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    The New Art Of Dying
    The New Art Of Dying
    The New Art Of Dying
    Ebook189 pages2 hours

    The New Art Of Dying

    By Diane Burnside Murdock

    ()

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    About this ebook

    How would you like to die? Only you can answer this. Whatever your age, cultural identity, ethnic background, or beliefs, read this book if you want to talk about dying but don’t know what you want to say.

    Each of us has our own special feelings, hopes, fears, and desires about this universal issue. These days, dying can happen in many different ways because of high-intensity therapies that prolong living and postpone dying. The proliferation of choices, possibilities, and alternatives can be overwhelming.

    The New Art of Dying is a constructive and thorough guide to empower you to make your own choices. There is no one answer for dying correctly. There’s no wrong answer either. Each of us wants to get it right and do it our own way.

    The New Art Of Dying is a handbook for our time. This step-by-step guide to making your own choices teaches:
    How to discover who you are and live life to its end
    How to deal with dying in your own unique way
    How to make decisions about life-sustaining treatments and procedures, palliative care, and legal documents on advance care planning
    How to keep unpredictable problems from upsetting what you want
    How to give loved ones the gift of caring for you the way you wish
    It is progressive about patient rights, making you the central figure and enabling you to experience dying the way you have experienced life— by being in charge of your own destiny. It’s for you only, a continuing reference and source of inspiration.

    An exposé on the American way of dying — penetrating and passionate…it speaks the truth. Scrupulously confronting the many options to choose from whether medical, palliative or legal — the problems we face and what can go wrong. Revelatory, helping you get at your attitudes on dying coming from your background and beliefs to create a personal end-of-life experience.
    LanguageEnglish
    PublisherBookBaby
    Release dateFeb 6, 2014
    ISBN9780989200318
    The New Art Of Dying

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      Book preview

      The New Art Of Dying - Diane Burnside Murdock

      M.D.

      PREFACE

      In 2008, my good friend Louise Wilson and I became impassioned on the subject of dying and how we die these days. I talked about my Mom, who died of cancer at 64, and the powerful last things a person remembers. How could Mom’s dying have been different—better for her and better for us? How is it that when a loved one dies, so many of my friends say, I don’t want that to happen to me?

      Weez, in her 80s, had moved to an independent living place that offered continuing care. To her annoyance, she noticed no one talked about dying. She talked about its inevitability. Everyone’s doing it. Why not know about it?

      I developed this habit of writing about ways of dying on slips of paper and reading them to her. Weez finally turned to me and said, Where’s the book?

      Then my father died. I was flooded with the same questioning that surrounded my Mom’s passing. Hadn’t I learned anything about dying? I know Dad wouldn’t have wanted my brothers and me to feel the way we did about his death—the overwhelming guilt and ruminations. We never did sit with him and talk about his wishes, and I don’t think he gave them much thought either. He had a boilerplate advance medical directive that included the words no extraordinary measures. But what does extraordinary measures mean, and what did it mean to him? Alzheimer’s made it too late to have a conversation.

      The book began as a catharsis and then was becoming the most incredible advance directive form in the world. But what really nagged me was this central question: If you have a plan and had the talk, what if you aren’t getting what you want? What if you’re getting unwanted care that equates to wrongful care?

      And there are also these facts: Too many of us believe advance directives are for people who are very sick or old. Many of us want to die at home, but few actually do. Only one-third of patients in the ICU have some kind of advance directive. Different people have different ideas about what’s best for them.

      These facts led me to examine common dying practices in America. I believe there is an art to dying, one where you can feel protected, where your wishes for care are intact. The book grew into and is a study of everything that can go wrong, what you can control and what you can’t, and how to get at your attitudes about health care and rethink what you think to get to an advance care plan that’s about you and about dying how you wish.

      The ars moriendi, the art of dying, relates to Latin texts from the early 15th to 18th century offering advice on how to die well. Practical guides informed the dying and family about what to expect, prescribing prayers, actions, and attitudes leading to a good death and salvation. Final hours were made sacred, and last words came to hold a particular place of reverence.

      Medicine has made it possible to postpone dying, and families struggle with how and when to accept that the battle is lost. We often panic and insist everything be done, forgetting that dying is all about you, not your illness or treatment.

      Some may feel this book displays a bias against expensive, heroic interventions even when the patient wants them. I believe this tension is inherent in discussions of how we die today—how we don’t talk about dying, have a plan, or take control of our destiny.

      I wrote The New Art of Dying as a handbook for our time.

      INTRODUCTION

      Everyone is doing it. Why not know about it?

      —My friend Louise Wilson, b 1921

      How would you like to die? How can you help your family and other loved ones to have a death that gives them comfort and support?

      Only you can answer this. Each of us has our own feelings, hopes, fears, and desires around this universal issue. These days, dying can happen in many different ways because of high-intensity therapies that prolong life and postpone death. The proliferation of choices, possibilities, and alternatives can be overwhelming. There is no one answer for dying correctly. Each of us wants to get it right and do it our own way.

      It’s not easy to think about death, whether that of a loved one or ourselves. We instinctively avoid it, don’t want to think or talk about it. That’s normal human behavior. But we’ve all heard or experienced painful stories of terror, confusion, useless and expensive extension of hopeless bad health, huge financial losses that lead only to inevitable conclusions. The fact is, these chaotic, passive, and dysfunctional experiences can be eliminated. Yes, we all are going to die, but it doesn’t have to be a passive, helpless, out-of-control nightmare. If we prepare and make plans, we can make it more like what we want. Facing the inevitability and figuring out how we want to do it can be a tremendous help for when it happens, for us and those we care for.

      That’s why I wrote The New Art of Dying. It’s a constructive and thorough guide to empower you to make your own choices. It is progressive about patient rights, making you the central figure and enabling you to experience dying the way you have experienced life—by being in charge of your own destiny. It’s for you only, a continuing reference and source of inspiration.

      Your changing attitudes about life influence how you wish to die. How you feel about death and dying at forty may not be the same as when you’re seventy-five. I hope this book helps you find consistency with who you are, what you are about, and how to live life to its end. I hope you’ll find this a book that you can put down and pick up again over the years as you grow and age and refashion your dying wishes.

      —Diane Murdock, Virginia Beach 2012

      Part 1

      Who Are

      You?

      Who am I? And how, I wonder, will this story end?

      —The Notebook, Nicholas Sparks

      The most important time in your life is not the

      moment of your death, but the time as it approaches.

      —Elisabeth Kübler-Ross, M.D., psychiatrist,

      hospice pioneer, author of On Death and Dying

      1

      HOW WE DIE

      There’s no doubt that how we die lives on in those who survive us. We’re gone, but those who live on carry our last days with them forever.

      It’s heartbreaking that so many of us aren’t happy or at peace with what happened to a loved one who died recently or even a long time ago. Frequently we hear people express guilt that they couldn’t prevent someone’s death or help them get through it with less pain and suffering. Others say they feel remorse because they couldn’t let a loved one go, and that led to unnecessary suffering and pain. Often those who’ve lost a loved one are devastated because they decided to pull the plug and felt they were on what amounted to their loved one’s death panel.

      Such feelings are common. How can we help our loved ones die more peacefully? And how can we plan a better death for ourselves? We can stop such ruminations by knowing who we are and what we believe constitutes a good death. We can have our dying reflect our core values and who we’ve been all of our lives.

      Questions about dying elicit different responses simply because we are different people. For example:

      Who should take care of you when you approach death? Do you believe that caring for a dying person is the responsibility of those who are closest and most loving, or a difficult burden that should be passed along to a professional caregiver?

      Do you believe that life should be preserved as long as possible? Do you believe there is always a chance for a miracle, for recovery with a decent quality of existence remaining?

      How do your own experiences with illness and death impact how you wish to die? Have you lived through difficult end-of-life situations as either a child or adult?

      What are the specific medical issues you or your loved ones are facing now or may face in the future?

      We even give different answers to what family means-Its definition is evolving to include the traditional and nontraditional, extended families, blended families, partners, and close friends. These days, family captures whoever is significant and part of an entourage of special people touching our lives. When you see the word family as you read through this book, interpret it as you define it.

      Our personal histories make it possible for us to answer these questions. And the answers are uniquely our own. If we ask the right questions and take the time to answer them honestly and thoughtfully, we can get past our apprehensions, blocks, and dreads. Then we can become masters in creating our own peaceful exit.

      Most of us are overwhelmed when we face end-of-life choices. It’s that tumultuous feeling that it’s impossible to know what to do because there are so many facts and so much to know. How can you hope to make the right choices?

      It is natural to feel this way. The medical facts are important, but they are only part of the whole. It isn’t only about your illness, your treatment, or a procedure, it is about you. It is knowing what you are about that allows you to say, I am a person with a whole life history behind me who is dying, not just the fragment of myself you see lying here now.

      The practice of medicine has changed dramatically in the last century, largely due to technology, and changes in medicine continue to expand at an alarming rate. We find that medical, legal, and moral decisions are intertwined with how we die. We hear of ugly disputes between medical staff and a patient’s family on what is or is not to be done for a person. It’s as if medical technology is in a face-off with patients’ rights.

      The fact remains that you do have rights. You can request to be cared for the way you want. You can say what you don’t want and decline treatments. You can also ask for everything to be done, but the treatment team may decline treatments it does not consider medically appropriate.

      Inevitably, an ill person reaches a point when medical interventions can do little to stave off death and may even prolong the process of dying and cause suffering. If we don’t think about dying now, we force those who love and care for us into deliberating and guessing what is best, negotiating about limiting or discontinuing therapies, and deciding whether or not to resuscitate us. These

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