A GOOD DEATH Really Starts With A GOOD LIFE

(Tom Johnson-Medland is a retired ordained Greek and Russian Orthodox clergyman (1997 – 2019) and chaplain for the Order of Saint John of Jerusalem [Hospitallers] since 1999. He has 26 years as an end-of-life specialist, advocate, and hospice leader. A certified end-of-life doula, Tom is a hospice liaison for Amedisys Hospice of York, PA. He has authored 22 books and over 50 poems and articles, stories and essays. He and his wife, Glinda, have founded a nonprofit foundation for poets)

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This year I am celebrating my 26^th year in end-of-life work. I started out as a spiritual care coordinator, bereavement coordinator, and volunteer coordinator for a start-up hospice in New Jersey just after ordination to the priesthood. Since then, I have played the role of hospice liaison, and I opened a hospice in a rural town of the Pocono mountains in Pennsylvania.

Throughout these years, my sense of what a good death is has shifted dramatically. Nuance has found its way into my understanding, based on the many deaths I have witnessed and the many paths that have led to those deaths. I cut my teeth on Dr. Ira Byock’s Dying Well and The Four Things That Matter Most, both of which help organize the critical issues the dying – and the living – face when it comes to life’s close.

I have seen what I would call good deaths and what I would call not the best deaths. I have worked with people – the dying and their families – that could say the same. Mostly, I see the conversation around what a good death is, constructed of many layers and levels which I’ve helped people discover and work with to achieve a good death – whatever that may be.

A good death — what it is and where to start

A good death is to be defined by the dying. We might also include the people in close proximity to the dying – their community of support – and what they see as a good death for this person. So let’s start there. What do you consider critical for your own GOOD DEATH CHECKLIST? What about those in your community of support? What would they want you to add (if you dare)?

Let’s dive in a little deeper. Let’s look at some areas I have noticed as critical in the lives of the dying and their community of support over the years.

The first item that makes up a good death is a good life. So we cannot really wait until we are dying to be concerned about a good death. Some of the things we will need at our end of life must be planted and cultivated into our lives earlier on.

Elisabeth Kubler-Ross always said, “We die the way we live.” There is much truth in that. How we live will be how we die. Sudden, traumatic deaths are no different. If we live a good life (not a perfect life – whatever that means – but a good life), then our death will be had amidst a goodly environment. But there is the rub. Are we working on what it means to have a good life, so that when death shows up, we will have a good death?

It is a mindset issue. We have got to unpack what we believe a good life is all about. What is on your GOOD LIFE CHECKLIST? What do you need to have a good life – NOW – not later when you retire?

I realized this early on in hospice work – personally – because I saw so many people come to their dying having hoped they would have been able to have more time after retiring; more time to live the life they wanted to live. They were dying not having been able to live the way they had wanted to live. They had put living on hold so they could survive.

So the key wisdom was to recognize there are no guarantees, and if you want a good death, it starts now with creating a good life you could contentedly die in – a life that was up to date on its living.

How to have a good life

The good life we live is really the bedrock of what it means to have a good death. I want to share some things I’ve learned about dying that would be good to build into living.

What first comes to mind as paramount is if you have a daily practice that helps you look at your life – evaluate it – and become the person you strive to be. Prayer? Meditation? Stillness? Silence? Singing or chanting? Reading religious texts? Reading poetry or aphorisms? Self-help books? This should be an organized time and place where you enter into the workshop of the soul. I’m not using soul as a religious soul term necessarily – but a central place in you of hopes, longings, desires, and dreams, and get a chance to look at yourself and become the soul you long to become.

This requires you be a person who wrestles with what it means to live a good life, not just at its end, but all throughout. And that you be a person that believes in the ability and possibility to make changes in who you are – and as often as necessary. The people that have mastered this – in my estimation and experience – have always said, “You do it a little bit at a time,” by working on who you are and at becoming better at who you are – EVERY DAY.

I’ve found that this daily work on the self must include a paradigm of the self so one can build with purpose. I think the thing most people can agree on when it comes to the self – when it comes to what it means to be a person – is that we are made up of a body, a mind, emotions, feelings, passions, dreams, and hopes (these last three make up what I call our soulful self). Each of these areas must be strengthened to make us whole and balanced. We need to feed the body, the mind, the heart, and the soul if we expect to be well. Simply defining these terms may be your first step toward building a daily practice that sustains the good life in you.  So go back to that GOOD LIFE CHECKLIST and add some things about daily practices that you need to have in place to have a GOOD LIFE.

Some things you may desire to work on to help you build a self that is capable of dying might be

• struggling to become patient
• wrestling with delayed gratification
• practicing love and practicing forgiveness
• trying to walk, exercise, and eat consciously
• learning to read regularly
• finding stories that improve you
• being creative in a couple of different ways
• listening to people without speaking
• sitting in silence daily and listening to what your heart tells you
• finding work that fulfills you – and leaving work that is killing you
• establishing and working at friendships and family relationships that are wholesome
• moving on when you need to
• getting out into nature as often as possible
• meditating or praying
• traveling to places to expand your sense of what “self” can look like (even locally)
• finding a teacher and following their teachings – and changing that when you have outgrown it
• crying, laughing, and chanting/singing.

So the foundation of the whole GOOD DEATH conversation is your personal checklist, and a daily discipline for building a self that is capable of dying well. Of course, then you need to make practical preparations for the challenges and choices that come up when you get toward the dying itself. Those topics have been abundantly covered in many previous blog posts.

To have a good death, we all need to start having a good life – TODAY! Don’t wait!

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Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers who support mentally competent adults as they navigate their end-of-life journey. Established in 2004, FEN seeks to educate qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence and defend a person’s right to choose. For more information, go to www.finalexitnetwork.org.

Payments and donations are tax deductible to the full extent allowed by law. Final Exit Network is a 501(c)3 nonprofit organization.