August 2023 |
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Can Death Be Brought to Life? |
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Ann S. Epstein describes how death, once a daily fact of life, has become a “forbidden” subject of conversation and asks whether, and how, death might be reclaimed as a normal part of life.
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Having “the talk” typically refers to a conversation between a parent and child about sex. But another “talk” that can be even more awkward is between a child and parent about death. In fact, talking about death with anyone, regardless of their age and relationship, is hard for most of us.
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Why we don’t talk about death
We are “deathly afraid” to talk about dying, as if the mere mention invites doom into the room. Instead we talk “around” it using familiar euphemisms: Passed; called home; entered the pearly gates; expired. Literary metaphors abound: Shuffled off this mortal coil (Shakespeare’s Hamlet), while humor
relieves our discomfort: Kicked the oxygen habit; took a dirt nap.
Reticence wasn’t always the norm. Death was once an everyday part of life. People died at home, surrounded by family, tended by the community. A shift began after the American Civil War. As growing medical knowledge improved survival rates, more hospitals were built to treat the ill. Paradoxically, it also meant more people died there. By the 1950s, the majority died in hospitals; by the 1970s, two-thirds did. Yet surveys show most people prefer to die at home.
The growth of the funeral industry can also be traced to the Civil War, when embalming preserved the bodies of dead soldiers who had to be transported home for burial. Funeral-home viewing in a costly casket also became standard. Before that, the dead were prepared at home and displayed in a simple coffin. Wealthy families had “proper” viewing rooms, some with a separate “death door” since it was considered bad luck for the body to cross a threshold used by the living. Seeing a body at rest and en route to the cemetery was a common sight.
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Today the funeral industry brings in $15 billion annually. Businesses range from compassionate providers to unscrupulous operators who exploit people at their most vulnerable. While regulations increased following the 1963 publication of Jessica Mitford’s The American Way of Death, violations, some sickening, continue to emerge. The death care industry’s high costs and adverse environmental impact are also controversial. Yet, lobbyists squelch public discussion of its shortcomings and of alternative “green” options to standard funerals and burials.
Silence about death is further exacerbated by a willing public. The elderly are reluctant to discuss death with the young. Facing our mortality raises existential questions about the meaning of life that we often lack the tools to answer. Likewise, the young resist speaking to the elderly whose loss is painful to contemplate. And as hard as it is to talk about death in reference to an old person’s decline, it’s tougher when the end is sudden or accidental, is preceded by dementia, results from violence or suicide, takes someone in the “prime of life” or, worst of all, a child.
Yet this discomfort is not instinctual. Children are fascinated by death. I can attest to this as a developmental psychologist and a grandparent. When my grandsons asked about death, I bought a picture book, The Dead Bird by Margaret Wise Brown, author of the classic Goodnight, Moon. They asked me to read it to them over and over, acted out the scenes, and showed that death was not an unsuitable topic to discuss with children. Why not satisfy their curiosity and prepare them for the loss of family members, friends, or pets?
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Mourning and grieving are also taboo topics
Not only do we not talk about dying, we avoid what happens to the living afterwards, namely mourning (the period immediately following death) and grieving (the accompanying emotions). Rituals such as funerals and memorials permit the bereaved to mourn for a limited time, but ongoing grief is frowned upon. No allowance is made for having had a difficult relationship with the deceased, nor does society accommodate “ambiguous loss,” when there is no body.
In reality, grief is universal, natural, and healthy. We don’t “get over it.” At best, we live with our pain and grow from it. It’s a myth that grief lasts a year. Other debunked myths include:
- Grief is a mental “condition” to recover from.
- Grief has five stages. (Based on the work of Elizabeth Kubler Ross, these stages apply to the dying person, not the grieving individuals.)
- It’s best to avoid talking about the person who died.
People don’t know what to say to a grieving person so they often say nothing, ignoring their pain. Or say the wrong thing, aggravating their pain. Here are some thing not to say:
- They’re in a better place.
- I know how you feel.
- They would have wanted it this way.
- You can have another child (or remarry or somehow replace the person lost).
Death is the proverbial “elephant in the room.” Pretending it’s not there won’t make it go away. Death is messy. But it’s also awesome. Only by acknowledging it can we deal with it.
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Norms are beginning to change
As other formerly taboo topics enter mainstream discourse, permission to “talk” about death is also slowly growing. Several noteworthy groups are at the forefront of this social movement:
- The Conversation Project offers free tools and resources to facilitate talking about wishes for end-of-life care. “This should begin at the kitchen table, not in the intensive care unit.”
- Compassionate Communities embed end-of-life services not in medical facilities but where we spend most of our time dying — the places where we live, work, and play.
- Death Cafés are informal gatherings to talk about death, led by volunteers, “to increase awareness of death with a view to helping people make the most of their (finite) lives.”
- Hospice offers at-home or in-facility palliative care for terminally ill patients. Physicians, nurses, aides, social workers, counselors, and volunteers address patient and family needs.
- No One Should Die Alone raises money for families who are unable to be with their loved ones and hires a compassionate caregiver to be with them in their final days and hours.
- An End-of-Life Doula (EOLD) accompanies dying persons and loved ones on the final journey, giving non-medical support to those who see dying as period of life, not just an abrupt ending.
I am a trained and certified EOLD. EOLDs offer many services: facilitating advance care planning; educating clients about in-home care, hospice, and funeral and burial options; assisting with pet care, child care, respite care; planning rituals or legacy projects; and sitting vigil. I use my skills as a writer to help people write life reviews — telling “stories” about the meaningful people and experiences in their lives — and ethical wills — stating the lessons they learned and want to pass on to survivors. Creating these documents allows those I work with to celebrate their lives and acknowledge that death will come.
Despite these enlightened efforts, most health care providers, social service practitioners, and family members continue to resist talking about the inevitability of death. As a consequence, dying is lonely for those facing the end and those left behind. Barbara Karnes, a hospice pioneer and EOLD, says, “In our medical society, it’s difficult for physicians to tell patients and families that we have come to the end of our ability to cure this disease. You are now entering ‘Precious Time,’ the time to do and say what needs to be done and said.” Such an admission would replace the false hope for extending time with the encouragement to use the existing time well.
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How we can restore death to life
Death is hard, puzzling, and sad, but it can be made easier, meaningful, and even joyful. A common metaphor for the end of life is “pulling the plug,” a medical reference to withdrawing life sustaining support. How can we replace it with images of death affirming care? Some ideas:
- “Normalize” talking and writing about death until it becomes a regular part of daily dialogue.
- Rediscover or create a “language” for death, be it verbal, written, or expressed through the arts.
- Challenge stereotypes about a “good death.”.For example, we assume people want to be surrounded by loved ones, but some might prefer to die alone. Replace the term “good death,” which is judgmental, with “respectful death,” which honors what the dying person wants.
- Make “death education” part of the civics curriculum and public service announcements.
- Stop stigmatizing grief. Provide more resources for those who want help.
Consider how you’ll bring death into your life. Have “the talk” with yourself and loved ones. Bring it up at a party or the office coffee dispenser. Tell us what you think about death.
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To learn more, consult these resources:
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About the Author |
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Ann S. Epstein
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Ann S. Epstein is a developmental psychologist, award-winning author, and certified end-of-life doula who uses her skills to help those who are terminally ill write life reviews and ethical wills. Her novels have been published by Vine Leaves Press and her short stories, memoir, and essays appear in North American Review, Sewanee Review, PRISM International, Ascent, and elsewhere.
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Disclaimer: The views and opinions expressed here are those of the author and do not necessarily reflect the official policy or position of Vine Leaves Press. Any content provided by our contributors are of their opinion, and are not intended to malign any religion, ethic group, club, organization, company, or individual.
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