End-of-Life Choice, Palliative Care and Counseling

Posts Tagged ‘Conversation’

Jan 22, 2010The *D* Word

In most published remembrances, loved ones dance around death — but does that really help anyone?
By Carlos Alcalá
The Sacramento Bee

Death is hard to find in death notices.

This is the time of year – January and February – when death rates are generally highest, according to the National Vital Statistics System.
The Bee and other newspapers tend to run more paid death notices at this time of year, too.

If you read those notices carefully, however, you’ll find many people in them didn’t exactly die.

Most of them “passed away.”

Some “entered into rest.” Others “left the world in God’s hands.”

In a few cases, there isn’t even a verb, only a date and location to indicate the death.

“Death is hard to deal with,” said University of California, Berkeley, linguist Geoffrey Nunberg, explaining why people avoid the four-letter word that starts with ‘d’ – died.

“This is one reality that’s hard to face head-on,” he said. “It happens in the Bible; it happened in Homer.”

Take Genesis: “Abraham gave up the ghost … and was gathered unto his people.”

It happens in the newspaper, too. A lot.

Bill Gaylord is a regular reader of The Bee’s “Remembrances.” That’s because of his age, which he described as “beyond four score.”

Gaylord joked, as George Burns once did, that he scans the notices and, if he isn’t in there, he shaves.

That’s how he noticed the variety of phrases.

“Over the years, I have realized that a fair number of people composing death notices for their loved ones avoid the simple statements of fact,” he said.

He started collecting phrases in The Bee’s paid death notices. They are submitted by survivors or funeral homes, as opposed to news obituaries, which are written by reporters.

In a few short months, Gaylord came up with more than 150 different ways to say a loved one died, fewer than 10 of which used the word “died.”

Among his more elaborate finds:

“At peace and sailing into the sunset.”

“Arrived on his last flight – as he called this final journey.”

“Left us to become an angel in heaven.”

“Slipped away quietly.”

And … “Went on to be with her well-known master, Jesus, where her husband of 57 years was waiting for her arrival. As he took her by the hand and led her up those golden stairs and through those pearly gates he might have said, ‘What took you so long?’ ”

The newspaper representatives who take the ads say they generally use “passed away.” The fancier phrases come from family members, not funeral homes.

When Alvin Joseph Broussard died from cancer in May, his family chose to say he “moved further north to live with his Heavenly father.”

“We believe he is alive and well, just different,” said his son, Joel Broussard.
By “north,” they meant heaven, he said.

Broussard’s family also said he was “fully restored.”

They believe, Joel Broussard said, that death restores the person to his perfect self, not the body that had been damaged by time or disease.

This is not an approach taught in the funeral services program at American River College, according to coordinator Jeffrey W. Stephenson.
“People really need to hear the words ‘dead’ and ‘death,’ ” he said, explaining that it’s a needed part of the mourning process.

Students in classes on the psychology of death and dying hear that, and it’s also conveyed in Funeral Directing 1, during which instructors discuss death notices, Stephenson said.

He prefers to use “died” when preparing an obituary but will change it at the family’s request.

Bea Toney Bailey also prefers a more direct approach to death, which she discusses on “Bea on Bereavement,” her local cable show sponsored by the Interfaith Service Bureau, at 9 p.m. Mondays on Comcast and SureWest.

“We’re a very young culture, and we’re very youth-oriented,” Bailey said.

Death makes us uncomfortable. “If we talk about death,” she said, “we might die.”

So people hedge.

“They say anything except, ‘Hey, they died.’ ”

Beyond death notices, people have developed a lot of slang for death – “kicked the bucket,” “popped their clogs,” “bit the dust.”

It isn’t just death, though. Other unpleasant and pleasant bodily functions – sex, aging, vomiting, defecation – also generate lots of euphemisms, Nunberg said.

Though she is a Christian, the daughter of a minister, Bailey doesn’t think those circumlocutions – roundabout ways of avoiding the point – are helpful to those who are grieving.

It means they are avoiding the reality, she said, but it also doesn’t help anyone to say, “Snap out of it! He’s gone!”

That only serves to alleviate the discomfort of the person who says it, not the mourner, Bailey said.

She also thinks people should prepare their obituaries ahead of time – as a favor to their families.

“Mine’s already done,” she said.

Although she says she favors the direct approach, what she’s written is not blunt.

It opens with no equivocation: “If you’re reading this document, it means I’m no longer with you.”

It continues, however, with one of those indirect phrases: “I’ve gone on to be with the Lord.”

Avoiding the ‘D’ word

People use many phrases to express death in death notices. Here are a few more examples collected by Bill Gaylord:
• Absent from the body – present with the Lord
• He was called home.

• As God swept His hand across the earth, He took his angel home.

• Fell asleep in the Lord
• Crossed over

• His spirit soars off to a new adventure.

• Joined his wife

• Left us suddenly

• Passed over to his reward

• Returned home

• Went to sleep peacefully

• Budded on earth, blossomed in heaven

• Taken away from us

Those looking for more information on death, dying and bereavement may want to look at Bea Bailey’s Web site, farewellmyfriend.net.

Elizabeth Kubler-Ross’ 1969 book “On Death and Dying” is still considered a classic in the field, and most bookstores will have a section of titles on mortality issues.

Aug 17, 2009Hello! We are Mortal! Grow Up and Plan Accordingly!

The Senate Finance Committee may strike end-of-life consultation reimbursement from their version of the health care bill, so maybe the hysteria will die down. But it’s sure to rise again if the provision survives in the House version. Will Congressional leaders summon the courage to deliver an adult response or cave in to hysterical attacks?

It’s remarkable how easy it’s been to gin up a frenzy of fear and anger with scary messages that remind people death is inevitable. Most politicians say they support advance directives for end-of-life planning and encourage their use. At least they did until a few days ago. That’s when the idea took hold that it’s highly dangerous and tyrannical to encourage doctors to talk with patients about what kind of treatments they would want if they were terminally ill and unable to speak for themselves. That’s why the provision to reimburse doctors for the consultation can’t be part of health insurance reform. Apparently this would be the first step to a Nazi regime, where doctors somehow profit from euthanizing their paying patients and panels meet to decree the death of granny and disabled children.

The national dialogue leaped from modest proposal to outrageous hyperbole so fast it’s clear something profound and quite apart from advance directive consultation was at work. International professionals in end-of-life counseling joke that in America people think death is optional. It certainly seems true, to judge by the public’s tantrum after being reminded it ain’t so.

Hello America! We are all mortal! It’s our fate. Adults know this in their hearts and the wisest among us live every day conscious of life’s impermanence. A mature society would have handled this differently.

One of my favorite poets, Edna St. Vincent Millay, wrote, “Childhood is the kingdom where no one ever dies.” Apparently that’s the fantasy some of our national leaders want to promote. “Terry Schiavo will be kept alive even if it takes an Act of Congress!” “No one need ever discuss with their doctors how their life might end.” Such attitudes treat American citizens like children, too young to come to terms with their own mortality. Why should we be surprised to see town hall displays of childlike temper tantrums? Treat people like children and they will act like children.

Playing into America’s pathological denial of death is to treat mature individuals like children, and very young children at that. Researchers and clinicians tell us it’s normal for children 3 to 5 years old to deny death is final. Telling a very young child Granny is “asleep” or “on a long journey” supports the denial. Between five and nine years old children come to accept that death is final, and can think about it’s happening to others. By about age ten a child is usually ready to start thinking about her own death.

National leaders deliberately sparked fear and anger over a consultation about death and sensational media threw fuel on the fire. They would have us remain a nation of five year olds, stuck in an infantile refusal to acknowledge, grieve over, and plan for, our own deaths or the deaths of those we love. For shame. Certainly that’s no way to come into our greatness as a nation. Certainly such stunted psychological and spiritual development is not what it means to be a human, created, as many believe, in God’s image.

No, coming into the fullness of being means living a life of thoughtful judgment and conscious decisions. And that includes decisions about the end of life. Recently the New York Times carried a story of the care and intention with which the Sisters of St. Joseph manage the individual deaths of their aged nuns as the entire order gradually dies out. They are thinking about their dying and they are talking about their decisions. “We approach our living and our dying in the same way, with discernment,” Sister Mary Lou Mitchell told the reporter. “Maybe this is one of the messages we can send to society, by modeling it.”

In Adulthood — a kingdom still distant from our shores — leaders will foster dialogue and pass laws to help their constituents on that very human quest to discern and embrace both life’s sweetness and death’s certainty with a similar quiet grace.