living your best to the end

What’s important?

personal decisions

We’re different, and yet we’re the same.

What’s important may be different for each of us, yet there are common human elements that are the same for many of us.

For many, it’s important to die without regrets.

Bronnie Ware Bronnie Ware, a palliative nurse identifies what are consistently the Top 5 Regrets of the Dying: (also available as a book of the same name)
  1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
  2. I wish I didn’t work so hard.
  3. I wish I’d had the courage to express my feelings.
  4. I wish I had stayed in touch with my friends.
  5. I wish that I had let myself be happier.

For many, resolving relationships is important:

Dr Ira Byock a palliative care doctor, author of The Best Care Possible: has the 4 most important things that need to be said before life’s end:

Dr Ira Byock
  1. Please forgive me.
  2. I forgive you.
  3. Thank you.
  4. I love you.

Byock wrote Dying Well in 1998. His views on how we die remain unchanged, in an interview with New York TImes ‘New Old Age’ reporter, Paula Span: The American way of dying, he points out, involves too much suffering for both patients and families, and routinized medical response with not enough individualized care. It means not enough listening, not enough support for families, way too much expense.

For many, honesty and straight talk are important:

Dr Stephen Workman, an internist, sees many patients who want to know, but aren’t told – in plain language – that they are dying. From his interview with New York Times New Old Age columnist, Paula Span:

“When I see patients who I think are at risk of dying, I say to the family and patient, ‘You could die during this hospital admission. Is that something you’ve been thinking about?‘ Then you can go forward and ask, ‘What have you been thinking, and what are your expectations?‘ When you plant the seed that death may be the outcome, people have more acceptance. They can initially be very shocked: ‘My goodness, I never knew he was that sick.‘ They need time to come to terms with it. So you give them more time, rather than tell them in the I.C.U. (Intensive Care Unit) that it’s time to turn off the ventilator.”

Interesting Reading:

When does ‘no’ mean ‘no’ in health decisions

©Kathy Kastner