What To Expect When You’re Expecting… DEATH. Five Things You Should Know.

You’re probably heard of the “What To Expect” series of books that are pretty much the bibles on expecting a baby. The first in the series is a book considered to be one of the most influential books of the last 25 years and deservedly so as pregnancy was formerly a much not-talked-about topic. It was time to bring pregnancy out of the closet. (It was also time to do away with the godawful maternity clothes that came in one size — TENT — and in one style –BIG BOW BABY. Thankfully, that happened too in the last 25 years.) The books offered information on a topic very few people had ever been willing to discuss.

Well, I’m about to launch a similar and yet opposite end of the spectrum series. I’m considering calling it, as above, “What To Expect When You’re Expecting…DEATH.” (Can they sue me for that?)

My point is it’s time to bring death out of the darkness into the light. Those closets in which we shun the topics we don’t want discussed in polite society are way too dark. Death is not something you can avoid by simply not discussing it.

I know you can’t bear thinking about losing the ones you love. The deaths I’m suggesting we talk about are the ones we start fearing when we are very young — the deaths of our parents. If things progress naturally in our lives we will live to see our parents die. It’s sad and I’m not suggesting otherwise. I’m suggesting we can make the transitional time less sad and maybe even a bit beautiful if we know what’s ahead. Here are five things you should know about what happens once a parent’s prognosis is determined to be terminal.

1. It doesn’t have to be all bad. We knew my dad was dying of lung cancer for only a short time before he died. But since we did have a heads up we were able to make his last weeks include some fun times. We did things he could still do and enjoy. Little things meant a lot. We played cards and pored over his coin collection. We watched movies. We cooked. We enjoyed simple day to day life in the days leading up to death. What could be better?

2. It doesn’t have to be painful. I worried about how much  physical pain my loved ones would suffer. Turns out one of the best advances in medical science is that many dying patients don’t have to be in pain. Depending on their condition, they can be medicated so the pain isn’t so intense. Pain management isn’t perfect, as it does in some cases render the patient pretty out of things but it can be very helpful at the end.

3. It doesn’t have to be a forbidden topic for the person who is dying. You may think not telling your aging parent he or she is dying is a good idea. It’s not. They are adults, they have a right to know what’s ahead. They have a right to speak up and voice their own choice about their death or dying process. In fact, you don’t have the right to keep this most important piece of news from them. If you’re worried they might be upset, you’re right. But isn’t being upset about your impending death a natural reaction they have a right to have?

4. It doesn’t  have to be your responsibility to make every decision. There will be choices to be made. Choices about where to die, choices about how to die and even in some cases when to die. (Life support machines or not?) You can get help. You can speak to people who are experts in this field like doctors, lawyers or hospice personnel. Then you can talk to family members and to the dying person. Yes, you will need a point person, a Power of Attorney person who makes the ultimate decisions. But if it is you, you don’t have to decide alone. Get help. Ask for help, ask for advice. And know this too — you are stronger than you think. You can handle losing your parent, you have to survive it, your life will go on and it can be good again. You can be happy again, the sadness will pass.

5. It doesn’t matter if you are there at the moment of death. I’ve spoken to many people who regret missing the last breath their parents took. It’s a wasted regret. Be there for as many breaths as you can while your parent is still breathing. He or she will cherish those memories. They will know the legacy of love they leave behind. What matters is  how you treat your parents while they are alive. If you somehow don’t get there at the very end, but you were there for other times throughout their lives, that’s what counts. In fact some parents manage to control their moment of death specifically so that you won’t be there. I was with my father for every minute of his last 24 hours except for about the five minutes it took me to walk from his room to the kitchen to brew a pot of coffee. While I was waiting for the pot to drip through, he died. Was that a coincidence? I think not. I believe he wanted to spare me the pain of watching him take that last breath. We come into this world solo, maybe it’s okay we leave solo. It’s what happens in between that first breath and last that matters.

Consider reading the book “Being Mortal,” by Atul Gawande. It will help clarify for you issues about end of life care. It could spur a good discussion in your family. It’s a start.

Finally, if we’re lucky our parents are going to live long lives and walk toward that light knowing they lived good lives and will be remembered with love. It’s our job to help make that happen. Let’s start by shining a light on the road ahead so we are all prepared for what’s coming.