Washington D.C., Nov 2, 2020 / 12:03 pm
Death. It's a subject seen as sad, morbid and fearful, something that people would rather not think about, and certainly not discuss.
Yet for Catholics, death is an essential part of the faith.
"For those who die in Christ's grace it is a participation in the death of the Lord, so that they can also share his Resurrection," reads the Catechism of the Catholic Church.
The celebration of the sacraments hearken for a kind of death: death to self, death as a consequence of sin, a remembrance of Christ's death and entrance into eternal life.
As the 20th century priest Fr. Henri Nouwen remarked, "Dying is the most general human event, something we all have to do."
The question, he asks, is "Do we do it well?"
Hiding from death
Advances in medicine and technology have drastically increased life expectancies in the past century. In 1915, most people would not expect to live past age 55. A child born in the US in 2017 is expected to see their 85th birthday.
As a result, death has become something distant and even foreign, argues Julie Masters, a professor and chair of the Department of Gerontology at the University of Nebraska, Omaha.
"We get lulled into thinking death doesn't hit us very often, because it waits until people are very old," she told CNA. "We know that younger people do die, that middle aged people do die, but in this country, the majority of people who die are going to be older people."
The average American in the 21st century simply doesn't have the experience with death that previous generations had, she said. And this lack of experience can lend itself to fear and a tendency to ignore the uncomfortable unknown of the future.
"So we'll put it off until we have to talk about it, and when we do talk about it, then we get in a pickle because we're not sure what people want," Masters said.
Hiding from death can have other consequences, as well. Cultural unease and inexperience with death can affect how we approach loved ones as they die.
"If we're uncomfortable with death, if someone is dying, we may be unwilling to visit them because we don't know what to say, when in reality we don't need to say anything," Masters said. "We may be less available to comfort them."
Avoidance of death can also impact vulnerable members of society who are not actively dying, Masters warned.
"Our uncomfortableness with dying may be symptomatic of our desire to control dying and death," she said. When that control or the fear of becoming a "burden" gives way to conversations about physician-assisted suicide, she continued, "we look at the most vulnerable and say 'are they really worthy of living, think of all the resources they're taking up?'"
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"Each step in that slope, it gets easier to get rid of people who are no longer valuable or are vulnerable. Yet don't we learn from the vulnerable?" she questioned. "They're the ones who teach the strong what's most valuable in life."
But Masters also sees a desire to move towards a broader discussion of how to die well. She pointed to the spread of Death Cafes and other guided discussion groups that encourage conversations about death, dying and preparation for the end of life.
Churches can offer a similar kinds of programming, she suggested: "People want to talk about it, they just need the place to do that."
What does it mean to have a 'happy death'?
While a person may plan for their death, ultimately the circumstances of one's passing will be out of their control. However, everyone can aspire to a "good" or "happy" death, said Fr. Michael Witczak, an associate professor of liturgical studies at The Catholic University of America.
He told CNA that the essential qualities of a happy death are being in a state of grace and having a good relationship with God.
The idea of a happy death, or at the very least the aspiration of it, gained popular consideration in the Ars Moriendi – a collection of 15th Century Catholic works laying out the "Art of Dying," he noted.
The texts elaborate on the temptations – such as despair – that face the dying, questions to ask the dying, advice for families and friends, how to imitate Christ's life, and prayers for the bedside.
Resources such as these, from ages of the Church that had a more daily experience of death, Fr. Witczak suggested, can be a good resource for beginning to live "intentionally" and to think more about death and how to die well.
Masters agreed that intentionality is key in shifting the cultural mindset on death and dying.
"What if people approached death with the same joy that they greet the birth of a new baby?" she asked.
It's a fitting analogue, she argues. Both processes – birth and death – are the defining markers of human life, and natural processes that all the living will experience. Both processes also open the door to a similar set of unknowns: What comes next? What will it be like afterwards? How will we cope?
She added that the modern tendency to view death with suspicion and trepidation – or to ignore it altogether – reflects something about the culture.
"If we're so afraid of death and dying, I have to wonder if we're also afraid of life and living."
Last wishes
Discussing death is the first step in making practical preparations for it.
Without planning, Masters said, loved ones may not know a person's preferences for treatment, finances, or funeral preparations, which can lead to sometimes sharp divides between friends and family.
"When we get comfortable talking about death," she noted, "we can let people know what our wishes are, so that hopefully our wishes are followed."
Thorough planning includes setting advanced directives and establishing a power of attorney who can make medical decisions on one's behalf if one is unable to do so.
It is also important to be aware of different care options in an individual's geographic location. These include palliative care, which focuses on improving quality and length of life while decreasing the need for additional hospital visits. Not just limited to end-of-life situations, palliative care is available for a range of long-term illnesses, and seeks to relieve pain rather than cure an underlying condition.
Hospice care is also an option when the end of life approaches. At this point, the goal is no longer to extend the length of life, but to alleviate pain and offer comfort, while also helping mentally, emotionally, and spiritually to prepare for death.
Funeral planning and creating a will are also important steps in the preparation process. Even for the young or those without material possessions, planning for one's death can be useful for grieving friends and family members, Masters said. She explained that the idea of creating an "ethical will" is a Jewish tradition in which a person writes a letter or spiritual autobiography, leaving behind the values and morals they found important in their life to pass on to the next generation.
The practice, which is growing in popularity, is available to anyone "to put down into words what's given their life meaning," and can have special meaning for those who "feel, because they don't have a lot of wealth or a lot of possessions, that they have nothing to leave their family."
Masters pointed to a student of hers who wrote an ethical will shortly before passing away in college and the example of her own grandparents instilling the recitation of the Rosary as people who left behind some of their most meaningful gifts to their loved ones.
"It's a testament to what that person believed in. What a gift that is!"
Paul Malley, president of the non-profit group Aging with Dignity, stressed that planning the more specific details of end-of-life care can help respect a person's dignity during illness or on the deathbed.
"Those who are at the end of life, whether they may be suffering with a serious illness or disability, tend to have their dignity questioned," he told CNA.
The sick and dying are often isolated, receiving care from medical professionals, he explained. And while advanced care planning often focuses on decisions regarding feeding tubes, ventilators, and other medical treatment options, that discussion "doesn't tell your family anything about what dignified care means to you."
"It's important not to just talk about caregiving in terms of medical issues," Malley stressed. "That's a small fraction of a day – the rest of the day plays out at the bedside."
Aging with Dignity promotes planning for acts of comfort, spiritual issues and family relationships in order to make the time surrounding death easier and more dignified for all involved.
"These issues were never talked about when it came to end-of-life care or advanced care planning." Among some of the requests participants make, he elaborated, are small acts of comfort like cool cloths on a forehead, pictures of loved ones in a hospital room, favorite blankets on a bed, or requests for specific family or friends to come visit.
Planning to incorporate what Malley calls "the lost art of caregiving," was important to his own family when his grandmother died. "One of the most important things for her was that she always wanted to have her feet poking out of the blanket because her feet were hot," he recalled.
Although nurses and care providers would often bundle her feet up to try to keep her warm, her family was able to untuck her feet afterwards so she could stay comfortable.
"That might be something that sounds very trivial, very small, but for her, for my grandmother, laying in that bed where she couldn't get up and couldn't reach down to pull up her own blanket, having her feet stick out at the edge of the blanket was probably the most important thing to her all day long," Malley said.
The end of the earthly pilgrimage
For Catholics, spiritual preparation for death should always include the sacraments, Fr. Witczak said.
The Sacrament of Reconciliation, important for all the faithful throughout their lives, is a particularly important spiritual medicine for those nearing death.
Additionally, Anointing of the Sick should be sought for those who have begun to be in danger of death due to sickness or old age, and it can be repeated if the sick person recovers and again becomes gravely ill, or if their condition becomes more grave.
"The Church wants people to celebrate the sacrament as often as they need to," Fr. Witczak said.
The Eucharist can also be received at the end of life as "viaticum," which means "with you on the way."
"It's receiving the Lord who will be with you on the way to the other side," said Fr. Thomas Petri, O.P., vice president and academic dean at the Pontifical Faculty of the Immaculate Conception at the Dominican House of Studies.
He added that the Eucharist can be received as viaticum more than once, should a person recover, and can also be given even if someone has already received the Eucharist earlier during the day.
A good death is a gift
Prayer, reception of the sacraments, and seeking forgiveness from God and one another can mark death as a time of peace, Fr. Petri said. Death can also be a time of surprise, as it "either amplifies the way a person has lived their life or it causes a complete reversal," with some people undergoing profound conversions or surprising hardenings of the heart during their last days.
"Much of it really does rely on the will of God," he reflected, adding that we should all pray for the grace of a holy death.
Dying a happy death is not only a blessing for the person dying, but can be a gift to others as well, Fr. Petri said, noting that family and friends can be drawn closer to one another and to God as the result of a holy death.
Masters agreed, adding that "the dying can serve as examples or role models," by teaching others how to die without fear.
Ultimately, Fr. Witczak said, Christians "do" death differently because Christians "do" life differently.
"I think as human beings, death is a topic we're afraid of and we're told not to think about, and the Christian tradition keeps trying to bring it before people, not to scare people, but rather to remind people of their ultimate destiny," he said.
"This is not simple and it's something people ultimately have to learn for themselves, but it's the important task of life. I think what the Church tries to do is to help people live their life fully and even live their death as an entryway into the life that is promised to us by Jesus Christ."
Looking toward death and the vulnerability that surrounds it can be a vital way of encountering death – and overcoming the fear of it, he said.
Masters agreed, noting that those who have had encounters with death or profound suffering often "look at life differently."
"They understand it is so fleeting. But because they know how close death is they look at life in a different way."
For many people, this different approach to life includes an increased focus on family, friends and service, she said. "That's how you're remembered at the end of the day: what did you do for other people?"
Starting with even the most basic conversations about death, she added, can be beneficial for those wanting to confront mortality.
"When you can acknowledge that you're going to die, you can begin to live your life."
This article was originally published on CNA November 28, 2018.
