How To Fight For Yourself At The Hospital and Avoid Readmission by Judith Graham
Have You Lived the Life You Wanted?

Old Age and the Fear of Dying

It is my long-term practice to have two or three books related to old age going at once along with stacks of printouts of related materials.

For the past few months, I've let that go in favor of other, lighter kinds of reading and during my two-week hiatus from this blog, I read almost nothing beyond the daily headlines.

The basic requirements for productive thought are quiet and solitude. I gave myself a lot of that during the past two weeks and once I got over feeling antsy without a book in my hand, old topics I've neglected began bubbling up. Today's post deals with one of them.

”How can we know how to live if we don't understand death?”

Confucius said that. Knowledge of our own demise is the central predicament of humankind and there are not many of us who do not fear it. So much so that we spend a great amount of time distracting ourselves from this ultimate reality of life.

What can it mean to no longer be? I have no idea. Two common facile answers involve, depending on one's beliefs, a great reward in heaven or as some would have it, returning to what it was like before we were born. Mark Twain had something to say about that second answer:

”I do not fear death,” he wrote. “I had been dead for billions and billions of years before I was born and had not suffered the slightest inconvenience from it.”

It's fun to read that but not really much help.

One of the problems of western culture is that although it is changing to a small degree in recent years, discussion of dying is not encouraged and certainly not acceptable in polite company.

Imagine saying over coffee with group of friends after dinner, “I was thinking about dying today...” I promise you the word “morbid” will be mentioned, no one will look you in the eye and one of the party will suddenly find tomorrow's weather fascinating.

Ageism has a lot to do with the taboo against talking about death and old people are not too much less likely than the young to spend a lot of money on trying shave a few years off their their act age. Many of the young won't hire people with gray hair no matter how qualified they are but a lot of healthy elders are equally reprehensible by being careful not to associate with less healthy people of their generation.

We try to appear younger than we are because we don't want to face the fact that we will die and we are conditioned from childhood to look for every possible way out.

We believe that if we eat enough kale, do enough pushups, buy enough Botox injections and face lifts, we will fool the grim reaper into believing he made a mistake when he comes by and sees how young we look but he can't be fooled that easily. (Have you read Appointment in Samarra lately?)

Death – of plants, animals and humankind – is nature's way of clearing out the old to make room for the new. It is foolish to fight it. Confucius reminds us of that as does, similarly, St. Augustine:

”It is only in the face of death that man's self is born.”

From at least the dawn of language, philosophers have been telling us how to live with this fearful certainty – most frequently as Augustine and Confucius advise – but I think we can each come to our own understanding.

To live well within whatever restrictions old age saddles us with comes to mind. To luxuriate in the private rituals and small pleasures of our individual lives helps.

To do good things for others. Not great things; few of us are favored with the power to change the world in big ways. But we can improve other people's lives in small and unexpected ways.

What all the philosophers tell us about facing death is to live meaningfully and that, perhaps, is another way to meet the despair of our impending demise and overcome it.

* * *

The Death Deal by Ron Padgett which you will find at The Writers Almanac.

Ever since that moment
when it first occurred
to me that I would die
(like everyone on earth!)
I struggled against
this eventuality, but
never thought of
how I'd die, exactly,
until around thirty
I made a mental list:
hit by car, shot
in head by random ricochet,
crushed beneath boulder,
victim of gas explosion,
head banged hard
in fall from ladder,
vaporized in plane crash,
dwindling away with cancer,
and so on. I tried to think
of which I'd take
if given the choice,
and came up time
and again with He died
in his sleep.
Now that I'm officially old,
though deep inside not
old officially or otherwise,
I'm oddly almost cheered
by the thought
that I might find out
in the not too distant future.
Now for lunch.


Thank you for this.
I am conscious that, if I make it to my next birthday, I'll be the first male in my direct line to reach 70 since my 3rd great-grandfather. I don't let it overtake me, but when we talk about our bucket lists I have pointed out that anything I really want to do I'm doing or plan to do as soon as possible which some family and friends think is morbid.
A friend of mine, 12 years younger than me, flew home from work last Friday evening and died - most likely from a blood clot - but in his short life I don't know of anything important that he put off doing. He loved, he laughed, he and his wife traveled. His life was too short, but a life well-lived. I think the Stoic philosophers would have been proud of him.

As an aspiring Buddhist I am familiar with the contemplation of my own demise. There's nothing to do about death, it will come to all of us. Recently I had to have general anaesthesia. I suspect that death is like that...except for the waking back up part.

Dying, on the other hand, that's the more troubling bit. One does what one can to control the how and when of it, exercise, a healthy lifestyle, avoiding crazy risks, surround oneself with loving family and friends, good quality affordable healthcare (okay, that last one, and maybe the one before, is not necessarily in our control).... and hopes it will happen while asleep or otherwise looking the other way or, even better, when one is enlightened enough to accept it's happening and consciously participate in a joyful letting go.

At 58 I'm very conscious that I've now lived to be 6 years older than my mother ever got to be. I'm hoping for 20 more years but making a concerted effort to get my stuff in order and live more simply, but more fully. I am the same age, after all, as Harold's friend in the comment above.

This conversation re. death is happening around the world. One format is called Death Cafes...where people gather, usually with the food incentive, to dicuss any part of death, the dying process, and/or the after life. Not a therapy group but one to break thru our concerns and taboo. There is something called End-of-Life University which has interviews 2 times a month with folks in the field...from green burials to hospice workers to a focus on forms for end of life decisions. There is much more happening here than your post seems to indicate.

Exactly - I've written about and/or attended all the events you mention plus many others on numerous occasions and I will continue to write about them in the future.

However, even as these professional gatherings and services begin to grow, it remains an extremely small universe that reaches only the people who seek them. In everyday life, discussion of death is as taboo as ever.

Today's post was not meant to be a report of all the possibilities. I had intended it to be more a meditation on an issue that hasn't changed much even as new opportunities for it arise.

Interesting how we ruminate on how and when our parents died. My mother died at 74 from complications of COPD. She was ill at 60, and at the end wheelchair bound and on oxygen. I will be 75 next March. I have COPD but I'm neither wheelchair bound or on oxygen. The age of 75 is a big round number but it feels for me like the end of the year of whistling by the cemetery.

I am more concerned about how I die than when. Mom was very ill, bedridden and frightened for months before she died and she didn't want to die, and I admit I'm scared of that. My father at 85 had a heart attack from stenosis of a valve and chose pain meds and death over another surgery he might not survive and a questionable recovery. I have my advanced directive along with my will written up and have discussed it with my sons who were very uncomfortable listening. I suggested they didn't want to be changing my diapers and/or wondering if I was still in there somewhere because they couldn't let me go. And, that I didn't want that.

I do exercise and eat in a healthy way but its more about staying on my feet while I'm here than prolonging my life. Our family seems to be blessedly free of dementias so I hope genetics will bring a gift there. Still it's a lot of hoping for a "good" end. An alarming number of older pedestrians got run over in our little town last winter. I'm not as fast as I used to be so I'm careful but one person was on the sidewalk waiting for a light. In spite of my planning and trying it really seems a crap shoot laden with hope.

I also meant to add I have not seen any classes or gatherings about dying here except for ones run by insurance people and such. I do discuss it with my grandchildren as they get old enough. We do talk about being old too.

Excellent and thoughtful post. My fear is not being dead (I don't think I'll know it), but the dying process and being in a nursing home, bedridden and being forced to "live" when I'm ready to go. I've heard of Death Cafes and it would be certainly something I would join. I so wish this wasn't a taboo subject. Sometimes I wonder why, when a large majority of people believe in an afterlife and that should make it something to look forward to, they so dread it. I think somehow lots of folks can't fathom that there probably is nothing after or some how we'll know there's nothing, which of course is an oxymoron as if there's nothing, you can't know there's nothing. I can imagine some really interesting conversations about all this.

I've prepared as best I can for the inevitable, but now prefer to focus on the pleasant experiences and adventures that are still before me. The fear will come soon enough, probably the result of some doctor's pronouncement and an obvious change in my physical condition. Perhaps I'm too cavalier in saying I fear dying, not death itself. But with luck my obit will read "died in her sleep" instead of "died following a long illness."

I just wrote to a friend that my 55 year-old daughter, in a conversation about current politics, said "I think of us as annuals." You know annuals we plant in our gardens. I could go on with the metaphor and may in another format...

I, too, was going to mention the death cafes, which I plan to go to, but I see they are covered by you and others. It has been a long struggle, but I have finally gotten my family more comfortable with talking about my death. When I came close twice in recent years, I think they were glad I had pushed them to be able to discuss it. Then my little writing workshop of women aged 70-91 had to be coaxed into a level of comfort talking and writing about death. I guess this old farm girl learned to be comfortable with life's inevitable ending. I could use another lifetime to do all that I would like to do, but if it comes tomorrow, I am ready and have no real unfinished business. I did my 1st slide show yesterday and would love to do more; I'm rehearsing in a couple of hours for 2 open mic vocal performances coming up; my eldest granddaughter is giving birth in 3 months to my 6th great-grandchild. I have a lot to live for, but at 83 I've outlived my genetic pattern and the prognosis for long-term Rheumatoid arthritis patients (60 years), so I really can't complain.

I envy those who live in states where one has some control over chosing time and place of death. It's the only thing I fear about dying... not being able to end my life shuld it become unbearable for reasons important to me.

Once, when I was drifting off to a pleasant nap, it occurred to me that dying must be something like that. Peaceful. I've also had the privilege of being present at two deaths, that of my 23 y/old husband and that of my 94 y/old mother. They were laboring a little at breathing and then just gradually stopped. Peaceful.

My UU Church has sponsored several death related workshops and a Death Cafe as well. Search deathcafedotcom to find one nearby or how to sponsore a cafe.

I can't add anything to what others have written. I'm glad I live in a state where one has SOME control over choosing time and place of death, but the barriers are high and relatively unavailable to many residents. I don't think I'm afraid of death, but I do know that I'm afraid of how I'll get there! I have the paperwork in place, including a 3-page letter to my family, but still there is no guarantee that someone who doesn't even know me will control the conditions of my demise. Now that is SCARY!

For many years here at the assisted living facility, death and dying were never talked about. At least officially.
While it was a topic for discussion among the people themselves, the passing of fellow residents was never mentioned or acknowledged by the management.
People just mysteriously disappeared.
It is only in the last two years, after many complaints, that notices of residents or former residents who have died been posted. And now, with the consent of relatives, we even have memorial services.
It's not enough, but at least it's a step in the right direction.

Noting Tarzana's comment, it seems at least some religious congregations are places where death talk is OK. My UU church has for years sponsored a monthly gathering, "Facing Life, Facing Death," where discussions feature dealing with the loss of loved ones and facing up to one's own inevitable demise. It is open to anyone interested; no need to be a UU.

I'm with Mark Twain and yet I have trouble explaining a 'near death' experience my late husband experienced.

When still a young man and I was pregnant with our first child, he was in an explosion. He was taken to the ER critically burned. While the doctors were working on him his heart stopped. Mercifully he was revived.

He was hospitalized for 3 months and knew nothing at the point of his heart stopping. He then told me about walking down a hall with caskets propped up and he looked in each one as he progressed toward a light at the end of the hall. He didn't recognize anybody so he continued down the hall. He told me of the great feeling of peace and that there was no such thing as time. He maintained that if he had reached the light he would have been dead.

Needless to say I found this story morbid and eerie. Since then I have been able to explain it as a dream and the light was the OR surgical bright light that penetrated his sub-conscious and became part of the dream. And yet----?

I think that if Houdini wasn't able to return, no one can. As Mary said, if there is nothing after death you will not know it. I'm okay with that.

I have an advanced directive in place...enough said. What will be will be...too much living laughing and loving to do to ponder this subject ad nauseum for me..

"Can't say you've had a good life until you've had a good death"

Chubby Checker circa 1961

I'm a death and dying explorer, hospice trained and attended a presentation by Elizabeth Kubler-Ross when I was 20 - a few years ago! Have continued to read, explore etc. and love the comments here!

My take on this is that we experience at least two levels of "knowing", egocentric and "consciousness" (still being explored and defined - but essentially the beginning of stepping beyond ego). Ego cannot possibly understand death - it's an energetic/spiritual experience. So we make up what's most comfortable to us I.e. Heaven.

I've also tried to talk to my adult sons about it and we're most comfortable describing it as "when I leave for Alpha Centauri" lol.

It's hard to accept there are no answers but I get what Mark Twain was saying... And it comforts me. I also think it's closest to the truth - who knows how many times we each cycle through those two portals? I'm imagining many...

I love that you offer up this conversation Ronni - it's necessary and without it we become the property of profit focused health care that has little to none awareness of death and no interest in accepting it - there's no profit for them if their customers die!


Five minutes after I entered the ILR today, the Manager announced the passing of a lovely resident who had waited a year for hip surgery, and just faded away post operation. The woman had one estranged daughter. Sad. I am sad now.

Because I asked him to, my doctor talked with me and answered my questions about how, if it became necessary, I could stop eating and drinking in order to die.
I am almost 86 now, and subject to TIAs and many other not-good things.

Accordingly, I am planning, when I think it's time, to stop drinking and otherwise taking in liquids. The doctor said it takes about 10 days to expire after doing this. He said the first two days I will be (maybe uncomfortably) thirsty, but after that, not much. I will gradually weaken as the kidneys start to fail. And after about 10 days, I will leave us.

I hope this is helpful to anyone who might need/want it--

Curious One

In states like WA and OR, "aid in dying" is not available to dementia patients, even if they have expressed their wishes much earlier. These are people who did not want to be in a nursing home, unaware of their surroundings, being cleaned and fed for no purpose and at great expense to their family, both emotional and financial. (To qualify for paid nursing home you have to basically bankrupt yourself.) This has got to change, but "Compassion and Choices" won't touch it, no doubt out of fear of the religious right.

Thank you, Ronni, for this post. I have been thinking about death and dying since my late '20's when a friend of mine, who was only 33, was diagnosed with an aggressive form of melanoma. At that time, there were no cures. He had no choice but to face his death. It was in watching him, as he fully lived life in his last days, that I lost my fear of death.
There is no question that death is painful for those left behind. And, because it is such an unknown, it can be a scary topic to contemplate. But I find it fascinating, never morbid. I love those people who prepare for their death because they recognize that it is inevitable. "None of us is getting out of here alive." I find it fascinating that we are given this thing called life, but it is not forever. I am fascinated with how many people seem to fritter away this gift of life. I am fascinated with all the near death experiences I have heard or read about. I am fascinated with the conversation of whether we end up in a paradise/hell paradigm or into the void.
I have a friend who is a hospice care nurse and she says that she believes that the death experience reflects the beliefs of the people who die. She also says that the experience of dying strikes her as similar to being born.
"We are such stuff as dreams are made on" Shakespeare

I'm with Woody Allen--

"I'm not afraid to die, I just don't want to be there when it happens."
Woody Allen

and from Nikos Kazantzakis:

WE COME from a dark abyss, we end in a dark abyss, and we call the luminous interval life. As soon as we are born the return begins, at once the setting forth and the coming back; we die in every moment. Because of this many have cried out: The goal of life is death! But as soon as we are born we begin the struggle to create, to compose, to turn matter into life; we are born in every moment. Because of this many have cried out: The goal of ephemeral life is immortality! In the temporary living organism these two streams collide: (a) the ascent toward composition, toward life, toward immortality; (b) the descent toward decomposition, toward matter, toward death. Both streams well up from the depths of primordial essence. Life startles us at first; it seems somewhat beyond the law, somewhat contrary to nature, somewhat like a transitory counteraction to the dark eternal fountains; but deeper down we feel that Life is itself without beginning, an indestructible force of the Universe. Otherwise, from where did that superhuman strength come which hurls us from the unborn to the born and gives us - plants, animals, men - courage for the struggle? But both opposing forces are holy. It is our duty, therefore, to grasp that vision which can embrace and harmonize these two enormous, timeless, and indestructible forces, and with this vision to modulate our thinking and our action.

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