You cannot imagine worse than the illness which has brought you great suffering. Pain, shortness of breath, nausea, vomiting, weakness, oh, the weakness, have made you feel a shell of the self you once knew. You have had endless nights of sleeplessness waiting on the next doctor’s report. Worry accompanies your days and fear accompanies your nights. You can’t imagine surviving the fear of your own death.
You are not alone and you matter here.
So often when we think about fear of death, when we identify our fears, it is fear of the dying process which can consume us. In my previous article, I discussed common fears and asked you to specifically identify which of those fears you were experiencing. We will discuss those associated with the dying process first.
The sensation of pain is a functional part of the human body. It serves to warn us of potential danger (a hand on a hot stove creates pain that results in a reflex reaction to withdraw) or internal dysfunction (abdominal pain due to gallbladder infection) are two examples.
However, pain associated with certain diseases can result from dysregulation of pain signals (neuropathy), tissue destruction (cancer), or dysfunction (irritable bowel syndrome). Management of pain control targets the specific cause.
With the advent of pain management specialties, the tools for pain control are greater in variety and effectiveness. However, palliative and hospice care’s primary focus in advanced disease is management of symptoms. This allows clinicians to work with the patient to provide that which is most needed.
I highly recommend reviewing the Planning for Peace Checklist which will guide you to definitions and resources for end-of-life care including an Advanced Care Plan Guide. Your wishes for symptom management can be delineated in this document as well as your healthcare providers.
If you have received a serious or terminal diagnosis you undoubtedly have been living with emotional pain. Each step in a patient’s emotional journey of processing his or her own mortality is as unique as the individual.
Emotional pain can originate from Anticipatory Grief, regrets, sense of loss, burden for those left behind, anxiety, concerns about loss of human dignity, and loneliness. The longer we carry emotional pain, we become better equipped to adapt and also find positive emotions to balance the negative.
Fear of emotional pain in the dying process can be mitigated by acknowledgement of what you have already been through. There is a training ground that you have already begun to navigate. Additionally, addressing your fears and emotions as they occur and processing with others you can create a plan to address them.
For example, burden for those left behind can be relieved or at least lessened by completing your Planning for Peace Checklist. Loneliness may be helped by identifying an end-of-life doula or faith group that cares for those who may not have surviving family or friends.
Studies have also revealed that treating “dying” as a distinct process from the underlying terminal illness is important for healthy death awareness. Another study reported, “Awareness of Dying led to a focus on living well with advanced cancer and movement towards living a life rather than living an illness.”
Regrets or fears of not having lived a meaningful life can creep into your thoughts more than any other time of life. May I first encourage you with the truth that every single life has meaning in the eyes of God.
Terrible circumstances, wrong choices, failed potential, and missed opportunities may consume our thoughts if we allow them. Personally, I understand deeply as I remember each of my missteps in life more than I remember my successes.
However, a simple practice that I began a few years ago is keeping a list of all the good circumstances, right choices, realized potential, and discovered opportunities that occur to remind myself of the right steps that I had. I also write down the truths of the Bible of how God sees me and considers me in light of the saving work of Jesus Christ.
I am a sinner saved by grace and that awareness seeps into my soul to comfort me with the knowledge that my life has rich meaning to the one who gave His life for mine.
You can begin your list of the positive now and if you struggle with finding that in the midst of shame and regret, pray for God to reveal himself to you and that faith would give you the peace you seek. I am praying for you as well because you matter here!
After three decades of medical practice, I have been extraordinarily moved by the resilience of the human spirit as death approaches. This is especially true for the one who begins to anticipate heaven and the end of their earthly journey. Hope returns in new ways and a confidence in a different destination becomes evident.
While many of the fears that you may be feeling about dying can be helped with planning, creating a support system, hospice care, and spiritual support. It is fear of the unknown which can leave you with a sense of uneasiness. “You don’t know what you don’t know” can make you lie awake at night.
A good approach is open and active dialogue with the professionals caring for you, those who love you, and those who may be walking their own dying journey. However, the best approach is seeking to discover what you believe about the moment that occurs after your final breath. Our final article in this series about fear will focus on a beautiful promise.
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