death and dying

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Why Is Everyone So Afraid of Flowers? Some Unmorbid Thoughts on Death.

A strange thing happened today. As I was moving three floral arrangements around the campus of the retirement community where I work, several people told me not to leave them where I intended. The flowers were cheerful, aromatic, and gorgeously arranged so it was strange to me that no one wanted them. When I asked what the rejection was about, the message was clear every time. “They are funeral flowers!”

Well, yes. They are. They were delivered to our campus for the memorial of a beloved resident who died. Her daughters asked if I would take them from our chapel — which isn’t used much during the week — to locations in the main lobby, skilled nursing, and assisted living units. They wanted the residents to enjoy the beautiful arrangements made in honor of their beautiful mother. What a lovely idea and kind gesture. Or so I thought.

funeral flowers

I was busy catching up on emails and admin tasks when my colleague Brad arrived for the day. He said, “What is your plan for the flowers in the rotunda?” To which I replied that the rotunda was my plan, as it gets a lot of traffic and more people would see the flowers there. He then told me the sales director wanted them moved ASAP because funeral flowers don’t send the right message when someone walks in our doors for a tour.

As a side note: our company’s new motto is Live with Promise. We recently rebranded and took away the word “retirement” from our community, replacing it with the word “living.” Apparently the word retirement carries the stigma of being put away, and a retirement community is a place you go to die. So now we only live.

I got a handcart for the other two arrangements and pushed them across the campus toward our skilled nursing and assisted living units. As I got off the elevator for assisted living, one of the staff asked hostilely, “Where are you going with those?” I told her I was going to place them in the lobby to be enjoyed by the residents and guests. She told me I wasn’t going to do that because the residents don’t like them. Though I’m not sure if she was really speaking for the residents or for herself, she said they don’t like to be reminded about death. I tried to engage her in conversation about this, but she deflected, so we compromised about the flowers. She would take the arrangement to her office, dismantle it, and make new, smaller arrangements that wouldn’t scream funeral!

Later, I ate lunch on the screened patio by the pool. (It’s one of the few public places where employees can eat their lunch.) As I took my seat, I noticed that the large arrangement from the rotunda had been moved to the porch. Now it was in a place where maybe 20 people would see it in a day, and with the Florida humidity, the flowers will wilt by tomorrow. A coworker came out to join me for lunch and hesitated as she approached my table. Looking at the blooms behind me, she said, “I don’t know if I can eat here. I don’t like seeing those flowers.” This staff person has worked at our retirement community for over a decade.

I have to remind myself that not everyone has had as much exposure to dying and death as I have as a pastor and chaplain. And I need to remember that even those who work regularly with the dying, like medical professionals, are often uncomfortable and superstitious around death. And I know that talking about death and even thinking about death makes many people uncomfortable. So I’ll try to moderate myself a bit as I write on…

Today’s experiences with the flowers reminded me just how guarded our culture is about death. Maybe shrouded is a better word than guarded. It’s like we are trying to put curtains up between us and the reality of death. As though a flimsy sheet could erase the reality altogether. This guarding happens even in places like retirement communities and hospitals where death is frequent.

Frankly, if my career has taught me anything, it’s that death is much easier to face when faced directly. When it’s called death instead of “passing away” or “expiring.” And I believe it’s much easier to face our own mortality when we talk about death like it is normal and common. Because it is normal and common.

Try this small exercise. Pause from reading this post and say, “I am going to die.” Let that sentence hover in the silence around you. Give it a good minute. Then maybe say it again. Say it out loud and slowly.

How did that feel? What are you feeling? And more importantly, why do you think saying that simple, direct, and true sentence makes you feel the way you do?

I remember the moment I consciously stumbled upon and accepted my own mortality. I was a chaplain intern at a large hospital. The chief pathologist invited any chaplain who was interested to view an autopsy. Call me crazy, but I rushed to put my name at the top of the list. I’d always been curious about and fascinated by the body. I wondered how all of the organs that I read about in my science books could fit inside a body. And, did they swish around in some kind of goo? Or, were they floating in air, doing some kind of delicate dance, not touching one another?

So I got to see a full autopsy — one where they not only emptied the chest cavity, they even extracted the brain. The process was clinical and methodical but not at all cold. The doctors showed great respect for the body out of respect for the person who had lived in it. As they removed organ after organ and took samples from each, I remember this moment when I said inside my head, “I’m going to die.”

In that moment I got the chills. That sentence zinged out of my head, shot down into my heart, and then reverberated throughout my own torso, plunging down into my toes. I may have shook a bit on my stool because the doctor turned and asked if I was okay.

“Yes,” I replied, “I’m okay.” And I was. Facing the reality of my death was, literally, breath-taking. Startling. A little bit scary. Very humbling. And more settling than I can explain.

Staring at the empty chest cavity of a human body — a body that once housed a living, breathing, vibrant woman, and then realizing that my body would one day be empty of my personality, my breath, my being — I was rattled but then settled. I faced the fact that I would die. It would be real. People would have to deal with the loss of me. I might experience pain while dying, but it also might be over before I even know what’s happening. I will die. I can’t control that because it is simply a truth. Death is natural. It is normal. It is common. It will be part of my story just as it is part of every human’s story that ever was.

I understand the fear. The resistance to and avoidance of the topic. The attempts to distance ourselves from the reality of death, foolish and unhelpful though they may be. I understand it, but I wish this wasn’t our way. I wish more of us used the words death, dying, dead, and died rather than vague and prettied euphemisms. Because death is. And denial and euphemisms don’t help us manage-well all the living, dying, and grieving that we do on a daily basis.

If you are still with me, there is good news here too. Dying and death can be the most beautiful days, hours, and moments you could ever know.

As a chaplain, I’ve supported hundreds of people in the long and short times preceding death. Many of them are afraid, but not about the impending reality of their death, or even the finality of death. They fear the not knowing of those paper-thin moments between life and death. At the very end, what will they be aware of? What will they feel? Will there be pain?

Beyond this fear, there is usually calm, peace, and a lot of rest and sleep. And here is where the beauty arrives. When people stop denying, fighting, or cushioning themselves from death — when they face death, speak it aloud, and accept it — then they are able to relax deeply into the moments that remain.

Dying people who accept their dying cherish more. Their senses are heightened because they know they have precious little time left to smell the roses, to feel the smoothness of your hand in theirs, to float pleasantly along the chords of their favorite music. They want to spend time with their loved ones. They want to tell their stories. They want you to feel comfortable around them and treat them with the same love, respect, and dignity that you showed them before you knew they were dying. They are still the same person, it’s just that their body is dying.

Spending time with people who are dying and their loved ones has been one of the greatest honors of my life. It’s pure time, like when you hold a sleeping newborn and feel their rhythmic breathing and perfect skin. Or when you sit at the park on a comfortably sunny day and simply take in the breeze and the sounds of children playing. Or when you are flying in an airplane and it’s all weightlessness and white noise and the view out the window is cotton ball clouds over soft blue skies. These pure times are meant to be taken in. To be held. To be breathed. They are a holy pause that we store and remember later when the grief comes.

When you spend time with people who are dying, all the stupidity of life falls away. No one cares about celebrity gossip or small town gossip, what kind of car you drive or who has gained a few too many pounds. They focus on what is true, what is important, and what is enduring. It’s time full of phrases like, I love you. Do you remember the time… Thank you for… I want you to know… I’m sorry for…

There is time and space for laughter, tears, warm hugs, hand-holding, singing, reminiscing, and for peacefully spinning dreams that may never happen.

Yes, there are instances near death when modern medicine cannot overpower the pain of disease and that is difficult to witness. But the vast majority of deaths I’ve attended have been quiet and calm with minimal pain. And most of these deaths have been peaceful times saturated with the sacredness of life and wreathed with the beauty of love.

I wish we would not fear death — the reality or the word.

I wish today’s flowers were colorful, happy reminders of a kind and contented woman who we shared life with, rather than funeral flowers that pricked us into depression or made us recoil.

I wish more people had the courage to be uncomfortable and use straight talk about death. I think it would be kinder and more helpful for our own acceptance and well-being.

Death won’t come faster just because we speak of it. But if we are able to think and speak of death with a calm, no-nonsense manner, we will be better able to live our lives to the fullest, to live with promise, and to breathe deeply of the roses.

 

 

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When someone you love is dying

My grandmother Betty battled cancer for more than a decade. Most of my memories of her are tinged by the effects of disease – terrible bloating and vomiting caused by experimental drugs, brutal rounds of chemo that made her hair fall out and grow back in different shades and textures, and our family spring break trips to Mayo Clinic when she was too weak to be at home.

Despite her prolonged illness, I remember many good things too. Grandma’s nickname was Mean Betty Jean but she was just the opposite: invariably kind and calm, with a gentle smile and a friendly chuckle that made me want to cuddle into her side. She taught me how to play card games like Crazy Eights and Kings in the Corners. Every year for Christmas, she bought me pajamas that came packaged with a matching stuffed animal; this was both delightful and silly.

Even though my grandmother was sick my entire childhood, I never realized that she was slowly dying. One ordinary Thursday I came home from school, made myself a snack and was eating it standing by the sink when my mom came in and told me that grandma had died. We stood there for a long time, quietly crying by the kitchen sink. I thought I’d share many more spring breaks with grandma. I was looking forward to another Crazy Eights tournament. But most of all, I wished I’d had the chance to say goodbye and to give her the best hug I had because I knew it would be our last.

Now in my mid-thirties, I’ve said goodbye to several beloved family members and friends. As a hospital and hospice chaplain, I helped people prepare for death and supported grieving families. With death and dying as the landscape of my daily work, I learned that while being a witness of death is never easy, it doesn’t have to be depressing or scary.

The time that precedes death can be the most beautiful time you share with someone you love. It’s a time to give and receive precious gifts. Not gems set in velvet boxes, but true words and actions. Things as simple and life-giving as presence, as saying I love you, as laughing over a hand of cards. These are gifts with the power to free souls from fear and pain and open them to gratitude and joy.

If your loved one is dying – my thoughts are with you. I pray you have the courage to give and receive the following gifts.

Talk about death. We often avoid the D-words – die, death, dying – because we fear it will be too painful for the one who is dying. In my professional experience, dying people want to talk about death. Unless they suffer from dementia, they know it’s their daily reality. Most want to acknowledge it, talk about it and prepare for it as best they can. They want the opportunity to review their lives, tell their stories, to confess their regrets, and seek forgiveness. How will they have a chance to do this important work, this emotional preparation, if we are afraid to accept their reality? One of the greatest gifts you can give your loved one is the freedom to openly face their death.

Know and honor their wishes. Terminal illness comes with an obstacle course of decisions. Do we pursue life-extending medical treatments? Will we manage the pain with narcotics or alternative therapies? What finances do we need to get in order? When and how should we prepare the memorial service? These are important questions, but too often families tackle them without consulting their loved one. Two of the greatest emotional struggles of the dying are loss of control and loss of identity. Asking your loved one about their wishes, and following through with them, honors their personhood. It helps them retain an important strand of control. Start with Five Wishes and advance directives.

Address the bucket list. People who are dying often daydream about what they would do if they had unlimited time and resources. For many, this ‘bucket list’ may not be written on paper, so talk to your loved one about what they want to do with their remaining time. Many bucket list items can be accomplished outright but you might need to do the legwork. Other items might be beyond your loved one’s physical capabilities, but could be modified to achieve the same sense of satisfaction.

Consider hospice. While hospitals do what they can to create a comfortable environment, it’s not an ideal place to share your final days. Hospice provides 24-hour on-call support for patients and families in a variety of settings: private homes, retirement communities, skilled nursing facilities, and in-patient hospice units. It is a free benefit of Medicare, Medicaid (in 47 states) and of most private insurance carriers. A consistent, interdisciplinary care team – including a physician, nurses, a social worker, and a spiritual care provider – will manage medications, address pain, provide informed and compassionate guidance as things change, and generally enhance your loved one’s quality of life. Not all hospices offer the same range of services, so ask for referrals in your area. If you have more questions, start here.

Share simple pleasures. It’s easy to get distracted by all the details that come with caring for a loved one. Meetings with lawyers and ministers are important, but no more so than surrounding your loved one with what gives life to their soul. Focus on simple things. Cook their favorite meal, even if they can only enjoy a few bites or the smell. Hold hands. Reminisce and tell your loved one why you cherish them. Say I love you. Put a cozy lounge chair in the garden and share the sunshine and the quiet. Have a family movie night. Read their favorite stories aloud. Let the grandkids star in a family concert or play. This will be their comfort and joy.

Let them apologize. It’s natural to seek forgiveness and express regret at the end of life. Research shows that the dying seek forgiveness in three categories: the forgiveness of God, of others and of self. Surprisingly, the data says that forgiveness of self is the most difficult category. Seeking the forgiveness of others is certainly a doorway to forgiving ourselves. Families often try to deflect, minimize or avoid such apologies because they don’t want their loved one to feel burdened by grief. Well friends, grief is unavoidable at this point. The good news is that letting your loved one speak their truth is precisely the thing that can lighten their burdens. So when they speak, don’t interrupt. Take deep breaths and listen until they are finished. Then offer words of acceptance and love.

Let yourself be weak. If I had a dollar for every time I heard a family member say I have to be strong… I know this is difficult advice, but it’s much kinder to let yourself fall apart from time to time. Have a good cry in the shower. Go into the basement or the woods and yell. Confess your fears and struggles to a good friend or counselor. Cry out before God. These are better coping skills than trying to rigidly harness the emotions that come with losing someone you love. Grief is an unruly thing; it comes and goes in unpredictable, sometimes turbulent, waves. Try though we might, the tide is not something we can control. It’s best to ride the cresting waves and trust that they will deposit you on shore.

Care for yourself. It’s okay to care for yourself even when your loved one is dying. In fact, it’s critical. Stress and grief will upset your ability to assess your needs, so listen to your friends and family when they say you need a break. Let them take you out for coffee or to the spa. Accept their casseroles, their offers to clean your house and their long hugs. These things are like a good saline drip to a body parched from grief. Plus, it will give them a practical way to help you, which is what they desperately want to do.

Plan a memorial service. This part of the grieving process can be difficult, but also incredibly healing. Through words, music, prayers, pictures, flowers and food you can craft a gathering that honors the life of your loved one. Invite family and friends to contribute and do the work together. You’ll laugh and cry and discover later that this is when the mending began.

Stay connected to God. Friends, this is the time for raw and real prayers. This is a time to use the Psalms like prayers when you have no words of your own. This is a time to sit on the floor in your closet and open your hands to heaven. It’s a time to acknowledge your weakness. To ask for comfort and for the strength for one more day together. It’s a time to realize that God is in every moment working for your good and for the good of your loved one. And when pain, fear, and confusion come, this is when you’ll need to trust that things are not as they seem. Remember that God is with you, doing the unseen, gathering you all under the shadow of his wings.

 

Have mercy on me, my God, have mercy on me,
    for in you I take refuge.
I will take refuge in the shadow of your wings
    until the disaster has passed.
Psalm 57:1

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Doctor of Goodwill

Woman: (laying in bed, looking at a man passing the doorway to her room) Who was that?
Chaplain: That is your doctor. He’s going to come visit you to see how you are doing.
Woman: Oh, another doctor!
Chaplain: You haven’t seen a doctor already this morning, have you?
Woman: I mean you, dear.
Chaplain: (chuckling with a smile) I’m not a doctor.
Woman: Yes, you are!
Chaplain: (Thinking she’s getting confused. She has Alzheimer’s.) Oh, really? Well, what kind of doctor am I?
Woman: (grasping my hand and smiling) You are the doctor of goodwill.

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People assume that being a hospice chaplain would be depressing; they are wrong. Everyday my patients inspire and encourage me.

Death is sad because it always involves loss, but death also has the potential to spark something good within us. The expertise of the dying is passing on life to another human being — this I am learning.

I receive and hold their spirit as a precious gift.