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The Answer: Compassionate Care

ve8QAd   |   January 01, 1998

Is suicide the answer for the person who is told that death is inevitable? If not, what are the answers?

First, one must realistically admit that dying is often difficult. It can be unpleasant and often times burdensome. But every person must someday tread that path into the Great Beyond. That person may someday be your parents, spouse, children or grandchildren, your loved ones, and, one day yourself. Our task, if possible, is to make this passage as comfortable, meaningful, fulfilling and peaceful as it can be. Our task also is to leave those persons around the dying one with good memories and a sense of peace and acceptance.

Is this easy to do? No, but it can be done, and it behooves each of us to try. Most are familiar with the stages that a person goes through after they are confronted with the edict that the end of their worldly existence is coming. Hopefully, there are supportive people around. They must give support to this person, as he or she slowly deals with and accepts the reality of what is to come.

Fear, depression, anger, despair and loneliness are all part of this. Physical symptoms and pain will aggravate it. The medical team must see to it that the patient remains reasonably comfortable physically. But that may well be the easy part. The difficult, but potentially most fulfilling part, lies ahead. Hopefully, with support and help from others, the dying person can get past her anger and come to the point of accepting that she will die, and accept that she will become dependent on others – often an entirely new experience.

With this often comes a feeling of uselessness, fearing they will be “a burden”, and a pervasive, continuing fear of this slowly developing and progressing different existence.

What, then, lies ahead? A clamming up, a shutting out of the world? Despair? Hopefully not, for there is so much to do before each one of us dies. None of us has led a perfect life. Through our lifetime we have made mistakes, and we have done many things that we have regretted. Oftentimes, these actions have been directed at or were directly related to those closest to us – a spouse, parent, child, sibling, or close friend. Each of us have left behind people who have been hurt, as we too have been: misunderstandings, resentments and buried anger.

But we have also, during our lifetime, in so many ways taken for granted those who cared for us, did us favors, worked with us and loved us. How often have we said, “Thank you”?

Then, there are the practical arrangements. How does one arrange for the disposition of earthly goods? This certainly includes finances, but it is also so much more – those pieces of china her daughter so loves, Dad’s old cane, her jewelry (valuable or not), etc. What of these? She won’t be needing them anymore. Now is a time to perhaps share them with her loved ones.

Without question, for many or most, there is a need for spiritual reconciliation, pondering, praying, and an attempt to make things right with the Lord.

Many people will say they hope that, when they go, they go quickly. But many of us, experienced in terminal care, would not share that. Rather, we see value to that time at the end. There is a five-point commentary from Hospice – a marvelous way of stating what one’s end can be like. They are “I forgive you -– forgive me – thank you – I love you – goodbye.”

Hospice care, or its equivalent, properly accomplished – lovingly and professionally done – is without question modern society’s answer to euthanasia. Hospice is usually an institution, but its services are not confined to four walls. More patient hospice care occurs at home, on visits to nursing homes and in other settings than actually occur within its walls. It is a wonderful place to die. A hospital is often a lousy place to die.

It’s often noisy, the lights never go out, and other patients keep you awake. You’re constantly being bothered to have your temperature and blood pressure checked or there’s a meal to eat. There are problems with visiting hours, and the list goes on.

A hospice is an approximation of the ideal situation of dying at home. In a hospice, there are no heroic efforts to prolong a life. When life naturally ebbs and slips away, this is accepted, not fought against. There is also an expertise available for pain control. That, above all, is taken care of.

In a hospice, visiting hours are whenever your loved ones want to come. They can stay as long as they like. Visitors can and should participate in the care of the patient – feeding, bathing, oiling, rubbing, singing, talking, praying or listening. Grandchildren can come and even bring their pets. Clergy are not merely squeezed into a busy schedule or tolerated, but accepted as an integral part of the team. This is a place from which the patient can go home, if his or her condition improves.

Hospice provides doctors, nurses, social workers, clergy, physiotherapists and, above all, the gift of time. Does that busy nurse in the hospital have time to sit down and just talk, or, more importantly, to just listen? Rarely. In a hospice, that is her job. For instance, a patient has an estranged brother in a distant city but no nearby family to make that contact. In a hospital, very likely nothing is done. In a hospice, that is what they’re all about. They will contact him and urge him to come to visit, talk and share before his sister dies.

Substantial personal growth can occur while approaching death and, literally yet, while dying. Dying can be a time of personal fulfillment to the patient and those around him.

This can be a time to complete things such as the following:

A son, long estranged from his father for, in his mind, justifiable reasons. The father is near death. That son can come back and forget who was guilty of what. He can tell his father that he loves him and ask for his forgiveness insofar as he himself was in the wrong. A father’s response in such an instance is usually one of embracing him whom he sees as a prodigal son. Such an exchange of love, very likely with tears, can release both from the emotional bondage of long-harbored anger, resentment and personal guilt.

A grandfather can gather grandchildren about him and recall for them tales of his earlier life and his own boyhood. He can tell how he met their grandmother, their courtship and marriage, and their bearing and rearing of the parents of these children. Such stories, often heard for the first time by these little ones, will not be forgotten. They offer a bridge to the past, a tie in blood between generations, a pride of “ownership” in having had this grandpa. This also serves as a positive and loving example to these children’s parents, and to the children themselves, of the inter-generational role that grandparents can and should play, and that hopefully each of them will play someday.

A divorced wife, long estranged from her husband, carries with her, as does he, a wall of bitterness from that painful separation experience. Deep inside both of them, completely unspoken and fully repressed (most of the time), there remain some feelings of regret. Perhaps for not having put forth the full effort to preserve that union, or of even being somewhat ashamed of oneself for having done or said some of the things that led up to that break. All of these can add up, deep inside of each, to unresolved emotional feelings. If she can come to this dying man, embrace him, and tell him how she remembers their initial love and that some of that still remains in her heart. If she can tell him she’s sorry for whatever hurts she has caused him and ask him to forgive her, almost certainly the wall between them will dissolve. He will accept, forgive and respond to her in kind. Now all of the facade, the built-up encrustations of time, pride and self-justifications fade away. After such a tender moment, it may be that he can die in peace, and that she knows it. She herself can then go back to her own life with a lighter heart, a cleaner conscience, a burden lifted from her soul.

This can be a time of clearing one’s spiritual conscience of guilt and sin. He can share time with a priest who can offer God’s forgiveness through the Sacrament of Confession. Or to share time with a minister or rabbi to discuss and relieve one’s soul and be reassured of God’s forgiveness of past sins. This is a time to share with a trusted friend. A time to open a locked conscience and get such previous violations of God’s rules (as he or she sees them) cleared from one’s conscience.

Memories are powerful things. They follow us our entire life. We have our share of bitter, angry, or just plain bad memories. It is not good to bury those memories. It is much better for them to surface in an atmosphere where love can be exchanged and mutual forgiveness is relatively easy to extend. When we strip away all of the encumbrances of modern life – money, prestige, power and pride – the important things that remain at the very end are our relationships to people. Primarily they are to our own flesh and blood, to those we have loved, those who are closest to us. It is so much better to bury good memories than bad ones.

Conclusion

Your author and many others who have cared for dying persons hope that each of you, when confronted with a person who is dying, will try to make those last weeks and days a time to remember, a time of fulfillment, and a time to consider once again those five last acts: I forgive you – Forgive me – Thank you – I love you – Goodbye.

This is an abbreviated version of the last chapter of Dr. Willke’’s new book, Assisted Suicide & Euthanasia.

 

 

 

 

 

 

 

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