How to talk about death?

Updated November 2016

Why is it so hard for us to talk about death?

I think we, as humans, experience fear when we face the unknown, and death is the greatest unknown event in our lives. Yet we will each die, in some fashion, at some point. This vulnerability of our human form is downright frightening.

I suggest that we fear death for a variety of reasons, even if we have devout religious beliefs. For example, we wonder about the following:

• What happens to our conciousness/soul after we die?
• Does our soul move on?
• Do we actually have souls?
• Do we just blink out of existence?

 

In my experience, the biggest fear of all for most of my clients and friends is this: what happens to my loved ones when I am no longer here to care for them or be a part of their lives?

We, as a culture, just don’t give the inevitability of death enough of our time, thought, conversation or planning.

I believe that our collective cultural denial of death needs to change. Let me offer some reasons why you might want to consider agreeing with me.

Why should we talk about our death and plan for it?

Dying in denial is, unfortunately, a common phenomenon in our country. In my experience, dying in denial typically manifests itself in the following way. The person who is dying denies to everyone that their death is imminent and refuses to talk about their life coming to an end. They get weaker, they stop eating or taking fluids, and everyone around them is confused: is the person just sick or are they dying? Eventually, the dying person is only intermittently conscious; now their loved ones are even more confused and anxious because they don’t know exactly what is going on and they are afraid to ask. Then the person dies and everyone around them is completely confused and often angry.

Welcome to my world. This is the aftermath of a death in denial, where I get called in to pick up the pieces after a client or friend dies. The person who died may have created a perfect estate plan, but they didn’t tell the people who love them that they were actively dying, and then they denied it the whole time it was happening. I’ve had clients who denied to me that they were dying when they were within mere days of death and knew their time was short.

For the person who is dying, dying in denial is very painful, both physically and emotionally. It’s the same for their loved ones who witness the suffering and feel so helpless. The result of such a death is your loved ones feeling a range of emotions, such as being angry, dismayed, disappointed, and hurt that they didn’t get the chance to say goodbye, or to help to ease the suffering of the one they loved. For more on that topic, you can read the post Is My Mom Dying?

I often see people die in denial out of fear of being judged by others at the end of their lives. In this scenario, the dying person does not want to have those talks about how they may have hurt or disappointed, abandoned or betrayed other people during their lifetime. Further, they believe that those closest to them will only want to have those negative conversations. They simply cannot imagine there is anything other than their failures to discuss with regard to their life.

I’ve also witnessed people dying in denial because they could not bear to admit to themselves that their time on this earth was soon to end.

There are thousands of reasons for denying you are dying to everyone around you.

I offer, for your consideration, some good reasons to not die in denial:

1. it can be very physically painful to not have the medical support you need;
2. you are going to subject those you love to witnessing your pain and that’s not how best to show your love for your family or friends;
3. a bad death, one of denial and physical suffering during those last weeks or days, colors how you are remembered; and
4. it is much harder for those you love and leave behind to grieve and heal from your death when you die in denial.

 

How do we talk about death with our loved ones?

One answer may be that we all acknowledge within our family and our circle of friends that even if our death isn’t imminent, like tomorrow, death is inevitable. Think about it, death is the only sure thing we know about our lives: we will die at some point in time.

Here’s a sample question to get the ball rolling. You could even read it out loud to your parent/spouse/partner/friend if it would help.

Dad/Mom/Spouse/Partner/Friend, I know you are not dying today, or even tomorrow, but eventually you will die and, while I know this is hard for you to talk about, it’s hard for me too. But I love you and I want to know what you want to have happen as you are dying. Just in case you can’t tell me or someone else at the time, can you talk with me about this now, today? It’s important to me that I know what you want in those last weeks and days of your life. I want to be able to give you what you need and want at that time in your life. So we need to talk about this.  Do you want to die at home? Do you want hospice care, do you know what that is? What if you can’t be at home, what should I do then? Do you have funeral instructions written out, if so, where are they? Who do you want to make decisions if you can’t make them for yourself?

Once we get comfortable with the elephant in the room, namely the inevitability of death and the need for a discussion about that, then the logical questions can come up:

• how and where do you want to die, if you have a choice about those two issues?
• do you want to die at home?
• do you want life sustaining care?  Do you want only care for your comfort?
• are your intentions about medical care at the end of your life written down somewhere in a legal document like an Advance Directive?  Have you had this talk with your doctor? Have you had this talk with your lawyer?
• who will speak for you if you cannot speak for yourself at the end of your life?

After those basic questions are answered, and believe me, they need to be answered for your own sake and for those you love, you can move on to the bigger questions like these posed below.

• What do you want people to remember about you?
• What do you think your greatest achievements were?
• What did you love about your life?
• What did you learn about life that you want to pass along as wisdom to your children or friends?

 

Care to share your experience with these conversations?

Have you had these conversations with someone you love about their wishes or your own? What helped you to have those talks? Please consider sharing your success stories with all of us so we can all learn how to have these difficult discussions with those we love.

Did you have someone you love die in denial? How did that affect you at the time, or since? Please consider sharing that story with us because it might help others to understand better the consequences of not talking about death with those they love.