Until the 1920s, most Americans died relatively quickly and at home, surrounded by things and people – including their minister, priest or rabbi – they knew and who knew them. And, because they died where they lived, and among those who cared for them, the fear, pain, relief and release that death brought was common knowledge.
Today, however, death and the dying process are a mystery to most Americans. Only rarely, and usually in a crisis situation, do we get a peek behind the curtain at the anger, fear, pain, guilt, yearning, etc., that dying people experience, whether they are being cared for in a health care facility or at home.
And, my gut (informed by many years of covering end-of-life care) tells me that many people who are dying are not experiencing the kind of passing – the “good” death – they want. Or the one that their loved ones, whether they realize it or not, want for them.
There is no such thing as a one-size-fits-all good death
Part of the problem of getting the “good” death that all of us want is that – in an era in which aggressive treatment is often labeled/mistaken for best care – it is a highly subjective and situation-specific goal.
It requires that the person who is dying and their family understand the person’s medical diagnosis, prognosis, and options (which are usually explained in medicalese); the balancing and juggling of what is possible (options) and what is desired (or, at least acceptable); and someone who can and will communicate the dying person’s desires to reluctant family members and health care professionals. Not surprisingly, since he or she may be on strong drugs to control unbearable pain, that is often not the person who is dying.
The upcoming Health Journalism 2016 panel “Defining a ‘good” death – and how to cover it” (10:40 a.m. on Friday) is a connect-the-dots session on: the evolving “landscape” of dying (and the challenges “evolution” brings with it); what is/isn’t a good death (it depends); who chooses the “good death” option (and why); what it takes to achieve a good death (again, it depends); and the challenges family members and the health care system have with “letting go.”
A downloadable resource list will be posted following the conference.