How to Avoid Spiritual Anguish in Our Dying Days
Preparing for a Good End

How to Avoid Spiritual Anguish in Our Dying Days

Preparing for death can be a profoundly healing journey.
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R.N.
July 27, 2023
Updated:
January 22, 2024
0:00
This is part 1 in Preparing for a Good End

In this series, we’ll examine ways of making meaning in the face of death, offering tools founded in traditional wisdom and scientific evidence to help our readers live well right to the very end.

According to palliative care experts, preparing for death can be a profoundly healing journey.

There’s a problem with death—it causes despair and suffering. In our modern culture devoid of traditions, death has been dehumanized. We’ve lost the art of dying well, knowledge passed down from family to family just a few generations ago.

Today, 80 percent of Americans die in medical institutions, such as hospitals or nursing homes, when most hoped to spend their final days at home. When our loved ones die, we leave their bodies in the hands of professionals—nurses, morticians, and coroners—unlike our ancestors, who considered death care to be a sacred honor.
Modern medicine has lengthened our lifespan, but some experts say the side effects have been spiritually deadly. We fear death, ignore it, choose overtreatment for incurable illnesses, and find ourselves surprised and unprepared when death comes knocking.
No wonder more people want to rediscover meaning at the end of life.
“We find ourselves in an era of frequent and normalized overtreatment of the very old and very ill. This overtreatment contributes to frailty and debility, which leads to the institutionalization of those unfortunates to lay and wait for death to come,” palliative care expert Rebecca Gagne-Henderson wrote in her forthright blog, The Palliative Provocateur.
Dr. Gagne-Henderson and many other palliative care experts argue that preparing for one’s inevitable death—rather than simply waiting for it—helps clarify what brings meaning to your life now and to your death later. It enables you to face fears and regrets, guiding you to uncover ignored hopes and forgotten dreams. It even opens hope of reconciliation with loved ones before you die.
Preparing for death—even when young—helps you live and die well.

What Is Dying Well?

A good death—a common oxymoron among palliative care teams—is more about living well during your final days than merely addressing physical pain.

“The spiritual side of dying is much more important than the physical side,” Dr. Gagne-Henderson told The Epoch Times.

After serving dying patients for 27 years, she’s well acquainted with death.

Dr. Gagne-Henderson is a provocative voice among palliative care experts and is the executive director of the Connecticut Hospice and Palliative Care Organization.

“Making meaning by addressing spiritual distress will bring more peace than morphine. You can live with pain if you have meaning,” she said, arguing that unresolved spiritual distress at the end of life is vastly more painful than physical anguish.

The term “spiritual” doesn’t have to relate to a religion or faith. Spiritual distress includes turmoil such as broken relationships, the fear of death, and leaving behind a loved one or unfinished life work.

Victor Frankl made a similar argument in his classic book, “Man’s Search for Meaning.” In Nazi prisoner camps, Dr. Frankl developed profound theories from observing which prisoners were determined to survive and which lost their will to live.

He wrote: “A man who becomes conscious of the responsibility he bears toward a human being who affectionately waits for him, or to an unfinished work, will never be able to throw away his life. He knows the ‘why’ for his existence, and will be able to bear almost any ‘how.’”

In terms of end-of-life patients, Dr. Gagne-Henderson calls this a sense of coherence, a concept first coined by Israeli American sociologist Aaron Antonovsky. According to Antonovsky’s theory, a sense of coherence is a state of inner peace when one feels his or her life is “comprehensible, manageable, and meaningful.” As Dr. Gagne-Henderson explained in her doctoral thesis, without these three components, an end-of-life patient experiences a “devolving sense of coherence,” causing suffering to feel only senseless, overwhelming, and hopeless.
“In my opinion, that devolving sense of coherence is what leads to existential suffering, terminal agitation, delirium, and ‘bad deaths.’ If we could each face our existential issues and accept our physical mortality—which I call a sweet surrender—that’s how you die well. And, if you don’t do those things, I can almost guarantee that you’re not going to die well,” she said.

Finding Meaning: An Individual Journey

Dr. Dan Morhaim, an emergency and internal medicine physician with more than 40 years of front-line clinical experience, said he believes that people can make meaning and build coherence in their dying days.

In his book “Preparing for a Better End,” he wrote: “We are different from all other generations that preceded us in one important respect: we can influence how that destiny unfolds. That gives us new responsibility and also new power.”

Dr. Morhaim said we can find a balance between seeking advanced medical treatment and preparing for our death with acceptance. By “making the best of both worlds,” as he terms it, we powerfully influence how our destiny unfolds in ways former generations couldn’t.

Many end-of-life experts and philosophers agree that we have a unique, even sacred ability to affect how we die. It’s possible to find and make meaning in the face of death.

Making Preparations for a Good Death

But how, you ask? What’s meaning at the end of life, and how does one find it?

Palliative experts agree that meaning is unique to every dying patient, and it’s often discovered in preparing for death, whether one is healthy or on the brink of his or her final days.

According to Mr. Frankl, we find meaning in the practical tasks of suffering rather than in “sweeping statements” about the meaning of life.

“Our answer must consist not in talk and meditation, but in right action and in right conduct. ‘Life’ does not mean something vague, but something very real and concrete, just as life’s tasks are also very real and concrete. They form man’s destiny, which is different and unique for each individual,” he wrote.

Talk about death to avoid needless suffering.