(c) 2003    Dying Awake

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Please also see My Name As A Prayer.

What does it mean to die awake? How can we pass from this world knowing who we are and where we are?

The wonderful thing about dying these days is we actually have choices. Remarkable. There is no right way and wrong way to die: only death as it comes to each of us. But there are choices to be made: lawyers and financial folks advise us to pick a legal power of attorney and a medical power of attorney and decide how we hope to go. And so, it is good to look at those choices.

Most people--92 percent (reported in JAMA, Nov. 2001) said they want to die mentally aware. And 89 percent said they wanted to be "at peace with God" when they die.

How do you die awake, mentally aware? How do we address the spiritual care of the dying?

Many if not most members of the medical and hospice community (I invite someone to prove me wrong) consider it a passionate act to keep a patient constantly under the influence of morphene and nerve-relaxers. It is called "palliative sedation."

Well-meaning nurses approach a dying patient and administer morphene round-the-clock even if the person is not in pain. "

WHAT DO YOU SEE IN THE DYING PERSON?

What astounds me is that when a person is dying, everyone who looks at them sees what they want to see. Perhaps the most useful exercise between family members who are dealing with the impending death of a loved one is to regularly ask each other, "When you look at her, what do you see?"

When my mother was dying, I saw a courageous woman who had never taken sedatives or pain killers or nerve relaxers and who wanted to die drug-free in her own apartment without medical intervention. She had said as much to me. She apparently did not say these things to the family members who had power of attorney.

Both the Hospice workers and the family member with power of attorney saw a very sick woman who needed to be in a nursing home and needed to be sedated for her "agitation." Agitation is a term that calls out for further investigation.

ADVANCE DIRECTIVES FOR A CONSCIOUS DEATH

You signed the advance directives and figure the decisions are finalized, right? Well, not exactly. There are still a number of fine choices to be made.

For instance, oxygen is considered a "comfort measure" for many folks in the medical community. They will continue giving oxygen to a patient who is hours from death on the grounds that it is the compassionate thing to do. But it clearly prolongs death.

We need an advance directive form for those who wish to die consciously. I am in the process of developing this. If you have ideas or wish to know more, please email me.

What does it mean to have a good death?

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Dying Awake, developing the means to die consciously, knowing who you are and where you are.
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