Preparing for What's Next
Designing a good death
Actor Gene Hackman died from dementia and a heart condition. Before his death, he remained in his house for about a week while his wife lay dead on a bathroom floor near him. She died unexpectedly from a rare virus. One of their dogs also died while caged in a bathroom. (Don’t trap your dog inside the house where no one can help him).
He must not have expected his wife to die first, as their thirty-year age difference could have secured her as his caretaker. Sometimes the outcome you see as certain slips off in the night and you are left facing an end you couldn’t imagine. This man, and woman, and dog were all set up for a secure life and an uneventful transition to death, but that’s not at all what happened.
You just never know what kind of end you’ll have.
We are never ready to let go of life, no matter our circumstances. I think of my future paintings not started, essays not written, houses not decorated, loved ones not cared for. Just listening to birdsong is enough to keep you attached to life. But I know my turn is coming; just not when. We don’t like to talk about death, and I wonder if that’s because we are trying to postpone its arrival by keeping thoughts of it at bay. It’s like my old favorite saying: “What we think about, we bring about.” Except I’m pretty sure it doesn’t work for death.
Planning Instead of Worrying
What I’m hoping for is a kind of certainty that whenever the time comes, it will be with ease. Keep me out of a hospital or other institution, please. I think that’s how most of us feel. While I know that certainty doesn’t exist (and Hackman is an example of it), I at least want to feel I’ve done all I can to support an easy end. My dog will not be in a crate by himself, so at least there’s that. But can we plan this inevitable death properly, like a checklist item that gets it off our worry list? If it can be better and less scary, we can keep painting, writing, gardening, cooking, and loving life now while we’re here, and that’s the point of this—to stay focused on living, knowing we’ve done our part to ease the stress around dying.
I’m a writer, not a medical or even death expert. You would think there is a whole population of such people who have sorted this out already so that every one of us doesn’t have to start from scratch. I’ve looked into it a little, and while there are some options, nothing is perfect. Don’t let that keep you from doing what you can now while you’re able.
Some things to consider before you arrive at this next journey:
End of Life choices (medical support instructions, a spokesperson, post-death wishes)
Death Doulas (a person trained to provide emotional, spiritual and practical support on your way out)
Governmental laws & private organizations (such as Hospice, Compassion & Choices)
Dying alone (everyone gets antsy about this but I’d at least prefer it to being in a hospital)
Fact: 170,000 people die every day. Some of them have done their part to leave their wishes spelled out with an attorney. Sometimes even that is not honored. I read a story in a Compassion & Choices publication about a woman who had secured legal documents directing no medical interventions in certain situations, but she was tied to a hospital table and had tubes forced into her body against her will anyway. These medical interventions and her time in a hospital actually caused her to become much more sick than she was when she went in for an exploratory exam. Her primary doctor suggested doing some internal testing to see if her stomach discomfort could be caused by cancer and that’s how she wound up in this predicament. The woman is suing now so that others won’t have to experience what she did, but I suspect this is not entirely uncommon. We should not be treated as prisoners in hospitals.
There are two separate but very related facts here. One, we’re heading towards death; and two, if sickness precedes it, we may have to trust a medical system that is designed for profit, not respect. And there’s a third part that makes it incredibly frightening: this may come about when we’re in our most fragile state, not able to advocate for ourselves.
Death and aging have become frightening and complex and, sadly, profitable. Could it be more like our entry into the world rather than our exit? While many of us are born in hospitals, it’s usually with limited intervention. Then we are sent off into the world, hopefully with a loving caretaker. This simple level of humanity has been removed from our last act though. We didn’t design this system around dying but we could do something now to restore the dignity that death deserves.
Make it a Worthy Exit
I want to plan for my death the way a mother prepares for a birth. Make a peaceful nursery, have supplies at hand. Get help lined up. Have emergency backup plans in order. Get documentation together. By not making these arrangements, we are throwing ourselves to the whims of circumstance and others who may not understand, or care, about our important wishes.
Most of us head towards the end with one eye shut, hoping for the best because it is frightening. Others—as
points out—say they’re not expecting their children to take care of things for them but then make no plan to organize it themselves, effectively leaving it to their offspring. We can do better. We can start by treating it as an honorable stage of our lives that deserves a ceremonious plan. We can plan for it to be comfortable. We can think our way into a peaceful transition. Then we can get back to living.Thank you for reading. If you’ve found this thought provoking, please like or share to spread the word.
**Please note, I am taking a sabbatical for the month of August. It’s a time to catch up and enjoy the sweating heat of the East Coast. I’ll be back in September.**
Hi Trevy,
We like to plan for everything, so why the hesitation for so many of us to plan for death? First, we need to start talking about it. I've been writing about the "D" word avoidance for years.
Gene Hackman's situation was/is so sad. I remember wondering and asking why no one had checked up on them. I guess, that's not such an uncommon thing. And that poor dog.
Their deaths are a good example of tragic endings. Hopefully, many are and will learn from it. Thank you for your important piece about a difficult topic.
Well said, Trevy. Thank you for talking about preparing as best we can for our deaths, and suggesting things we need to do. (Like not leaving the decisions to others because we don't want to deal with them!) After "midwifing" the deaths at home of two of the people I love most in the world, I have a much better understanding of what I want. But I can't say I've done a great job of being prepared though. It's too easy to put off that kind of preparation with the excuse of being busy in the here and now. But as you point out so clearly, we don't know what's ahead, and we might, like Betsy Arakawa, Gene Hackman's wife, die suddenly years before our expected lifespan ending from a disease or other condition that comes out of the blue and we couldn't have anticipated. (She died of complications of hantavirus, a rodent-borne disease she probably got from breathing dust of infected mouse droppings from one of the outbuildings on their secluded Santa Fe estate.) A tragic ending for both of them, and a good warning that preparation helps. Thank you and blessings.