person so family members can have, in the voice of the person who lived through them, a history of important events, such as immigrating to a new country, setting up a home or memories of historical milestones.
Such a recording of her Italian immigrant grandmother was incredibly helpful not only in getting Emry through her grief after the woman died, but also in helping her family keep a sense of its own past and identity, she said.
Hashimoto suggests helping the patient write an “ethical will.” Unlike a legal will, which specifies the disposition of wealth and material possessions, an ethical will provides a way to impart one’s values, morals and beliefs to those they care about.
“It shows a lot about not what they had, but who they were,” she said.
The process of creating oral histories and ethical wills can help the dying realize — and have acknowledged by their survivors — how much they accomplished throughout the years.
Don’t be afraid to ask the dying what they’re afraid of and how you can help. Such fears may concern not only what’s coming, but also the financial and legal situation the patient is leaving behind. Talking about legal wills can go a long way toward addressing the financial and legal issues, and, at the same time, introducing the topic of death without getting too emotional, Emry said.
Ross Robinson, bereavement coordinator for Swedish Home Care Services, which provides palliative-care services through its hospices and in-home services, said it’s also important to talk about living wills, which concern end-of-life care and decision-making.
Remind the dying person that it’s important to communicate what he wants to happen, and make sure the person knows you’re willing to listen, even if it can be hard sometimes.
“Generally, we don’t value death as we should, and it remains a part of a poverty of ritual we have in our culture,” Robinson said. “This is a rite of passage like any other, and it is important to mark and talk about.”
Talk about your own fears. “There are never any ‘wrong’ emotions,” Emry said. Make sure you tell the person you will miss him.
Seek out comfort from others — and provide it, too, especially to children, who might not fully understand the concept of death.
Emry and Hashimoto said the one thing parents should never tell a child is that the dying are simply “going to sleep” — because the child may then resist sleep out of fear. Instead, they say, be frank about what death is — a time when the body physically stops working — and let them know it’s a natural part of life. Make sure children’s feelings are heard and that they get ample opportunity to spend time with a dying family member or friend.
Offering comfort to a loved one as death approaches can be a rich experience, not only for the person dying but also for the survivor, Hashimoto said.
“I’ve faced a number of deaths since the first one I experienced when I was 16,” she said. “And through them all, I’ve learned that I’ve never felt so alive as when I was with someone who was dying.”
Nathan Hurst: firstname.lastname@example.org