The Art of Dying Well

We are in new territory when it comes to dying these days. In my grandmother and great grandmother’s times and for the many generations before them, one was more likely to die of natural causes at home. Most have heard the saying that pneumonia, a relatively gentle way to go, is “the old man’s friend.”

In contrast, today, while the majority of people still want to die quietly at home, more than two-thirds die in hospitals, nursing homes or other institutions instead. 17% of us will have been in the Intensive Care Unit (ICU) within the month before our death. What has happened? It’s certainly a confluence of factors, from people’s lack of familiarity and comfort with dying and death to the pressures and often well-intentioned efforts of physicians, in the absence of directives to do otherwise, to do everything possible to keep someone alive, and then add to the litigious climate.

In working beside families, many in the last year of life, I’ve been quite surprised to see even the most prepared—with clear instruction on what interventions they want or do not want, as well as a good advocate to communicate these—can sometimes find themselves in a scenario they did not anticipate in an ICU they did not want to go to.

While North Carolina is not one of the eight states in which physician-assisted suicide is allowed, there are means that people can consciously elect when they have had enough. A 2017 survey found that only one-quarter of people wanted to live as long as possible, no matter what. The rest cared much more about the quality of their lives and deaths: not burdening their families, being at peace spiritually, dying at home and dying comfortably. How can we increase the odds of being able to do that?

As you can see from the photo above, my copy is already well-marked. I encourage you to get and mark up your own copy.