Overview of a Good Death: How to Die Well
There certainly is an element of objectivity to the concept of dying well. In other words, each of us has his or her own idea about what we consider a good death or dying well. With that said, because dying and death are the ultimate shared experiences … indeed, the only experiences generally accepted to be universally shared – there are some attributes of a good death that warrant sharing and considering. These include:
- When possible, know that death is coming
- Have a decent understanding of what to expect in the dying process
- Have control over pain
- Have control over other symptoms
- Retain at least some control over where death happens
- Retain at least some control over how death happens
- Maintain a sense of dignity
- Have an opportunity to prepare for death
- Reconcile damaged relationships, if reasonably possible
- Resolve regrets, when reasonably possible
- Forgive others, if reasonably possible
- Forgive yourself
- Have a say in end of life care and treatment
- Ensure your wishes regarding end of life care are carried out
The nature of life and death may prevent you from being able to carry out completely the items listed a moment ago in this article. These are meant to be ultimate objectives that we strive towards as best as we can.
Know Death Is Coming
Of course, each and every day people die unexpectedly. This includes women and men in their Golden Years. Thus, being able to know that your own death is coming is not something that be guaranteed. There are instances, however, when an individual can be imparted with knowledge from a healthcare provider that death is in the not too distant future. If that becomes a reality in your own earthly existence, you have the right to know that you are facing death in the not too distant future. Armed with this knowledge to which you are entitled, you are in a position to address the other items that are set forth in this article intended to provide an overview of a good death.
Have a Decent Understanding of the Dying Process
There are unique elements to the dying and death process for each individual. Understanding that every individual has a different death process, if you are in a position of facing an approaching death, you may find yourself going through three stages that are relatively common by people entering the very last phase of their lives.
One to three months prior to passing, a person is likely to see or feel the approach of his or her own death. The process of facing an advancing death largely is influences by a person’s cultural background and religious beliefs.
Mentally, an individual in this first or early stage of death may start to withdraw from society. An individual may want to spend time reflecting on life (and death). A person may not be particularly inclined to interact with others, at least not in the manner done so in the past.
Physically, a person may start eating less and begin to lose weight. Indeed, a person in this stage heading towards death may stop actually experiencing hunger or thirst. He or she may sleep more.
One to two weeks before death, the process of dying accelerates significantly. In many ways, this time period is one in which a person disconnects from life in this realm. Some argue an individual becomes better connected with what lies ahead.
At this juncture in the process, an individual will sleep a great deal. He or she may become confused, more significantly and more commonly than any other time.
Signs that death is approaching become evident at the end of this time period. These signs nearly always include:
- Body temperature that’s a degree lower than normal (or more)
- Lower blood pressure
- An irregular pulse that may slow down or speed up
- Increased sweating
- Skin color changes, with pale or bluish lips and nail beds
- Breathing changes (rattling sound and cough)
- Less or no talking
- Sudden arm or leg motions
There can be some surprising changes in the days and hours before a person dies. VeryWell Health provides a useful description of this point in the dying process:
The last couple of days before death can surprise family members. At this stage, your loved one may have a sudden surge of energy as they get closer to death.6 They may want to get out of bed, talk to loved ones, or eat food after having no appetite for days or weeks.
You may take these actions as signs that a dying person is getting better, but the energy will soon go away. It can be hurtful to watch this happen but know that this is a common step within the end-of-life timeline. These energy bursts are a dying person’s final physical acts before moving on.
The surges of activity are usually short. The previous signs of being close to death return more strongly once the energy has been spent.
At the very end of life and of the process of dying, a person will usually be unresponsive. Eyes may be open, but an individual is not likely to be able to see the surroundings.
Researchers believe that hearing is the last sense to leave a dying person. For that reason, it is valuable for people to sit and talk to a dying individual, even at the very end of his or her life journey.
There is absolutely no reason why a person in the dying process should suffer from pain. There is a wide array of medications that can eliminate pain afflicting a person as he or she dies.
There can also be emotional and spiritual pain accompanying death as well. Every effort should be made to attempt to eliminate these types of pain as all.
There are four tiers associated with end of life pain management, which we present here for consideration:
- Non-opioid drugs, such as aspirin or Tylenol (acetaminophen), should be tried first. This may be done with or without other drugs that are used to reduce fear or anxiety at the same time.
- If the pain gets worse or doesn’t go away, an opioid meant for mild to moderate pain, such as codeine, may be added. Non-opioids and other drugs, as in Step 1, may also be used.
- If pain still gets worse or continues, a stronger opioid for more severe pain can be used, morphine, for example, can be given along with non-opioids and anxiety drugs.
- Other treatments can then be tried if pain is not relieved. This may include nerve blocks and palliative chemotherapy.
In addition to pain, a person heading towards the end of life may exhibit other symptoms as well. These symptoms need to be controlled or managed as well.
The manner in which specific symptoms are controlled as death draw nearer depends specifically on what these symptoms are in regard to a specific individual. Some symptoms are easier to address. For example, a person who is dying might persistently feel too hot or too cold. These types of issues may be addressed by doing something as simple as change the temperature in the person’s room.
Where Death Happens
A person heading towards the very end of his or her life should make it clear where he or she wants to die. For example, a person may want to die in his or her home and not elsewhere.
In order to best assure that you are in the best place for your life to draw to an end where you desire is to impart to trusted people in your life where you want to pass on. You will also want to put this is writing.
Some people put this particular directive about where they want to die in their wills. The problem with that approach, your will is not apt to be opened until after you die and this issue naturally predates your dying process and death.
How Death Happens
How death happens really has two meanings in the dying process. We already discussed one of these – the biological process of death. How death happens also means you having control over the manner in which you die as permitted by law.
At the foundation of having control over how your death happens is the preparation of a medical directive as well as a durable power of attorney for healthcare. A medical directive sets forth what extraordinary measures you do or do not want in order to sustain your life. A durable power of attorney for healthcare designates an individual you trust (and who knows your wishes) to make decisions in regard to such matters as to how your death happens when you cannot do so on your own.
A good death is also one in which a person’s dignity is preserved. Maintaining dignity is closely connected with selecting where you die and indicating how you want that death to happen. For many individuals, it means palliative or hospice care (really, both when it comes to the end of a person’s life) as opposed to ongoing treatment in a hospital.
Opportunity to Prepare for Death
Of course, having the opportunity to prepare for death can never be guaranteed. Sudden deaths happen – and they happen often. With that said, you should be as proactive as possible in regard to matters associated with end of life issues.
For example, you are wise to have a last will and testament or to establish a trust to set forth how your property will be dealt with upon your death. As mentioned previously, you should also create a medical directive and a durable power of attorney for healthcare.
In regard to more basic matters, and has also been discussed previously in this article, you are wise to ensure that a person or persons close to you and that you trust are well aware of your desired surroundings when the time of your death draws near.
Reconcile Damaged Relationships
A step to consider as part of a process of dying well is to try and reconcile or repair damaged relationships. If there is going to be a time when repairing damaged relationships is possible, it is when you or the other party to a relationship are dying.
Keep in mind that reconciliation is an ideal and not something that is guaranteed to happen. The best you can do is try. You cannot blame yourself for failing to reconcile, particularly if you do make an attempt to do so.
Resolving regrets is another possibility when you are approaching the end of your life. The truth is, all people have regrets of some type or another. Within reason, you should attempt to work through these regrets and try your best resolve them. As will be discussed in a moment, you should not add to your burden by blaming yourself further for an inability to resolve various regrets at the end of your life.
The final stretch of your life does provide an ideal time to attempt to forgive those people in your life who you perceive as having caused harm to you or even individuals you care about. As is the case with resolving regrets and reconciling damaged relationships, an objective to forgive others is an ideal to be strived towards and not something you have the ability to assure will happen. By making a legitimate, sincere attempt to forgive others who have caused you harm in your own life, you have achieved this objective and added to an overall pathway to a good death.
No one lives a perfect live. There are going to be things that occurred in your life that you likely will carry with you into the final stretch of your time on Earth.
You need to make a concerted effort to forgive yourself of mistakes you’ve made and so forth. Self-forgiveness can be a challenge. Nonetheless, as your own death comes closer, you will make your passing more peaceful if you are able to forgive yourself of your mistakes.
In conclusion, by following the steps outlined for you in this article, you sincerely will place yourself in the position to die well, to have a good death. You will be more at peace with yourself, your life, and your death when your final months, weeks, hours are faced by you.