Death is as common and as natural as birth but death discussion is always avoided till its usually too late. With death being a reality, the more we discuss it, the more we can understand it but also the connections we have with others and their thoughts and desires. Talking about death does not illustrate a morbid fascination but recognizes a reality that time is precious and we must enjoy the time we have with our loved ones. No next day is ever promised. Unfortunately, many fear this topic or wish to deny it.
The article, “If death happens to us all, we should probably talk more openly about grief” by Dinah Lewis Boucher discusses the impact of losing someone and the long mental process to learn to live without that person. Boucher states,
“Three years after my husband died, his toothbrush remained in our family’s toothbrush holder. It didn’t make any sense, of course. He didn’t need it. But there it stood, three toothbrushes altogether. Our daughter’s, mine and his. It was a visual representation of how I wished for it to be. But our family was down to two. People say time is a great healer, and the pain of grief changes — over time. But if we aren’t active in the process of grieving, some say it may not change so much. “
“If death happens to us all, we should probably talk more openly about grief”. Boucher, D. (2022). ABC News
Whether we discuss death or not, it will come to our loved ones and eventually ourselves. The process will always be difficult since the lost of a loved one is so intense due to attachments and love. The brain does not respond well to such change. The neural networks need to realign to the new situation and past memories can haunt. The adjustment period is only adjustment. It is not a recovery but a realignment to new realities. Those who do their grief work and avoid complications within the process still remain sad but are able to move forward in a healthy way and find joy in the world despite the loss and the pain associated with it.
Hence, discussing death while others are alive is important to understanding the needs of our loved ones and their wishes. It allows one to express emotions now instead of when it is too late. It is recognizing that everyday is not guaranteed and that time goes by fast. It helps one also understand the inner thinking and wishes of the loved one and what the loved one would want for us if he/she passed away. Concretely sharing these moments instead of speculating what ifs after death can alleviate future suffering.
The phobia of death can paralyze an individual into a state of inaction during life. It can prevent a person from expressing love the day of instead of when its too late. It can make one unprepared and not ready for the loss of a loved one. It is hence important to embrace the reality of life which includes death and express fears or anxieties associated with it to others. One will discover it is not a morbid discussion but a a discussion that is very real and an opening to emotional connections that will not be there one day.
After acknowledging death with loved ones, one will understand spiritual and emotional sides of the loved one that one may not have known before. There may also exist a greater peace if something occurs knowing each other’s feelings and not being left to wonder what one would think or do after they passed away. When death is discussed, one discovers not only religious beliefs, but also how one would deal with particular situations when one is gone. One is hence better able to handle situations or execute legal decisions with more certainty and confidence instead of guesswork.
Trying to introduce this much needed conversation can at first be difficult and maybe even awkward. One does not merely begin the conversation with death itself but it is gradually implemented from such topics of legacy, the future, desires, or religious thoughts. The death of a celebrity can be an excellent introduction to the topic as well.
While death is naturally feared because of its unknown aspects, death discussion takes away the taboo element of it and helps individuals discuss and better understand implications of it. It allows one to also be better prepared for one’s own death from all financial and spiritual concerns. Many individuals today pre pay for funeral expenses, urns and cemetery plots. This is not pessimistic or morbid planning but real and true planning for eventual reality. Live everyday and stay healthy, but do not allow one’s fear of speaking about death to become a pathology.
Some suffer from a mental pathology of Thanatophobia or the fear of death. This is more than a natural fear of the unknown but a topic that physiologically upsets the person to such an extent that the topic causes extreme anxiety and physical reactions such as higher heart beat or blood pressure. While some may have been exposed to something traumatic others can merely develop this fear. If the fears and reactions persist for longer than six months, then professional help may be needed. Therapists usually utilize cognitive behavioral therapy to help understand the phobia as well as exposure therapy where individuals are gradually under the guidance of a counselor are exposed to concepts of death.
Death discussion can seem taboo or morbid but it is a healthy discussion that recognizes reality and life itself. Pastoral Thanatology is the field of care where individuals in ministry help others prepare for death, as well as, help others deal with the death of a loved one. Chaplains, ministers and others in Human Service fields need a strong training in Pastoral Thanatology to better help individuals deal with death issues.
AIHCP offers a four year certification in Pastoral Thanatology. Qualified professionals can earn the Pastoral Thanatology Certification and apply the knowledge and training to their own ministries and help others face and cope with the reality of death. The program is online and independent study. After completion of the core courses, one can apply for a four year certification.
“Thanatophobia (Fear of Death). Cleveland Clinic. (2022). Access here
“Thanatophobia (Fear of Death) Explained”. Fritscher, L. (2023). VeryWellMind. Access here
“We Need to Talk About Death”. Beaumont, A. (2017). Psychology Today. Access here
“Talking About Death With Family: 7 Tips to Start a Dialogue”. Vasquez, A. (2022). Cake. Access here
The two most important events in life is birth and death but the later is rarely spoken about. Individuals fear and dread death and avoid the existential topic as much as possible, but death talk is important. This important discussion helps focus individuals to the reality of life and that days are precious. This discussion helps prepare others express feelings and put financial and inheritance matters to rest. It allows the deceased to have his or her wishes known for funeral and burial. Yet, despite the healthy discussions that the topic of death brings, it is still avoided as if the topic itself will bring about the existential event.
Individuals dread and fear death so they hope to avoid, dismiss and ignore it. It can only happen to others not oneself and the mere discussion seems morbid too many. Yet this important discussion is critical and taboos, fears, and myths about speaking about death need to be removed from society. Death talk itself is healthy. Many in Pastoral Thanatology ministry minister to the dying but the topic of death has been avoided and even when dying is occurring, no family or friends know how to broach the subject. This leaves the dying person very much alone. It is healthy to discuss death in the prime of life as well at the final moments.
The article, “If death happens to us all, we should probably talk more openly about grief” by Dinah Boucher looks at why many fear discussing death or even talking about the pain associated with death of a loved one. She states,
“Identity rupture is a common response to loss, Professor Gill Straker and Jacqui Winship explain.’ For sure, it affects our identities. Our sense of ourselves is intricately associated with our sense of ourselves in relation to others. So when we lose a really important person in our lives, our identity has to kind of shift and change to adapt'”.
“If death happens to us all, we should probably talk more openly about grief”. Boucher, D. (2023) ABC News. Access here
Hence, whether it is about one’s own mortality or losing a loved one, the fear and pain of the subject can paralyze one from speaking about it or trying to understand it. This can be unhealthy for the grieving as well as unhealthy for those who fear any discussion about the event of death. Death itself or when someone dies cannot be swept under the rug but needs to be discussed and understood in order to have a healthier understanding of it as well as the ability to heal.
The Importance of Having End-of-Life Conversations
End-of-life conversations are crucial for several reasons. Firstly, they allow us to express our wishes and preferences for our own end-of-life care. By discussing our desires in advance, we ensure that our loved ones are aware of our choices and can honor them when the time comes. Additionally, these conversations provide an opportunity for us to clarify any misunderstandings or misconceptions about our preferences, preventing potential conflicts or disagreements among family members.
Secondly, end-of-life conversations foster emotional and psychological well-being. They can help alleviate anxiety and fear surrounding death by providing a platform to openly express concerns and emotions. By addressing these concerns, we can find comfort and support, allowing us to cope with the inevitable reality of our mortality.
Lastly, having end-of-life conversations enables us to support and comfort our loved ones. By sharing our thoughts and wishes, we provide them with guidance and alleviate the burden of making difficult decisions on our behalf. These conversations also encourage open communication within the family, fostering deeper connections and understanding during a time that can be emotionally challenging.
Common Challenges When Discussing End-of-Life Topics
Despite the importance of end-of-life conversations, there are common challenges that can arise when discussing these topics. One challenge is the discomfort or fear associated with discussing death. Many individuals find it difficult to confront their mortality or to acknowledge the possibility of their loved ones passing away. This discomfort can hinder open and honest communication, making it challenging to have meaningful conversations.
Another challenge is the cultural or societal taboo surrounding death. In many cultures, death is seen as a morbid or forbidden topic, leading to a lack of awareness and understanding about end-of-life matters. This taboo can create barriers to open dialogue, preventing individuals from expressing their wishes or seeking the necessary support and guidance.
Additionally, differing perspectives and beliefs within families can pose challenges. Family members may have varying opinions on end-of-life care, leading to potential conflicts or disagreements. It is important to approach these conversations with empathy and respect, acknowledging and validating differing viewpoints while working towards a shared understanding.
Benefits of Having the ‘Death Talk’
Despite the challenges, having the ‘death talk’ offers numerous benefits. One of the significant advantages is the peace of mind that comes from knowing that our wishes will be respected and honored. By discussing our end-of-life preferences, we can ensure that our values and beliefs are upheld, providing a sense of control and dignity during our final days.
Another benefit is the opportunity to strengthen relationships and deepen connections with our loved ones. End-of-life conversations allow for intimate and vulnerable discussions, fostering trust and understanding among family members. These conversations can create a safe space for emotional expression and support, ultimately strengthening the bond between individuals.
Furthermore, having the ‘death talk’ can alleviate the burden on our loved ones. By openly expressing our wishes, we provide clarity and guidance, reducing the stress and uncertainty that can arise when making difficult decisions on behalf of someone else. This proactive approach ensures that our loved ones are equipped with the necessary information and can focus on providing comfort and support during our final moments.
Key Elements to Consider Before Having End-of-Life Conversations
Before initiating end-of-life conversations, it is essential to consider certain key elements. Firstly, it is important to reflect on our own values, beliefs, and desires regarding end-of-life care. Taking the time to understand our own wishes allows us to articulate them clearly to our loved ones. This self-reflection also helps us identify any fears or concerns that may arise during the ‘death talk,’ enabling us to address them proactively.
Secondly, it is crucial to choose the right time and place for these conversations. Finding a comfortable and private setting can create a safe space for open and honest dialogue. It is important to ensure that all participants feel at ease and are free from distractions, allowing for focused and meaningful discussions.
Thirdly, considering the preferences and needs of our loved ones is vital. Each individual may have their own unique approach to discussing end-of-life matters. Some may prefer direct and straightforward conversations, while others may require more time and gentle guidance. Being sensitive to these preferences can facilitate effective communication and ensure that everyone feels heard and understood.
Strategies for Initiating End-of-Life Conversations
Initiating end-of-life conversations can be challenging, but with the right strategies, it can become more manageable. One effective approach is to start the dialogue gradually. Begin by mentioning the importance of discussing end-of-life matters and expressing your own willingness to have these conversations. By framing it as a shared responsibility, you create an environment that encourages participation and collaboration.
Another strategy is to use open-ended questions to prompt discussion. Instead of asking yes or no questions, ask questions that invite reflection and personal experiences. For example, you can ask, “Have you ever thought about what kind of care you would like to receive towards the end of your life?” This approach encourages deeper conversations and allows for a more comprehensive understanding of each individual’s thoughts and wishes.
Active listening is also crucial when initiating end-of-life conversations. Give your loved ones the space to express their thoughts and emotions without interruption. By truly listening and validating their feelings, you create an atmosphere of trust and respect, facilitating open and honest communication.
Tips for Effective Communication During End-of-Life Discussions
To ensure effective communication during end-of-life discussions, it is important to keep certain tips in mind. Firstly, use clear and concise language. Avoid using medical jargon or ambiguous terms that may cause confusion. Instead, opt for simple and straightforward language that is easily understood by all participants.
Active and empathetic listening is another essential tip. Give your full attention to the speaker, maintaining eye contact and providing non-verbal cues that show you are engaged in the conversation. This active listening fosters trust and encourages individuals to share their thoughts and concerns openly.
Respecting differing opinions and beliefs is also crucial. End-of-life discussions can bring to light varying perspectives within a family. It is important to approach these differences with empathy and understanding, acknowledging that each person’s perspective is valid. By creating a non-judgmental environment, you encourage open dialogue and prevent potential conflicts.
Addressing Fears and Concerns During the ‘Death Talk’
During the ‘death talk,’ fears and concerns may arise for both the initiator and the participants. It is important to address these fears and concerns openly and honestly. By acknowledging and validating these emotions, you create a space for individuals to express their anxieties and seek reassurance.
One common fear is the fear of loss and separation. End-of-life conversations can bring to the surface the reality that our loved ones will not be with us forever. It is important to provide emotional support and reassurance, emphasizing the importance of these conversations in ensuring their wishes are respected and their legacy is honored.
Another fear that may arise is the fear of burdening loved ones with difficult decisions. Assure your loved ones that by discussing end-of-life matters, you are lightening their burden and providing them with guidance. Emphasize that these conversations are an act of love, enabling them to focus on providing comfort and support rather than making challenging decisions.
Resources and Tools for Navigating End-of-Life Conversations
Navigating end-of-life conversations can be made easier with the help of various resources and tools. One valuable resource is advance care planning documents. These documents, such as living wills and healthcare proxies, allow individuals to legally document their preferences for end-of-life care. They provide a clear framework for decision-making and ensure that our wishes are known and respected.
Another helpful tool is the use of conversation starters or discussion guides. These resources provide prompts and questions that can facilitate end-of-life conversations. They offer a structure for the dialogue and can help individuals articulate their thoughts and preferences more effectively.
Additionally, there are numerous organizations and support groups that specialize in end-of-life care and discussions. These organizations offer educational materials, workshops, and counseling services to guide individuals and families through these conversations. Seeking support from these resources can provide additional guidance and reassurance.
Seeking Professional Support for End-of-Life Discussions
In some cases, seeking professional support can be beneficial when navigating end-of-life discussions. Palliative care teams and healthcare professionals trained in end-of-life care can provide guidance and facilitate conversations. They have the expertise to address medical concerns and can offer advice on treatment options and symptom management.
Therapists or counselors specializing in end-of-life issues can also provide emotional support and facilitate communication. They can help address any unresolved conflicts or emotional barriers that may arise during these discussions. Seeking their assistance can promote a more open and constructive dialogue among family members.
Conclusion: Empowering Yourself and Your Loved Ones Through Open Dialogue
Having end-of-life conversations may seem daunting, but they are crucial for our own well-being and the well-being of our loved ones. By openly discussing our wishes, concerns, and fears, we empower ourselves and our loved ones to make informed decisions and provide the necessary support during end-of-life care. Remember to approach these conversations with empathy, respect, and active listening. Utilize the resources and tools available to navigate these discussions, and don’t hesitate to seek professional support when needed. By embracing open dialogue, we can ensure that our end-of-life journey is guided by our own wishes and preferences, providing comfort, peace, and a sense of dignity for ourselves and our loved ones.
Call to Action:
Start the conversation today. Take the first step towards having end-of-life conversations with your loved ones. Begin by reflecting on your own wishes and desires, and then find a comfortable setting to initiate the dialogue. Remember, open and honest communication is key to empowering yourself and your loved ones through this journey.
Please also review AIHCP’s Pastoral Thanatology Certification and see if it meets your academic and professional goals. The program is online and independent study and open to qualified professionals seeking a four year certification in Pastoral Thanatology
‘Death talk’, ‘loss talk’ and identification in the process of ageing”. Karen West and Jason Glynos. (2014). Cambridge University Press. Access here
“End-of-Life Stages Timeline”. Angela Morrow. (2023). VeryWellHealth. Access here
“The Taboo of Death”. Mark Whitmann, PhD. (2019). Psychology Today. Access here
“What Is Thanatophobia?”. Team VeryWellHealth. (2023). VeryWellHealth. Access here
“Death anxiety: The fear that drives us?”. Maria Cohut, PhD. (2017). MedicalNewsToday. Access here
“Facts to Calm Your Fear of Death and Dying”. Ralph Lewis. MD. (2018). Psychology Today. Access here
Affairs untended to after death can lead to a multitude of problems for surviving family. Division, arguments and issues with the state can follow the death of a loved one without a will in regards to possessions and financial funds. In addition, one’s wishes after death may not be properly carried out. In addition to death itself, sometimes individuals can become unable to make decisions due to an injury. A Medical Directive or Living Will can also list one’s affairs in order and lay out important medical decisions that one would make if conscious. These directives protect the individual from others making medical choices for them in regards to medication utilizing extraordinary measures.
Please also review AIHCP’s Pastoral Thanatology Program, as well as its Grief Counseling program. The program is online and independent study and open to qualified professionals seeking a certification in Grief Counseling or Pastoral Care.
In the meantime, realize it is not a morbid thought to contemplate death or accidents, but an intelligent one that does not wish to ignore this important part of life. Hence actively partake in what legally must be done with one’s life and health to prevent others from doing it for oneself.
Upon a worrisome visit to the doctor, eventually in one’s life, one will come to the grips of existential crisis, where one must deal with a life or death illness, or hear the terrifying words, that one is dying. For some, these words come earlier in life, for many, later, and for some, death can come like a thief in the night. Those who are granted the ominous warning are given a blessing and a curse. A blessing to prepare oneself and others, to put things right and affairs in order, but also a curse in knowing the clock is fearfully clicking to a deadline that is unavoidable. Please also review AIHCP’s Grief Counseling Certification.
There is a myriad of emotions and feelings that one goes through when a terminal illness is announced. An existential reality of one’s own finite nature is made rawly known to the intellect. What was once considered an abstract but real concept suddenly becomes personal and intimate. One comes to the conclusion that death will concretely and definitely happen. It is no longer a future imaging of how but becomes a concrete concept of now and here. Please also review AIHCP’s Grief Counseling Courses
How one perceives life and existence itself plays a large role in the existential dread of this bad news. Levels of fear and anxiety are measured and varied in regards to one’s own existential beliefs. Someone who is profoundly convinced of life after death and molded by an undying faith, may feel a sense of fear, but also a sense of hope and reward, while one who holds empiric and only observable phenomenon as a basis for existence, may feel a deeper dread of creeping into nothingness. Some individuals are less attached to the temporal reality and are able to sense a stronger sense of purpose and peace beyond the observable world. Those of this deeper faith, whether rightly placed or not, will react quite differently to the bad news of approaching death than one of lesser or no faith.
Fear of the unknown still exists even if in the smallest grain to the faithful. So naturally, the evolutionary push to exist when challenged will spring forth within the soul a type of fear. The fear of the unknown still exists for those of faith, but the levels of fear that may surround one who is terminally ill, differs greatly in intensity. One of faith upon the announcement of bad news will definitely still feel a sense of fear and be forced to reckon with the unknowable. This type of fear is a natural reaction. Since one’s conception, the urge to exist is programmed within the body. The urge remains a strong driving force.
For those facing death, a general fear may also be replaced with a more acute fear of the now. Fear of sharing this news, or keeping it to oneself. Fear of the disease itself and what this particular disease may do to one’s body during the final phases. Oneself may fear the pain, the treatments, the side effects and quality of life or even the fear of leaving family and children without one’s guidance and protection. Obviously these are grounded fears to one who has come to a firm acceptance. While initially one may be swarmed with questions and options, one may soon find oneself consumed with collecting as much information about the disease or condition, understanding pain management or reviewing various extraordinary measures to preserve life. Understanding the enemy can sometimes qualm some fear and even give a glimpse of hope. One finds oneself with more power over fear when one faces the enemy across oneself. Some individuals face the enemy, while others choose to live in fear and hide from it. One in the end accepts how they will face death, either with a strong will, or a broken one. Accepting death but facing it with a strong will despite fear is the true definition of courage.
Due to this natural fear of death, even among the most spiritual and religious, one when faced with this terrible thought will undoubtedly deny it. Elisabeth Kubler Ross who worked with the terminally ill observed this natural human reaction to reject bad news initially. Something so frightful at first refuses to be processed by the brain. Bad news is met with an equally powerful rejection of it. As one receives this bad news then, one will probably initially reject the sentence of death. How long this reality takes to sink in may differ among some. Some may seek additional medical opinions, until all options are removed. Others will proceed with elaborate alternative therapies in hope of a cure. For some, hope can be a evolutionary device for survival. It definitely is not something to rejected but when hope blinds oneself to such an extent that is masquerading as denial, then it can become problematic to oneself and prevent oneself from dealing with the reality of death.
Death itself is a process that many run and flee from. Evolution to survive engrains this feeling into oneself. Yet, if one stops and realizes that death is a process one must face, then maybe one can allow oneself the process of dying properly. Many cultures value a good death. A good death is as part of life as birth. Dying well, handling oneself well and maintaining dignity is critical to the last chapter. Long term denial strips one the opportunity to handle affairs, repair relations, prepare the mind body and soul and live the final chapters. So, absolutely, upon terminal diagnosis, one will feel fear and denial and this is OK. What one does not wish to continue to entertain is a long term denial. Hope should not be squashed, but denial should not be masked as hope either.
Oneself may think if one ignores the horrible diagnosis that it will go away. For this reason alone many in denial, may keep a terminal diagnosis as a secret from friends and family. One will ignore checkups and important procedures and postpone wills and other critical business at hand. These types of secrets are part of denial at its core. Oneself may feel as if one is sparing others grief, but this type of internalization of bad news only denies the reality and creates less time for others to express love and accept reality.
Following this diagnosis, other emotions may erupt within oneself. As Kubler Ross points out in her famous stages of grief, one experiences far more than denial upon the initial announcement of bad news. One will experience also a range of emotions with the first minutes or days or weeks or months. Anger is a powerful emotion that may erupt. One may find oneself angry at God, or others. One may feel one’s life has been stolen or cut short. Others may become jealous of others who were granted better health. Again, in grief, one cannot deny these initial feelings, but understand them and see where this anger comes from. While one may feel like they may be treated unfairly, one cannot allow anger to turn into envy and become caustic within one’s very being. There is little time left with a terminal illness and negative emotions and negative energies while acknowledged should not be permitted to fester, unless one wishes for the soul to also suffer with the body.
With the lamenting of death, some will feel greater melancholy. How long one grieves the impending loss of life, like fear itself, varies upon the spiritual nature and resilient nature of oneself. One should clearly come into contact with the sadness of loss of one’s physical life, but again, like anger, it is important to evaluate the emotion within its proper degree. Some may go into a deep depression or no longer wish to live. Oneself may recede to the shadows well before the date of death. When sadness of this level overtakes oneself, then one must realize that the diagnosis is now taking more life than it originally took before. The intense grief is taking what is left. It is stealing the final days of sunshine, family memories and expression of love.
With such deep emotions, sometimes it may be good to express these feelings. Some may find solace in their family and friends, but others may feel a fear to cause them more pain. While this is noble, in many ways, family and friends wish to help one carry this cross. Oneself should not feel isolated to the point where one has none to share the fear and emotions of dying. An additional option is finding others in support groups or other social venues where others of like diagnosis can meet and share emotional fears and acute physical symptoms. A good balance between sharing with family and other like diagnosed individuals can play a great tool in helping one face the emotions of one’s diagnosis.
Kubler Ross pointed out that many may also bargain. As if one has a final say with the grim reaper, oneself may feel the need to negotiate with the angel of death. This sense of powerlessness is lessened with bargaining and creates an illusion as if oneself can negotiate the final days. Oneself may ask, if I can only have an extra year, or have only this procedure instead the other procedures. This illusion of power and control over death is merely another way oneself may try to create one’s own ending. Instead of focusing on “ifs”, oneself should focus on the realities and what can be done within the time given. Less time bargaining and more time doing is a far better way to accept the angel of death.
Upon this terrifying news of one’s own impending death, one can react in a multitude of ways, intellectually and emotionally, but while no emotion is initially to be ignored, there is clearly a better way to face death. It is up to you, the person facing the terminal illness, how you will face the final chapter in your life and no-one else but you can author that chapter.
If you would like to learn more about death and dying, or about AIHCP’s certification programs in Grief Counseling and Pastoral Thanatology, then please review AIHCP’s online programs. The Grief Counseling Certification and Pastoral Thanatology Certification Programs are both online and independent study and open to qualified professionals seeking a four year certification.
Elizabeth Kubler Ross Stages of Dying. Please click here