Thoughts on Compassion and the Dying

I’ve been giving a great deal of thought to death, and the process of dying, recently. Not in any sort of morbid, depressing way, but because death is, quite basically, a part of life –  and as we age, as our families and friends age, and as disease strikes, we are often left floundering when confronted with the inevitability of death. We don’t know what to say, what to do. Quite simply we don’t know how we are supposed to act.

Those of you that read my blog semi-regularly know that my, still mentally alert, nonagenarian mother-in-law passed away last year, after a year of her body slowly failing. We all knew the end was coming, and she had long accepted it (welcomed it, even). Time spent with her in the last year, and also in the preceding years, was primarily for sharing happy memories and sharing our lives and those of our children (and in some cases, their children). Although not a terminal illness, the realities of living to a very old age allowed for mentally preparing for what would come – and it allowed us all to enjoy the time we had left together.

Age combined with natural causes is ‘normal’ – on some level all of us realize that our time is finite – our bodies will eventually give out. There are even theories that we all have our own unique, genetic, ‘expiration dates’, as it were, even though we do not know how to decode them. But terminal illnesses, especially when they strike well before advanced old age, are far more complicated for us to process. With three recent cancer-related deaths of friends – one my age, one younger, one older – I’ve been doing a bit of processing myself.

In her groundbreaking 1969 book, On Death and Dying, Elisabeth Kübler-Ross first laid out the 5 Stages of Grief. She posited that people commonly experienced most of these stages when confronted by a terminal diagnosis – denial, anger, bargaining, depression, acceptance. This process is now widely accepted to also be experienced by those coping with the loss of a loved one, or other types of grief. And we do begin the grieving process with the diagnosis that the end is near. Although part of our own grieving may be the hunt for the often elusive ‘closure’.

The concept of closure, from an overly-broad psychological perspective, is defined by the degree to which an individual avoids ambiguity and needs well-defined – and clear – outcomes. There is even a scale used to determine an individual’s need for cognitive closure. In recent years, however, there has been a ‘pop psychology’ type of belief which promotes closure as something that is needed, and to be expected, when endings come. Always. But perhaps it shouldn’t always be. I was surprised several years ago when a coworker’s spouse unexpectedly died during a chemotherapy session, and he mentioned to me when he returned to work that it was the lack of closure that he was having trouble dealing with – the things left unsettled and unsaid. And I understood, sudden death is always very hard – we are never prepared – but what surprised me was that he contrasted that with the death of his nonagenarian father. His father had slowly ebbed away over a two week period, and during that time, my coworker felt that he was able to resolve things with his father, and in that respect he was ready to accept his death. That notion always disturbed me a bit – surely the compassionate thing to do is not to look for resolutions to your own inner issues from someone grappling with the far more traumatic knowledge of their own imminent demise? I recognize that part of coming to terms with imminent death for some people may be by seeking closure with those closest to them, but that decision should be theirs to make.

Shortly before my third friend was diagnosed (his was a late diagnosis and a very rapid decline), I came across an article on Next Avenue that discussed the same subject with much the same conclusion – it is better to appreciate the bonds that tie you together and love that you share, than to try to clear any historical grievances. Few people really achieve the magical clearing of the air that they are looking for, and really, isn’t the important part trying to ease the worry that the one that is dying has for those about to be left behind? My own experience has been that telling stories when they are unable to talk much, letting them direct the conversation when they are, is a much better, and kinder thing to do. Saying a final good-by is never easy, but when we have the opportunity, we should use it selflessly.

“The reality is that you will grieve forever. You will not ‘get over’ the loss of a loved one; you will learn to live with it. You will heal and you will rebuild yourself around the loss you have suffered. You will be whole again but you will never be the same. Nor should you be the same nor would you want to.”
― Elisabeth Kübler-Ross

 

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6 thoughts on “Thoughts on Compassion and the Dying”

  1. Thank you, Yvonne. Yes, I think that on some level we think closure will help either postpone the loss or help with the grieving – but it will do neither. Grief is a very complex, individual, process. And in order to move past our own pain we need to embrace it first

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  2. Sorry for your losses Carol; it’s hard to face so many deaths in such a short time. My family has had similar this year, losing a 96 year old aunt and a cousin my age. Like your mother-in-law, my aunt was ready to go and was in a lot of pain in the last few weeks, so I felt relief more than anything when she died.

    But it’s rare to feel like that, and you thoughts about closure are very interesting. I can definitely see what you mean. Even when closure is needed for those left behind, I’m not sure that it necessarily needs to come while the person is alive. It is most likely that feelings – perhaps of guilt or anger or shock – are what need to be released and that can happen long after a loved one has died. (Or people might hold onto those feelings even if they’d had “closure” with the person who is dying.)

    My own experience is that closure in the sense you describe does not necessarily make the loss of a loved one easier. My father died of cancer and though we knew he hadn’t long left, in the end his death came suddenly, months before expected. In the weeks before he died, I had many beautiful conversations with him, on a far deeper level than we’d mostly had before. Sometimes he brought up feelings of guilt for how he’d parented when my sisters and I were children, and I helped him let go of that guilt and to see that he’d more than made up for any hurt he’d caused. All I felt for him when he died was deep, deep love – and I still grieved deeply. I was, and am, hugely grateful for the conversations we had, and yet they did not stop the pain I felt. What did was allowing the emotions and also allowing them to go, as well as being compassionate with myself when I realised I was holding onto suffering. I think perhaps in seeking “closure” we are trying to avoid the pain of losing a loved one, when perhaps it makes more sense to embrace it, and in that embracing we can find something much deeper than loss.

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