FACING THE END-OF-LIFE
Turning to face the end of one’s life, whether this is imminent or a focus of one’s contemplation, raises several challenges. These challenges are a complex mix of one’s thoughts and emotions, relationships with others, spiritual philosophy, physiological well-being, as well as practical considerations. Turning to face the end of one’s life is the beginning of a journey; a journey that is as much a part of life as one’s birth, and a journey that is as natural as the cycles of the seasons. As human beings, however, our sense of self, and our ability to reflect on our own mortality and circumstances, makes this journey difficult.
Reflecting on the dying process can highlight personal fears and anxieties, some of which may involve uncertainty around what happens as one nears the end-of-life. The process of dying, which we will all face one day, can best be nourished through self-preparation, self-exploration and through a personal understanding of what death means. Ultimately, It is about an acceptance of one’s mortality.
For those nearing the end-of-life, many issues may come into focus; issues such as a sense of not having said all that needs to be said to a loved one, an unfulfilled ambition or a personal regret. For the dying, fears and uncertainties, regrets and concerns exist within a context of physical change; physical change that demands the navigation of the unfamiliar, whilst facing an ongoing sense of inevitability. Many of these fears and uncertainties are influenced by one’s beliefs, such as beliefs surrounding one’s ability to cope or the level of support available. They also exist within the context of one’s spiritual or religious beliefs.
In the West, medical protocol is geared towards saving lives rather than enabling people to die well. When needed, however, medical advances do ensure that pain and overwhelming suffering can be alleviated when nearing the end-of-life. This is of real comfort and is very reassuring, but there is more to this uniquely personal and complex journey.
The late Dr Elisabeth Kubler-Ross is a world-renowned psychiatrist who, in 1999, was named by Time magazine as one of the “100 Most Important Thinkers” of the past century. Kubler-Ross theorised that those who are dying potentially experience five psychological stages of loss and grief. These stages are: