Can There Be Such a Thing as a Good Death?

Written By: Jason Rose, CD-SV, RIT, RUPES USA

This article is a contribution on behalf of the IDA Health & Wellness Taskforce. 

On behalf of the IDA Health and Wellness Taskforce, this article about grieving, death, and dying is relevant and timely as our membership has experienced the loss of several industry leaders recently. Many of us were shocked to hear of the passing of Denis Healy and then gut-punched with the passing of Rick Goldstein in November 2021. More recently, Chris Evans and Daryl Lyons, CD-SV. In addition to our thoughts and prayers for their families, we have our own reactions and emotions. Many of us are deeply sad and grieving in our own way.
 
What follows is an abridged interview with a “death and dying” expert, of sorts. Our hope is this discussion will raise awareness of death being an important part of living, and something for which we can be prepared.  

Michelle Cagle, CEO of Circle of Life Community Hospice and Jason Rose, CD-SV, RIT of RUPES USA 

Jason: Michelle, tell us about your company and what you do.

Michelle: I am the CEO of an agency called Circle Of Life Community Hospice based in Reno, Nevada. Founded in 1999, I became a majority shareholder in 2021. Circle of Life serves individuals and their families during the advanced and final stages of a terminal illness.

Jason: Your website states on the landing page, ”Hospice is many things, but first of all, it is a philosophy. We believe that dying is not a defeat but rather a natural part of human life. Death happens to all of us and hospice allows it to happen with maximum respect for each person’s inherent worth and reverence for the process. Hospice care is for people in the advanced stages of a chronic or terminal illness who have made the decision to discontinue curative treatments, emphasize physical comfort and live their remaining days with dignity, surrounded by our team of compassionate caregivers.” Wow. So you and your team are there when people are dying? That is fascinating to me. How do you do it? 

Michelle: We have a team of doctors, nurses, chaplains, and caregivers. The main emphasis of our team is to never put profit over care. To do this, we have to have a team that genuinely cares, first.

So, we are available 24/7 to provide customized care. There is no one way to leave this world; your way will be special for you. Our team will be there for the individual and their family. Contrary to what many think, hospice is not about death. It’s about the living.

Jason: Why do you choose this kind of work? Most of us shy away from talking about death, even thinking about it. Why would you lean so deeply into hospice work?

Michelle: I didn’t choose this work. It chose me. All my life, I have been intimately involved with death and dying in my family. At age 10, my grandpa died of cancer. When I was age 14, my cousin died of cancer. At age 15, my mom cared for her best friend dying of colon cancer. I was with her daily during those last few days. When I was 18 years old, my grandma died suddenly of a heart attack. That same year, my dad had a massive stroke. I moved back home to help care for him. He died in 1997. In 2005, my mom moved in with me while she was dying of colon cancer. I held her hand and cared for her in her final days, just as she showed me how to do with her best friend years earlier. My stepfather died a few years later. My 16-year-old son died suddenly in a tragic automobile accident in 2017. That year, I realized that my life experiences, passion, and abilities are ideally suited for hospice service. I became the Operations Manager of Circle of Life Hospice, which led me on this path to becoming majority shareholder and CEO.

Jason: Yikes. Wow. Your life experiences and your “life’s work” are certainly aligned. This brings me to the main purpose of this interview. Our IDA membership has experienced the loss of several leaders in our industry. As we each grieve and process in our own ways, I feel it is important to take a loss and own it. Allow it to be personal. Ask questions. Learn from it. Feel it. Let that person’s life contribute to us as we hurt and as we go forward. Make an intentional effort to assign meaning. Otherwise, it can seem like a bundle of random emotions without purpose. So, my first question to you, isn’t it a very different experience to have someone in our lives suddenly die versus a hospice-like scenario where family and friends are aware that end of life is eminent for a loved one?

Michelle: There are differences yes, and many similarities. Both involve loss, grieving, and the process of accepting the changes brought upon us with someone’s end of life. A sudden death adds the element of surprise and shock. The advanced notice of a terminal illness adds the element of time and an opportunity to share the end of life experience with a loved one. It provides a chance to prepare for the passing, for all involved. Both scenarios offer a profound occasion to internalize the meaning of someone’s life to you, and to celebrate a life.

Jason: You used the word “prepare”. For our IDA membership, the passing of Rick, Denis, Chris, and Daryl was each a sudden announcement that we were not prepared for. Perhaps their immediate families might have had more advanced notice, but for most of us, it was a shock. Personally, I lost my youngest brother in a motorcycle accident. It was years ago, but I remember it very well. I had an overwhelming feeling of shock, a jolt to the core. Disbelief! How could this be?!? He was so young. I kept going over it in my mind, "this is not supposed to happen!" I’m sure you, Michelle, had similar experience with your son’s accident. So being prepared in a situation with advanced notice makes sense to me. But how can we prepare for a sudden, unexpected event?

Michelle: Unexpected? In this life, we are given our first breath and our last. Everything in between is uncertain. But those two events are certain. Many people prepare for various parts of life, early education, college maybe, jobs, and housing. We prepare for marriage, family. We plan vacations. Many prepare finances for different stages of life, building assets and retirement. But end of life? Our own or others around us? It’s rarely even talked about. I can assure you that most people do not discuss, plan, or prepare for end of life with the same vigor, assertiveness, or thoroughness that they do while buying a house or having a baby. When buying a house or having a baby is loaded with many uncertainties, end of life is 100% certain. It is gonna happen. Prepared or not.

Jason: Why is that? Many of us, myself included, respond to a sudden death as a completely unexpected thing. It’s a side impact. Why?

Michelle: In American culture especially, it is taboo. It is considered the norm in our society to refrain from discussing death and dying. Somehow, we think if we don’t talk about it that it won't happen. In other cultures, it is often more acceptable to discuss, prepare, and even celebrate end of life. And for many, the strong emotions can make it difficult to share. For some of us, our own feelings are so uncomfortable and painful that it makes others around us uncomfortable. And somehow that is viewed as unacceptable. When it really is a natural part of the process.

Jason: So, what does that look like? To be prepared for end of life, our own or someone else’s?

Michelle: One powerful way to be prepared is to say it. Talk. Say what needs to be said to your loved ones, friends, family, co-workers. Don’t leave anything important unsaid. Be mindful of your last words to people, because the reality is they could in fact be your last words to a person. Be attentive of energy in a relationship. Would you regret it if that energy is suddenly frozen in time forever?

Jason: Ok, that seems like very wise advice, directed towards emotional preparedness. Since end of life seems to bring out many strong emotions, what other suggestions do you have?

Michelle: Feel it. Feel whatever it is. Cry if and when you feel like crying. Laugh. Somehow it is viewed inappropriate to laugh or feel joy at end of life, your own or someone else’s.There is no right or wrong way. It’s a very individual thing. Respect your way and the way of others. To intentionally lean into the feelings of end of life is a good way to prepare. For yourself, and to help those around you be prepared. Here are some suggestions:

• Have a “safe share place”. This could be a support group, a friend, family, a meaningful physical location, or a meditation spot by yourself. It should be a place where you feel safe and comfortable sharing your feelings.
• When feelings are intense, seek professional counseling or hypnotic therapy. When feelings are intense, it is a call to action. If those feelings involve a family member or significant other, it could be much better to intentionally address those proactively, rather than at end of life. This is the essence of being prepared.
• Start a Eulogy Club. This is a developing idea where you gather friends, family, and loved ones to express eulogies to each other as if they were dead. This can be a very cathartic and empowering way to prepare. It can have the added benefit of strengthening relationships, which is also another way for mutual end-of-life preparedness.
• Participate in a Death Café. It is an open forum where people who are interested in the many topics associated with death and dying can come together to discuss subjects of their choice, fears around dying, and stories they may want to share with others. It is an event — usually, two hours in duration — that is inclusive of all religions, philosophies, and choices of hospice care — should that be a topic of discussion. There is no intention of leading participants to any particular conclusion, product, or course of action. The events are held in an open, respectful, and confidential space. All views are welcome and honored. Death cafés are facilitated by one or more facilitators and topics of discussion are determined by participants. They are always free.
• Pray. For spiritual care, pray with your spiritual/religious leader or group. Or pray alone. But have intentional and focused prayers about end-of-life. Connect with the finality and the eternity. The blessings.
• Journal. If it is one of your better ways to express yourself, write about end-of-life. Write about what it means to you, how you hope it happens, how you hope it doesn’t happen. Writing can help you prepare.
• And again, say it. Feel it. Talk about end-of-life. Sharing it now will make it easier on you and your survivors.

Jason: Those are amazing suggestions. I have one more I can add.

• Clean up your mess. Having cleaned up multiple houses and storage units after my mom and dad passed away, I know very well the physical mess that can be left behind after a family member passes away. So I think of things like this when leaving my house in the morning. I ask myself, "Am I ok with my survivors cleaning up my mess? What will my survivors find?" Cleaning up messes you don’t want left behind you is one way to be prepared. One day it will be the case that you will leave the house one last time.

Michelle: Yes, I agree. That is a good suggestion to be prepared.

Jason: There are other practical things to be prepared. What are some of those?

Michelle: There are documents called Living Wills, Instruction Directive, Health Care Proxies, Power of Attorney, and other Advanced Directives that can be completed to prepare for end-of-life from a legal and medical perspective. These documents clarify your desires and intentions to medical professionals and family. Individuals that die suddenly without any of these documents prepared can leave behind a sometimes frustrating situation for a family to figure out what can legally be done, and what might have been accurate desires or intentions of the deceased.  

Jason: And of course, there is a Last Will and Testament document. This is a legal document that designates beneficiaries who will receive real estate and personal property after death. Having first-hand experience with this in my family, I can assure you it is significantly more loving, considerate, and respectful for your family to have these documents prepared before end-of-life, compared to leaving it up to your family to sort out what legally can be done about what they may be guessing is your wants/needs/preferences.

Michelle: Yes, it is easier for survivors if you prepare emotionally, medically, legally, and financially, but it can also be self-serving and gratifying to know that you are preparing yourself, as you prepare your loved ones for your end of life.

Please know that your IDA Members are in my thoughts and prayers. On behalf of Circle of Life, I would like to offer your IDA membership a monthly zoom call conducted by our grief counselors. And any of your members can reach out to us anytime.

Jason: Thank you. With that, we will summarize and conclude our interview. Sincerely, thank you Michelle for taking the time in your busy schedule to contribute to our IDA members in this way. For our readers, I want to suggest and refer to Michelle’s article called, “A good death, did I hear you right?”. This article and other resources are listed below and can also be found in the IDA Health & Wellness Taskforce resource library.

A “good death” seems hardly ok to say. I’m certain death will seldom feel good, especially for family and friends. But it can be "gooder", better, if we prepare for what will be a certainty for each of us.

I would like to be a “safe share place” for you. If you reach out to me, I will listen and be there for you.

Let’s face it. Expect the unexpected. It’s time to accept and take action. It could be one of the most loving things you do for family, friends, and yourself.

If you found this article meaningful and inspiring, please give us feedback and share.

Resources:

1. Circle of Life Community Hospice www.colhospice.com
2. A good death, did I hear you right? Article by Michelle Cagle
3. Death Café www.deathcafe.com
4. Nevada Peer Support Network www.nvpsn.org
5. Griefshare is a grief recovery support group. www.griefshare.org
6. The Compassionate Friends, supporting family after a child dies. www.compassionatefriends.org
7. Free virtual grief support groups. www.mygriefangels.org

*The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the IDA.