According to an Institute of Medicine report, a good death is:
“Free from avoidable distress and suffering for patient, family and caregivers, in general accord with the patient’s and family’s wishes, and reasonably consistent with clinical, cultural and ethical standards.”
According to the research findings in April 2016 of American Journal of Geriatric Psychiatry, by Dr Dilip Jeste, showed that the categories considered most important were: preferences for a specific dying process, being pain-free and emotional well being. However, there were certain discrepancies between the patient, the caregivers and healthcare professionals. Spiritual and religion were deemed more important by the patients than family member. If you are interested to find out more, this is a link to the research performed.
During the covid 19 panademic, I have heard stories on how it was difficult to allow all the families to visit when the patient is dying in the hospital due to the fear of spreading the virus. If the patient has contracted the covid-19 virus and passed on, the funeral was also held in haste and with restrictions in the effort to reduce infection. Even right now when I am writing, there are restrictions to the number of visitors that can visit each patient in the hospital in order to reduce the spread of the infections.
I was also recently being asked this question : what is a good death? Each individual defines a good death differently. For me, It is having families around me. Even if I am dying on the bed, I hope to have my family gather around me. I too would like to say goodbyes to the friends and family before I pass on. As I recalled my ex-colleagues keeping their illness a secret and both have passed on, my regret was that I only managed to attend their funeral, my lack of opportunity to say good byes to them. One of my friend who was very close to one of this ex-colleague expressed hurt and disappointment. She was kept in the dark. She struggled with self doubt on her friendship with this friend.
Questions that came to her:
Am I not close enough for her to share her struggles?
Have I been too busy for her?
Why even when I asked her about her chronic cough, she did not at least share some concerns with me?
I too pondered. If I was having a short prognosis (less than a year to live), would I have the time to share my diagnosis with everyone? Surely, I would also like to reserve time for my closest family and friends. Maybe there are many issues, reconciliation to be made, LPA, WILL to be established. Even in the midst of trying to go for chemotherapy (if cancer) and adjusting to the side effects of the therapy, lethargy, nausea and other symptoms, would I have the strength to meet up with my friends and tell them my struggles? Or should I conserve my energy so that I can fulfil all the things I want to do before I leave this earth? What about my attitude towards the diagnosis? Maybe there is denial, anger and other emotions that needed to be dealt with. Certainly, there is no right or wrong answer.
For some, it could be a good death because they have family with them when they passed on. They have achieved their To-do list. They are at peace.
However, for those who are left behind, those who do not know of the diagnosis, they may struggle with the guilt and also questions on how the friend or family member has passed on without saying goodbye. There were also no closure.
Though we cannot choose how and when we are dying, but with the diagnosis of an illness with the exception of sudden death or acute accidents that leave the person without mental capacity, there may still be time, however short it may be. My wish is that the reconciliation in my life will be completed by then.
I would be able to say: ”Please forgive me”, “I forgive you”, “Thank you for everything” and “I love you”. I also hope to say my goodbyes to those who has made a diffierence in my life, in different seasons of my life. I hope that when I do so, I would not looked too ugly or haggard to say goodbye to all of them.
With all these thoughts, I feel that it is never too early to think about what is a good death. If there are unforgiveness and conflict in your life, do not wait till your deathbed to resolve. The time is NOW. Let us not procrastinate further. Let us not live in regrets.
Let us be Thriving.
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