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Senior Spectrum Newspaper
August 2017
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Senior Spectrum Publications

“A good death, did I hear you right?”
by Michelle Cagle
Circle of Life Community Hospice

I wrote the following story about a “good death” in May of this year, a mere month before my 16-year-old son died in a horrific car accident. Tomorrow isn’t promised to any of us. A “good death” means more to me now than ever before. 


Michelle Cagle
Michelle Cagle

For so many, death is something they fear more than anything else in this world, so how could the term a good death even come from one’s lips?

I think one can only understand the meaning of the term, if they have made their life’s passion come true by caring for terminally ill patients, or have experienced a loss of a close loved one, especially those who have received the gift of helping someone take their journey home with the help and support of hospice. I am grateful to have personally experienced the latter.

Although I wish I hadn’t had to lose my dear mom, I wouldn’t be able to speak on this topic authentically and share what has become my passion and life’s work, without that experience.

A good death just doesn’t start as a person is transitioning and leaving their body, a good death starts when we become aware that our death is upon us, whether weeks, months or longer. At that moment when we accept that we are in fact going to die, and choose to now live, yes, live every day to the fullest, for however many more sunsets remain. Then we truly begin on our journey towards a good death.

For my mom and her family, the good death began the moment the oncologist confirmed and was honest about the prognosis. Yes, it did take some serious direct questions to pry it out of him, he was teetering on “well chemo may help” and, “we could try this,” before mom told him to not mince words and to treat her as though she was his mom. He took a deep breath, and said, “you’ll need 3 months to recover from the life-saving surgery we just performed, before you can start the chemo or the chemo itself will kill you.” He paused as if he had never had to tell anybody before in his career, “You are dying.” Mom looked at him straight in the eyes and asked, “How long before the tumor returns and I die?” He whispered; “60 days.” As my legs buckle and I lean into the wall for support, I hear my mom take a deep breath and say, “Kids we have two months to share together and get some things done, and sorry doc, looks like you won’t be making any money in this case, but thank you for your honesty.”

The next step in the journey was having the hospital social worker treat me with such compassion and honesty about what I was venturing on when I arranged to take my mother home with me to care for her in her last days. She fully educated me on hospice and its philosophy and what responsibility I had in honoring my mother’s wishes for a peaceful death, one with dignity and with only the use of comfort measures.

Although I had witnessed other friends and family members die on hospice, this was altogether different when it was my mom and I was taking power of attorney of her healthcare decisions, thereby vowing to honor her directives.

She was very vocal, my mom. She had been preparing me for some time about her final wishes. I hated it when she would talk about what she wanted should she ever be faced with lifesaving measures or feeding tubes. The Terry Schaivo story was huge during this time and Terry had finally passed peacefully about a month before we got our news. This forced us to have heated debates about life sustaining treatments and the ability to be unplugged when it is our time. I knew my mother’s stance. Loud and clear.

When a person accepts their impending death, something greater than peace for the dying takes place. Peace and acceptance comes to those who love and care or them. Not to say that it is easy for anyone to be okay with what is happening, but that they find the strength to embark on the journey.

In this time so many beautiful things can take place. Like sewing the binding on a few more quilts, a trip to the lake to throw a pole in with your grandson, your favorite meals, cuddles with the grandbabies, speeches, advice and instructions to each family member about things that have yet to come, and conversations with those whom you wish to thank, forgive, ask forgiveness of, or to merely tell, “I love you, and goodbye.”

We begin the dying the moment we take our first breath. It is a given. How many breaths we have left are unknown. A profound fact that should make us live each day to the fullest, cherishing all the beautiful gifts each day offers. Our life. Relatedness and bonds to those we love are what the dying person focuses on in the end. To me this is a powerful message to love and be loved, for that is the treasure we’ve all been living for.

In closing, a good death ends surrounded by family, being loved and cared for and in absolutely no pain, with the utmost of dignity and peace. A good death affords the surviving caregivers and loved one’s peace and comfort taking every last precious memory with us. We carry on and follow their instructions throughout the rest of time on earth.

The last exhale completes the circle of life.

I highly recommend that we as a culture stop fearing death and rather embrace the ride. That we start having the difficult conversations about our final wishes and execute advance directives, no matter what age we are.

I would be remiss if not to say that one thing that prevents a good death from taking place is (or perhaps “waiting too long to begin hospice???” instead of late referrals) late referrals to hospice and comfort care. When a person is only made aware of their impending death mere days before, it does not allow for the spiritual work necessary for everybody involved. Let alone symptom management. The Medicare hospice benefit is for 6 months, or longer in some cases.

Be educated and learn about hospice before you or a loved one find it necessary.

For additional resources on free community bereavement, grief support and information on the death café movement, visit: www.colhospice.com