For those with terminal illnesses and their families, or those that have lost loved ones suddenly or at a young age, talking about death is not easy. Saying the words, "death... dying... died... will die" is hard. Death is final. We miss our loved ones when they are gone. We worry that we may die before we do all the earthly things we were meant to.
Because the language of death is hard to use, people will use other words.They may say "pass away, moved on from this life, or passed over" to describe death. These softer versions create the illusion of softening the blow and to ease social discomfort around the topic. Sometimes families and friends simply avoid the subject completely for fear of saying the wrong thing, upsetting one another, or because they can't find any words to use.
So why is death so hard to talk about? We are aware that it's inevitable, yet for many of us, it's easier to avoid the subject. In the documentary and book titled Being Mortal, physician Atul Gawande struggles with the death conversation with terminal patients. He states "death and aging are the things we can't fix." He realizes that doctors sometimes provide false hope to patients, transferring their own desire to fix things to their treatment protocols, even when deep down they know treatment is likely not to work. What is it about death that will cause even a doctor to deny reality?
Hospice professionals know that patients and families do better when they have a specific plan in place regarding directives for lifesaving treatments, living wills, last wishes, and priorities for how the last days and months of life are spent. Yet, these arrangements cannot be made if no one is talking about them. And even for hospice professionals, it's difficult to broach the death subject with patients and families who aren't yet ready to go there. Sometimes it seems like not facing reality is the compassionate thing to do. But is it?
Complex emotions accompany death. Counselors are well positioned to help people explore these feelings, ease the inherent discomfort of talking about them, and hopefully provide a safe place to make plans that make the dying process easier. Here are a few of the feelings we may have about death.
1. We feel afraid because death is scary. It's the ultimate end, and is potentially painful. The dying person must consider whether death will come slowly or quickly. They wonder if there will be physical pain in dying, and how they'll manage it. They wonder how their loved ones will endure the emotional pain of their death. And the dying person has their own emotional pain.
2. We feel responsible for comforting others. Even if we are grieving, we still want everyone around us to be ok, and to not worry. We may skim over details, minimize the negative, and emphasize the positive in an effort to save everyone's feelings.
3. We feel sad at the thought of losing a loved one or about our own lives ending. With that, regret, guilt, or remorse may surface as we consider the journey we've taken in life. We consider what we did well and what we didn't. We consider our mistakes, and maybe who we hurt along the way. We ask whether there is meaning in any of those experiences. We use our spiritual beliefs to answer some of these questions and make peace (or not) with ourselves. We use the same beliefs to make peace (or not) with our dying loved ones who may have wronged us.
Each of these feelings can be difficult to process.
The lack of language to describe feelings may likely be responsible for the lack of language to describe and prepare for death. By recognizing, expressing, and working through feelings about dying, a path opens to recognize and express the reality of death.