Many people wouldn’t consider death suitable kitchen table conversation.
Lani Leary would.
For more than 25 years, the Kaneohe psychotherapist, grief counselor and consultant has been helping others die with grace and dignity, and — more to the point — helping their loved ones realize it is part of love to aid in the inevitable goodbye.
The author of a new book, "No One Has to Die Alone: Preparing for a Meaningful Death" (Simon & Schuster/Atria Books, $15), believes firmly we shouldn’t wait until death is imminent to discuss it with our spouses, our partners, our parents, our children and certainly with the professionals who can attend to the business and legal matters that must be handled in advance if the wishes of the individual are to be carried out and respected.
With children, especially, Leary said, death should be on the table — in age-appropriate language — just as, in good parenting, drugs, sex, bullying, relationships, college and careers should be discussed, because death is the one absolute certainty in our lives.
There is time. The Centers for Disease Control and Prevention’s National Vital Statistic Reports show most of us will not die unexpectedly; 90 percent of Americans die of an illness of some length.
"No One Has to Die Alone: Preparing for a Meaningful Death," by Lani Leary (Simon & Schuster/Atria Books, $15) |
Leary has been a witness at more than 500 deathbeds. "The book’s title is meant to acknowledge that the greatest fear of the dying is not their imminent death, not even their pain. Their greatest fear is being alone," she said. "We can be their companions in this."
Another factor is distance. Older people in America rarely live in a family home. There is little opportunity for them to tell their stories, to say whatever they might wish to say or do, to just be there and watch life go on around them. Instead, if they can afford it, they buy a funeral plan.
It concerns Leary that we have given over the whole matter of death to the funeral industry.
"We are a culture so youth-oriented that to us, aging is weakness, something to be put away. We have no experience with it. We do not watch it," she said.
There is no time with the body, no laying out, no period of memory and mourning that is not clothed in solemnity and … well, Leary would say, pretense.
We’re not allowed to wail. We’re lucky if we’re allowed "a minute alone."
Today she has the skills, the training, the competence she didn’t have when a seminal incident changed her own life and, in effect, put her on her career path.
As a young girl, when she lost her mother at the age of 13, she never got that opportunity.
She recalls an ordinary day when her mother, perhaps anticipating the end, not feeling well, turned to her out of the blue and said, "I love you so much." Leary responded with the feigned indifference of an adolescent. A few days later her mother was hospitalized suddenly.
Leary never saw or spoke to her again. She knew nothing about what happened — it was a rare disease of the immune system called Guillain-Barre syndrome — and was never allowed to go to the hospital.
Later she dared not approach her father in his own overwhelming grief.
"The greatest act of kindness and compassion would have been for someone to ask me, ‘What do you need to know?’ But no one did. People didn’t explain death to children. They thought, like the English, ‘least said, soonest mended.’"
She held these things in her heart. And years later, after years of study and caregiving, Leary was able to do for her cancer-stricken father what she had been unable to do for her mother: to be there, to ask him what he wanted and needed, to provide all she could.
She closed her practice on the mainland to be here in Hawaii with him to the end. It is, she said, an unexpectedly rewarding experience. "When we have done all we could, we have less guilt, less regret. It doesn’t mean we won’t be sad, but we will know that we have done what we could do," she said.
She is a great believer in the use of hospice services to keep the dying in their homes and manage their pain, with professionals there to answer the family’s questions and with the person’s desires respected.
But isn’t it hard to bring up this taboo subject? What if Mom thinks you’re trying to get rid of her? What if Dad doesn’t know what he wants?
Knowledge is power, said Leary.
The book summarizes what she learned from the thousands of dying patients she worked with, what she wished she had known before her mother died. It encourages readers to be brave and proactive about their own death arrangements, not to fear death, but to embrace it as one of the experiences of life.
In summary, she said, "I fully believe that enhancing the quality of a person’s death enhances the quality of our life. I believe that those who engage and participate in the death of their loved ones experience their grief in a softer way than those who, for whatever reason, do not participate. Participation and service heal all of us at the deepest emotional level."
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Lani Leary writes the column “No One Has to Be Alone” at www.psychologytoday.com, and about healing and loss at www.healingthespirit.org. Her website is www.DrLaniLeary.com; contact her at 292-5347 or lanileary@msn.com.