There is a famous book on pregnancy and birth that explores what to expect when you are expecting. It details the unfolding physical and emotional landscape that comes with pregnancy and birth. Somehow dying, the other half of the cycle of birth and death, is buried under our social and medical focus on extending life instead of including and welcoming death as equally as we do birth.
Instead of denying, downplaying or simply ignoring these stages and the signs that accompany them, could we expect them, and when they begin, allow ourselves to take (not fight) the opportunity they present for completion on physical, emotional, social and soulful levels? This isn’t about bucket lists, but about honouring the incredible part of life that death and dying is, equal to pregnancy and birth in everything but popularity, and not giving up, but surrendering to the process instead of fighting it off.
So, how do we know when we are entering the cycle of death and dying? What are the signs, what is to be expected and is there anything we need to do?
There is a saying attributed to the military that says: proper prior planning prevents poor performance. Not that death is a performance but it is an event for which we are both planner and performer, and for most of us today responsibility for how and where we die is increasingly relinquished to institutions with results and outcomes that even the caring professionals within them consider to be offering less end of life quality, dignity and care than any of us deserve [Ref 1].
Planning for death and dying isn’t just about putting your affairs in order, this is a valuable part of it, however the lion’s share is in our everyday living and our ability to be aware of what is unfolding in our own bodies as they transition from a cycle of living and enter a cycle of dying.
Noticing and responding to these changes without fear or denial is no different to the pregnant mother honouring the signs and signals in her body along the way to giving birth, making adjustments in her daily life as needed – resting when tired, moving in a way that respects and accommodates the changing physicality of her body, being open to feeling what’s needed.
We don’t need a book on what to expect when we allow ourselves to notice what is happening and accept and appreciate it in a way that lets it be, so we can gracefully surrender and respond without judgement or remorse to what’s being called for: physical aids to support us, adjustments in our daily rhythm and an ever deepening relationship with ourselves and our continued responsibility to live joyfully till our last breath.
It is important to know, as the pregnant woman knows, life goes on alongside the processes of the stages leading to birth and death.
Dying is not about withdrawing from life but adjusting our daily living to keep the body comfortable and supported in life.
This ranges from changes in food and furnishing, rest and toileting, medication and therapies through to daily activity and focus, dependent on the degree to which our body is wearing out and winding down and even, in some cases, becoming ill with an overload of ailments that are part of a deeper discarding that is yet to be once again fully understood, appreciated and embraced.
What is there to expect when it comes to death and dying? Pain? Joy? As with birth, there is no one-way, except for the way that it is for each of us entering the birth canal into the next sphere of life.
Adrienne H., Funeral Director, Australia
- The Cost of Denying Death:
Ken Hillman is Professor of Intensive Care at the University of New South Wales. He is passionate about improving the way dying patients are managed. Speaking from experience, he says while most of us would choose to die at home, increasingly people do so in hospital where the elderly patient is more likely to be over-treated, and face death without much dignity and the Intensive Care Unit has become a place where the frail and soon-to-die are given life-prolonging treatments without the patient’s wishes being taken into account.