Dr Pamela Prince Pyle

Facing Death: How to Plan for Peace

“You can’t plan for all possibilities, but you can possibly plan for most.”

  • Dr. Pamela Prince Pyle

I stepped into the elevator and immediately sensed the tension between the two women who stood with arms crossed, one tapping her foot with an annoying volume. I could feel the weight of words which must have ceased just before the door opened for me to enter. 

On the next floor they rushed past me as we all exited and the foot tapper spoke tersely, “Well I am the one who has been taking care of him and you just…just show up and act like you should be running the show. That is so typical of you. You did the same thing when Mom died and then dropped out of sight for the last year. Oh, and after you took her best jewelry! The only thing good about Dad’s disease is he can’t remember when you come and go and you can’t keep breaking his heart.”

Their voices faded as they turned the corner, however, as I sat down at the nurse’s desk, I could see both of them clearly. The second sister must have been more dominant because she continually jabbed at the toe tapper’s chest as she spoke. From my vantage point I then realized they were standing directly in front of a patient’s room. The door was open. 

I got up to intervene but was relieved to see a nurse coming out of the room and shushing with a finger over her lips. Whatever was said next must have been enough as the women then entered the patient’s room. I don’t know that patient but I was sure hoping he didn’t have the clarity of thought to understand the vitriol shared between the sisters.

Taking Care of Business

I wish I could report to you that these types of interactions are rare in a hospital setting. However, I’ve witnessed arguments between family members over care decisions, end-of-life decisions, and even over finances or the patient’s belongings. It’s a true, but sad fact, that humans don’t stop being human in the midst of someone’s dying journey. 

Medicalized death, is also described as the wild death by Philip Aries in his classic study of death through the ages. Medicalized dying in 1945 led to 40% of deaths occurring in the hospital setting, whereas in 1995, approximately 90% of patients die in the hospital. Often, in the 20th Century patients were not told they had cancer or even that they were dying. The battle cry was we must not have the patient give up hope. 

This transition was rapid and yet, imperceptible. It did have profound effects on the patient experience of dying, the families understanding of death, and the unintended consequences of the unplanned death. 

In this sense, the unplanned death, leaves heavy decision making to the very last moments and while in crisis or in the deep, dark end of grieving which occurs immediately after that final goodbye sigh. It also occurs in elevators, over patient’s beds, and in family consult rooms. I can remember countless times walking up to the consult room to hear arguing on the other side of the door and a tense silence as I shared the patient’s condition who was actively dying. After leaving, the loud voices could be heard again. 

I don’t place judgement on these families who are living out the experience of the unplanned death or the death crippled by chaos and crisis. I just want to help others avoid the deep and harmful stress which can occur when families firmly understand the patient is not sick in the hospital, he or she is dying.

The following are general categories of planning that can occur when one is healthy, when one has been diagnosed, or when one has been given a time stamp. Hopefully, you and those around you will help with them early and not during a crisis when you need them and you need a peaceful energy surrounding you. 

Categories to Consider

  • Healthcare Plan
  • Relational
  • Belongings
  • Key Contacts
  • Financial
  • Insurance
  • Accounts and passwords
  • Subscriptions
  • Digital death
  • Funeral Planning
  • Legacy
  • Life Memories
  • Spiritual
  • Giving Strategy
  • Letters from the Grave

If in reading this, you feel completely overwhelmed, it’s okay. I was too when I first considered all that needed to be done. This can be even more difficult when you are not feeling well. However, starting it in small pieces or having help from a loved will make it a bit easier. What is most important is that you are caring for you and for those you care for in this simple act of love. In the Planning for Peace Checklist, I will be giving you great resources that will make the task more bearable. 

Our future series on What to do When Dying, will be more about your living than you’re dying. I hope you are ready!

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