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. It is about an acceptance of one’s mortality.
For those nearing the end-of-life other issues may come into focus too, 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, uncertainties and regrets exist within a context of physical change; physical change that demands that the person navigates the unfamiliar whilst facing a sense of inevitability. These fears and uncertainties also exist in 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 very reassuring, but there is more to this uniquely personal journey than physiological needs.
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:
These psychological reactions are fundamental to loss, grief, and the process of dying. In my work, however, I am aware that not everyone experiences each of these stages or responses. Nor are these reactions necessarily experienced in the order in which they have been given. Furthermore, the dying person can move back and forth through these stages more than once.
I believe that, as with one’s journey through life, the end-of-life journey is a unique and personal experience. My approach is that the end-of-life journey is an individualised and deep process in which one can be supported to experience a quality and fullness of living, within the limitations faced. It is a time in which precious opportunities should be seized, a sense of the “completion of life” can be experienced, and in which an opening to profound moments is facilitated. It is a journey that allows one to face fear and uncertainty, and through love, acceptance and peace to ease these fears and anxieties. It is about revisiting one’s perception of, and relationship with death. In this way, this journey is about living life in the context of one’s physiological condition, and choosing that which brings meaning, richness and value into this time of life, moment by moment.