Planning a Death

Planning a death, believe it or not, is part of planning a life. Who knew?

My sweetie has been interested in the dying process for a long time. It's part of how she wants to spend her retirement -- serving people in that process. When her 92-year-old parents were dying, she sang them into release. It was an amazing process.

So it wasn't exactly a surprise to me when my beloved scheduled a meeting with the lady from the Final Exit Network. It's a group of people who grew out of the Hemlock Society who advocate for "good" death.

What's a good death?

Well, there are as many definitions as there are souls, but some of the criteria for a good death are: pain-free, in my right mind, able to care for myself till the end, healthy if a little slower, falling asleep and not waking up. In our society, though, we rarely if ever talk about what we want in a death. Furthermore, when we do, or even raise the subject, our loved ones shush us as being either a) morbid or b) too young for the conversation.

A precious friend of mine is in Texas this weekend with his family making these very decisions for his aging and unwell step-dad. It's painful and uncomfortable despite the fact that his step-dad at the least had this conversation with his wife, my friend's mama.

The step-dad is in the hospital: on a feeding tube, post-heart attack, with a fractured hip that needs replacing, caught in pneumonia on a respirator, complicated further by long-term diabetes. A kind doctor took my friend and his sister aside and explained that the future of their step-dad's life looked none too rosy even if he did recover. He isn't well enough for the surgery for his hip; this means life in a wheelchair and lived in gargantuan pain or even more dramatic pain management.

After the visit from the Final Exit lady, my sweetie said, "If I don't recognize you for six months, and I can't get to and from the bathroom by myself, will you please promise me you'll put me out of my misery?" She was, uh, dead serious. (Full disclosure (with much love): she can also be a bit of a cheapskate and she doesn't want me to spend all her hard-saved money on heroic measures that only prolong her discomfort; I thoroughly appreciate this about her.)

The people who have put a referendum on the November ballot in Massachusetts to allow doctor-assisted deliverance, as the Final Exit peeps say, are serious as well. There are laws about this in Oregon and Washington, and I hope it passes here in Massachusetts. Not that I think life isn't precious, it is. In fact, I think life is precious enough that we need to think and talk about how it ends, or, how each person wants their own life to end.

I was delighted to learn of the launch of The Conversation Project on Friday. Started by Pulitzer Prize-winning journalist Ellen Goodman, and affiliated with the Institute for Healthcare Improvement, it seeks to provide a free starter kit to help every person in the world have the conversation about what they want as a good death.

The 11-page PDF is a primer on what to think about, what needs talking about, and to whom and why. It's designed to help you figure out what's most important to you, and help you communicate that to those who could/might/will be/are in the situation with you. The most exciting part of it to me is that it's a beginning -- which is all The Conversation Project means it to be. The starter kit is a prompt for as many conversations as it takes with as many people as necessary to have your own version of a good death. Its opposite -- what's called a "hard" death -- can be very uncomfortable to contemplate, let alone experience.

We've all heard the ongoing and labored lament about runaway health care costs and how we have to do something about it if we want this to change. Beloved, here is something each of us can do.

Get the starter kit. Figure out what your wishes are, and begin The Conversation.

My sweetie and I ended up in laughing tears once she copped to the financial part of her desires. She told me to take the money and go on the trip of my dreams instead of adding three days or three weeks or even three months to her well-lived life. "Have a grand time on me, babe."

As Ellen Goodman said on NPR, "So, have you had the conversation?"

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