Dying Well

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Humanofearth
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Dying Well

Post by Humanofearth »

Inspired by the 20M thread answers, how to live a good life often reflects in how we die.

So how do we die well? With peace, surrounded by family and the knowing we gave our best in life.

How to help aged parents die with peace? Surrounded and cared for by a cohesive yet independent family, yet we’re all in different continents.

How do I make 80 year old humanofearth die happy? Doing my best every day, stopping all time wasting behaviors and building (health, work, family) every day while being present to the miracle of it all.

What are your answers to this?
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Chatgpt’s answers:
Dying well can depend on an individual's personal beliefs and values. Some ways to die well include:
• having open and honest communication with healthcare providers and loved ones about end-of-life care
• having a plan in place for end-of-life care, including a living will or advance directive
• being comfortable and as pain-free as possible
• having the opportunity to say goodbye to loved ones and to make amends, if desired
• finding meaning and purpose in one's life
• exploring one's spirituality or religion and connecting with a higher power
• having support from loved ones and healthcare providers during the dying process
• having a sense of peace and acceptance of death. It's also important to remember that dying well can be different for everyone, and what may be important to one person may not be important to another.

Helping your aged parents die with peace can involve several steps:
1. Communication: Open and honest communication with your parents about their end-of-life wishes, preferences and expectations can help them feel heard and respected. Encourage them to make their own decisions about their care and respect their choices.
2. Advance Care Planning: Encourage your parents to document their end-of-life care preferences and make sure their healthcare providers have copies of their living will or advanced directive.
3. Pain and Symptom Management: Work with your parents' healthcare providers to ensure they are as comfortable and pain-free as possible.
4. Emotional and Spiritual Support: Be present and supportive for your parents emotionally and spiritually. Encourage them to express their feelings and fears and offer reassurance and comfort. Offer to participate in religious or spiritual rituals or practices that may bring them peace.
5. Caregiver Support: Being a caregiver for a dying loved one can be emotionally and physically taxing. Make sure to take care of yourself and seek support from friends, family, or professional caregivers.
6. Create positive memories: Encourage your parents to make peace with their past, to say goodbye to loved ones and to create positive memories with family and friends that can be cherished.
It's important to keep in mind that every person's experience is unique and what may bring peace for one person may not for another, so it's important to communicate and respect your parents wishes.

Making yourself proud of the life you lived when you are on your deathbed may depend on your personal values and beliefs. Some ways to achieve this may include:
• Living a life true to your values and beliefs
• Achieving your personal and professional goals
• Building and maintaining meaningful relationships with loved ones
• Making a positive impact on the world and leaving a lasting legacy
• Finding meaning and purpose in your life and experiencing a sense of fulfillment
• Being true to yourself and not sacrificing your integrity for the sake of others
• Being a good person and treating others with kindness, empathy, and respect
• Reflecting on your life and finding satisfaction and contentment in the memories and experiences you have had. It's also important to remember that what may be important to one person may not be important to another and it's okay to have different perspective on what living a life to be proud of means.

AxelHeyst
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Re: Dying Well

Post by AxelHeyst »

Good thread idea. I think it makes a lot of sense to start at the end and work backwards. I just posted this in the other thread but here it is: Die Wise, by Stephen Jenkinson, was a terrific book for me to think through - not dying - but how to live well now.

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Ego
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Re: Dying Well

Post by Ego »

A good death is the culmination of a good life. One important aspect of a good life is matching both the physical & psychological aspects of healthspan as closely as possible with physical & psychological lifespan. Living beyond one's healthspan is the largest contributor to a bad death. While we do not have complete control over healthspan, we do have a great deal of influence over outcomes.

ETA: How doctors die versus the advice they give is interesting: viewtopic.php?p=68712#p68712

ertyu
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Re: Dying Well

Post by ertyu »

I don't see this discussed often but one of the advantages of moving to a developing country to retire is precisely that one is unlikely to be overtreated as described in the article Ego linked above.

icefish
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Re: Dying Well

Post by icefish »

Absolutely agreed on the country being an important factor, but I'd also really want to focus on end-of-life options. Two observations of that for me:

My partner's grandfather had a pretty good death, I think. He was a healthy man right up until the end: in his late 80s, he fell during his routine tennis game while over-reaching for a ball, hit his head, and developed a brain bleed that meant that night he went to sleep and never woke up again. He was a little groggy at the weekly family dinner that evening, and there was enough concern in the air that all his kids and grandkids each went and had a serious just-in-case-something's-wrong goodnight talk with him. He died a few days later in hospital, surrounded by a large, loving, and supportive family, who were able to easily navigate the medical system by dint of education and money. What more could you want, right?

But because euthanasia still isn't legal here, the few days between the fall and his death were there because the only option was to remove all life support and just wait for him to waste away "naturally". That was emotionally gruelling for everyone involved, and even though he didn't regain consciousness, he was clearly in pain as well.

On the other hand, my MIL died from a mean terminal cancer that lasted weeks. Her family were unable to navigate the medical system as well as the other side of the family could due to a lack of money, but instead were able to use social capital to get through it. Extended webs of relatives took shifts caring for her at home, and also caring for the people who were taking care of her.

But again, because of a lack of euthanasia, her death was painful and prolonged. Some of her EOL caretakers still feel incredible guilt from the way she begged them for help, and feel that they failed her by not being able to give it.

Both social and financial resources could help smooth the way to a good death, but they couldn't help with the final political stumbling block. Part of dying well for me involves lobbying for better EOL legislation-- or failing that, keeping tabs on which countries I might make a quick jaunt to in the worst case scenario.

guitarplayer
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Re: Dying Well

Post by guitarplayer »

I was trying to find words for what I wanted to say and I figured maybe the 'doing vs being' tool from the ERE toolkit could help (I think it first appeared somewhere in the context of boxing one 'is' rather than 'does'?)

It sits quite well to say 'I am alive', but regarding dying it is often about a way of dying, such as

'peacefully',
'surrounded by friends',
'in pain'
similar.

But in fact, we are alive and, so to speak, dying every moment. And then we are dead.

I see no difference between 'living well' and 'dying well'.

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Sclass
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Re: Dying Well

Post by Sclass »

I’m not sure why this matters. Dead is dead.

I went through this with my mom in 2019. She died “well” with me holding her hand in her home. Took a significant amount of money to do this. The last eighteen months were like slow motion. More money just slowed down the train wreck. In some ways I think it would have been better to die “not well”.

So I’m focusing more on how I live. The last year is a drop in the bucket of life. Whether you go out in a flash because you don’t have money or you extend your suffering and surround yourself with your hangouts doesn’t mean much to me. Especially if I’m dead.

It’s all about how I get there. And the decades leading up to it. Not the last moments.

ETA - like the $20M thread most of us are speaking from a point of zero personal experience. I would do this, I would do that. Blah blah. Try it first then report back. This dying well thing is like funerals…it’s all about the living. It’s for the people left. It has little to do with anything for the dead person.

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Re: Dying Well

Post by jacob »

I recall a longer article about someone who had vowed not to accept life-critical medical treatment after the age of N, where N was 70ish?

I suspect this could easily become a moving goal post type of situation both in terms of N and criticality.

guitarplayer
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Re: Dying Well

Post by guitarplayer »

Brings to mind Garrett Hardin of the Tragedy of the commons fame. But then yep most people change their mind, I think there is some research in that department.

Frita
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Re: Dying Well

Post by Frita »

And I notice a narrative of “courageously battling cancer” forcing people to accept whatever treatment regardless of the stage and prognosis. For example, most recently my cousin was diagnosed with stage 4 pancreatic cancer. Originally she was only going to do palliative care. Now she is pursuing treatment, in more pain, bald, and wearing a lot of pink. No judgment, just noticing.

My four year old daughter fell off the top of a slide’s ladder at developmental preschool when the PT intern was not spotting her. (Her twin witnessed this. And no, we did not sue.) She hit her head, seized, and when into cardiac arrest. Though she was intubated, they could not revive her. I, alone, decided against life support. (My spouse was traveling for work. The decision needed to be made.) I still feel the weight of the situation when recall it. I feel at peace with the decision though. It is likely to not be the last hard decision I ever make.

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Ego
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Re: Dying Well

Post by Ego »

jacob wrote:
Sun Jan 29, 2023 9:40 am
I recall a longer article about someone who had vowed not to accept life-critical medical treatment after the age of N, where N was 70ish?

I suspect this could easily become a moving goal post type of situation both in terms of N and criticality.
The Oncologist Ezekiel Emanuel wrote the article almost ten years ago when he was 65 saying he would refuse all treatments (including vaccination) after 75. A followup interview https://www.advisory.com/daily-briefing ... el-emanuel

The thing I find interesting is that the people who spend their days in end of life care have strong opinions about it.

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Re: Dying Well

Post by jacob »

Ego wrote:
Sun Jan 29, 2023 12:02 pm
The thing I find interesting is that the people who spend their days in end of life care have strong opinions about it.
Last paragraph was interesting. The flu used to be considered a good death. It takes about a week.

It seems like it's turtles all the way down. The material question then is "how many prescriptions, tubes, machines, etc. do you want to be on when you die. Please check a box. 0-3, 3-5, 5-10, 10-15, as many as it takes".

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Ego
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Re: Dying Well

Post by Ego »

Ah... I posted before I read it and assumed that he was 65 when he wrote the article as he looks older than he is. He is now 65, not 75. Still has ten years to go.
In particular, Emanuel said he wants to be realistic about when his own "consumption" exceeds his "contribution."
One of the problems he is starting to face is his spouse's opinion. Is he willing to suffer the indignities of outliving his healthspan to allow his spouse to avoid suffering his loss. I think a lot of elderly couples face a situation where both are suffering in different ways. One suffers with a disease and the other suffers watching their partner endure it. Both believe they are suffering for sake of the other and neither wants to be the one to admit reality.

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Re: Dying Well

Post by jacob »

Ego wrote:
Sun Jan 29, 2023 12:28 pm
One of the problems he is starting to face is his spouse's opinion. Is he willing to suffer the indignities of outliving his healthspan to allow his spouse to avoid suffering his loss. I think a lot of elderly couples face a situation where both are suffering in different ways. One suffers with a disease and the other suffers watching their partner endure it. Both believe they are suffering for sake of the other and neither wants to be the one to admit reality.
The good 'ole Roadtrip to Abilene problem.

Normalizing and ignoring objectively bad situations because one's five closest friends are also doing badly is also a [similar] issue. "When it's normal to take 5 different prescriptions, be 50 pounds overweight, retelling the "that one time; have I ever told you that?"-story for the 10th time, and failing the https://en.wikipedia.org/wiki/Sitting-rising_test ; ...

J_
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Re: Dying Well

Post by J_ »

Sclass wrote:
Sun Jan 29, 2023 7:36 am
This dying well thing is like funerals…it’s all about the living. It’s for the people left. It has little to do with anything for the dead person.
As long you are not ill from an extern accident or an inborn health issue, I frame dying well as an "ere" thing.

In our "western" society is so much unhealthy food, unhealthy beverage, unhealthy stuff. And so much media/advertising to sell all those.

There is an analogy to striving to financial independency.

Teach yourself about living well by studying about healthy food, enough movement of your body, enough rest for your mind as well as for your body. And apply what you found.

Then you can stay long on your own, and bypass the medical industry.

Then you can say: I strive to die well.

Humanofearth
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Re: Dying Well

Post by Humanofearth »

The reason for the thread is that I want peace at the end. It’s not about focusing on the dying rather than accepting it and living with that knowledge in mind so that I live a good life.

@Ego
Has already added perspective I hadn’t considered and extending the dying part. I realized that extending the dying part beyond time needed to express final wishes and hopefully bring my family to join for last wishes is only extending the pain. Mom already expressed this wish, I now think I will as well if treatment involves indefinite living in the hospital rather than with freedom of movement.

@Frita
Thank you for sharing that. It sounds like a very intense experience that illuminates a painful reality I’ll have to deal with some day.

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Re: Dying Well

Post by chenda »

When my aunt died her house was full of 80 years worth of letters, diaries and academic work, all chaotically stored. It took weeks or sorting and difficult decisions about what to do with it. Especially when flicking through diaries and letters I saw some pretty personal and malicious content about other family members. In the end we decided she probably wouldn't want us reading it and most of it we burnt before it shattered any nice memories about her.

So it's worth asking the question if you died tomorrow is there anything compromising you might not want others to see ?

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Re: Dying Well

Post by jacob »

In that regard, "Swedish Death Cleaning" is always a good idea.

I can't provide a reference since this has apparently turned into an industry by now. I'm referring to the original book.

mathiverse
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Re: Dying Well

Post by mathiverse »

jacob wrote:
Sun Jan 29, 2023 5:34 pm
"Swedish Death Cleaning"
I think this is the original book The Gentle Art of Swedish Death Cleaning by Margareta Magnusson.

guitarplayer
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Re: Dying Well

Post by guitarplayer »

This book looks so interesting @mathiverse, thanks!

Also makes me think how 'Nordic / Scandinavian' made a distinct brand of itself; I am drawn to the aesthetic.

There is a documentary along the dark side of those lines about people in Scandinavia who die and there is nobody to inherit little there is left, so the council employees take the task of post mortem death cleaning.

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