Friday, 23 November 2018

Preparing to Live or Die: Coping with Loss During the Holidays

From the moment we emerge from the womb, we are on a trajectory toward the inevitable ending of this incarnation. It is a thought most would prefer to avoid considering. Humans are hardwired toward self-preservation and we are inclined to do all we can to remain animated. Even those whose health habits don’t lend themselves toward vitality — call it addiction or denial — would say that reflection of premature death frightens them.

Today, I was strolling the aisles of a local dollar store in search of an ice scraper, since we are experiencing the first snowfall of the season here in the Philadelphia area and I couldn’t easily find one that I used last year, when I had an almost knock-me-over-with-a-feather thought. It had to do with the idea that if someone is facing a serious illness with various treatment possibilities, they are uncertain if they are preparing to live or die.

When given the choice between quality or duration, what might you choose? For me it is no-brainer. In this moment, I would elect quality of life over calendar days. I attribute some of that to having faced potential death four and half years ago following a heart attack at age 55. Now, at 60, I engage in mostly healthy habits designed to remain on this side of the veil. Although I don’t want to hasten my death, I don’t fear it either. My spiritual beliefs tell me that love awaits on the Other Side.

What triggered the mental meandering was the sight of holiday decorations that filled the shelves. This time of year is challenging for many because it reminds them of lives lost, either at that time around the winter holidays or more intensely missing their loved ones even if they died on other days. That empty chair at the table will forever be unoccupied. I am in both categories. My husband died on 12/21/98 and had entered the hospital in a coma on 11/11/98. We spent Thanksgiving, Hanukkah and the Winter Solstice together in the ICU. By the time Christmas arrived, he was gone.

My mother died the day after Thanksgiving 11/26/10. The last holiday I spent with her was Halloween; one of the many times when I trekked down to Florida to visit her while she was in hospice. In both cases (as well as the death of my father on 4/3/08), I found myself in that betwixt and between state of wondering if each day was the one when they would breathe their last. My psyche and heart were toggling back and forth between holding out hope that their life expectancy would extend beyond medical prognosis, knowing that I had no control over the outcome in any case and the day would come when I would say the final farewell. I needed to love them as fully as I could and prepare to let them go. Tough stuff.

A dear friend whose beloved partner died three years ago, finds herself still in the paradox of having prepared as best she could for his death, while knowing she was not prepared to live without him. Is she functioning well? It seems so. At 85, she still works in her chosen fields of counseling, speaking, writing and ministry. She has family and friends with whom she spends time. She loves her two black cats, Della and Daisy. I wonder how she did the prep work that had her seeming so resilient now. She likes to say that overcoming is not the same as getting over the death of a loved one.

One thing I am grateful for is that my parents raised me to be able to live without them. I miss their physical presence each day, but feel them with me, often hear their voices, and they sometimes come to me in dreams.

My questioning extends beyond that to an even deeper dive. If someone is teetering on the edge with a life challenging diagnosis…perhaps they will live longer than expected or die sooner than anticipated, how do you wrap your mind around that reality? Is it possible to prepare for their eventual passing by remaining in the “just don’t know”? I have come to understand that everyone is on loan to us, so I appreciate each precious moment in my own life and with those close to me.  

Anticipatory grief as expressed in a recently published article called The Roller Coaster Ride of Grief, is a term describing the process that a person undergoes before a loss actually occurs. They may wonder how their lives will unfold without the loved one physically present. They could find themselves crying spontaneously, as well as exhibiting other signs such as poor sleep and appetite, isolation and lack of motivation to engage in daily activities. They may (as I tend to do) compartmentalize; holding fast to the need to function, so that feelings are relegated to a shelf where they can sit until the person is able to face them. They are beginning to relinquish the role of caregiver in place of bereaved parent, child, partner, friend or other extended family member. When in the anticipatory grief experience it is important to feel whatever might arise.

A tool kit of comfort might include:

  • Say what you need to say to this person so that you have no loose ends afterward.
  • Provide needed self-care.
  • Allow for a full range of emotions.
  • Read books on grief and loss.
  • Seek support.
  • If you have a spiritual practice, engage in it.
  • Write about your feelings.
  • Ask the person what they want at the end of their life.
  • Be as fully present to them as possible.
  • Engage in life as fully as possible, rather than detach from it.
  • Learn to create a “new normal”, since what passed as normalcy is no longer.
  • Be kind to yourself as you navigate what might feel like unfamiliar waters.

“For what is it to die but to stand naked in the wind and to melt into the sun?
And what is it to cease breathing, but to free the breath from its restless tides, that it may rise and expand and seek God unencumbered?

Only when you drink from the river of silence shall you indeed sing.
And when you have reached the mountain top, then you shall begin to climb.
And when the earth shall claim your limbs, then shall you truly dance.”

From “On Death” by Kahlil Gibran



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