By Kelly Crawford
I’ve been thinking a lot about death over the past year. I’ve researched assisted dying, learnt about palliative care, upskilled on conversation starters for death and dying, and tried to understand how we can best support people who are at the end of their lives. Perhaps more importantly though, I’ve been thinking about death because in June of last year my dear grandmother died. “Grandmother” doesn’t fully capture who she was to me though; she was like a mother in a lot of ways and for a long time I would have referred to her as my best friend. She died of congestive heart failure surrounded by family. I was not there as I live about as far away from my Pennsylvanian family as one can get.
In some ways I think my grandmother had a good death. She knew that death was coming, she was of sound mind and could make decisions about what she did and did not want at the end-of-life, and she had two of her daughters-in-law present with her in the final moments singing her favourite hymns. In other ways though, it wasn’t a good death. My family didn’t want to admit that she was dying until the very end and because of that she probably suffered in silence a lot more than she needed to given what we know palliative care can offer.
I called my grandma towards the end of her life. I usually called her once a week and this time I knew that I wanted to say a proper goodbye to her. I asked her how she was doing and she told me that she was trying to get better. She was trying to do the physiotherapy. My father only the day before had said that she could get better if she would just eat. My family kept trying to feed her, unwilling to understand that refusing food is something that happens when someone is dying. After she told me that she was trying to get better, I told her that she didn’t have to, that she had lived a really good life and that it was ok to die. I thanked her for the beautiful friend and grandmother she had been to me over the course of my life. I told her that I would miss her, but I looked forward to seeing her again in Christ. I told her that I would come home after about a month to check-in on my grandfather. She breathed a sigh of relief and candidly asked me to pray that she wouldn’t suffer much longer. In some ways, I felt as though I gave her permission to die. She wanted permission not to hold on any longer and she died a few days later.
Through the research I have done, I am convinced that we need to become more comfortable talking about death. In Dying Well, Swerissen and Duckett (2014) say, “When dying is not discussed and concerns about voluntary euthanasia and assisted dying cloud the debate, the quality of death is poorer” (p11). Death was a part of my life growing up. I remember open casket funerals, saying goodbye to relatives in hospital before they died, and cleaning out people’s homes afterwards. I did all of this with my grandmother because I spent a lot of time with her and she was the executor of quite a few wills. I wasn’t shielded from the realities of death, even when my cousin died of brain cancer when we were both twelve. By being included in the reality of death, I guess I feel more comfortable talking about it now.
What is a good death? According to “Dying Well”, a good death is:
- To know when death is coming, and to understand what can be expected
- To be able to retain control of what happens
- To be afforded dignity and privacy
- To have control over pain relief and other symptom control
- To have choices and control over where death occurs (at home or elsewhere)
- To have access to information and expertise of whatever kind is necessary
- To have access to any spiritual or emotional support required
- To have access to hospice care in any location including home, not only in hospital
- To have control over who is present and who shares the end
- To be able to issue advance directives that ensure wishes are respected
- To have time to say goodbye, and control over other aspects of timing
- To be able to leave when it is time to go, and not to have life prolonged pointlessly
What would it mean for us to talk openly with people in our lives about a good death, to adequately communicate our own wishes, to encourage our loved ones to prepare advanced care directives and to feel comfortable supporting people through those final weeks, days and hours? What would it mean for our churches to become centres of excellence in caring for the dying? What message would that send to our neighbourhoods and our world?
Over the coming months, the Baptist Association will be highlighting resources that help our churches do the things listed above. We hope to capture your stories, encourage good conversations, and equip each other to support people who are dying and their carers. Will you join us? Will you share your expertise? Will you talk to your loved ones about death? Will you advocate for palliative care services in your community?
If you would like to talk about these things further, please contact Kelly Crawford at firstname.lastname@example.org.
Swerissen H. and S. Duckett. 2014. “Dying Well”. Grattan Institute Report No. 2014-10, September 2014.