Living with Death

Facing death brings emotional and spiritual challenges. Follow this wisdom to help you through the process.

Contributor

Suzanne E. Pertsch, M.D.

Mills-Peninsula Medical Center

Palo Alto Medical Foundation

When you or a loved one receives a terminal diagnosis or realizes that further treatments cannot cure an illness, you have to face the reality of death. This can be a challenging stage of life, but also a deeply rewarding and meaningful one.

Don’t focus too much on death itself, palliative care doctor Suzanne Pertsch, M.D., suggests. "Dying is a very short stage of life, just like birth. Birth is what, 24 hours? Dying is about the same,” Dr. Pertsch says.

Elderly woman and caregiver

As medical director of Palliative Care at Mills-Peninsula, Dr. Pertsch helps patients focus instead on living each day to the fullest. Our culture, she says, needs to do a better job of making the end of life “a celebratory stage of life, like the anticipation of the birth of a child.”

Dr. Pertsch recalls one patient who did just that.

After the woman decided not to receive further treatments for advanced cancer, “she turned her energy toward having really intimate and meaningful conversation with all of the people that she had relationships with throughout her life.” She also helped plan her son’s wedding and made a video about her life for her future grandchildren.

While everyone’s end-of-life journey will be unique, Dr. Pertsch offers some suggestions for navigating this period of life.

Approach Death as a Normal, Developmental Stage

“Dying is not a medical condition—it’s a developmental stage of life,” Dr. Pertsch says. “When a child goes to elementary school and goes through all kinds of developmental stages, we look to our friends, our parents, our teachers, our coaches to support us through those stages.”

Find Safe Spaces to Talk

Often, Dr. Pertsch says, people feel more comfortable talking about medications and tests than about “the elephant in the room—‘how much I’m going to miss you.’” Make space to experience all of your emotions and to have them validated, she says. That can be with loved ones, a spiritual group or advisor, a grief-counseling group or resources provided as part of palliative care or hospice.

Don't Force Acceptance

Most people, as they approach their senior years, have come to accept death, Dr. Pertsch says. Others have to accelerate that process because life throws them a curveball. “Acceptance comes for almost every patient I’ve ever worked with, and it’s a natural thing; it doesn’t have be forced,” she says. “But supporting the process with the right conversations can really help.”

Recognize that Death is not “Fixable”

Resist the urge to control or stop what is essentially a natural process. “It robs everybody else of the opportunity to be present in the moment, to just bear witness, to settle one’s heart, to have those conversations and allow for true peacefulness and acceptance of the death,” Dr. Pertsch says.

Have Confidence that the Body Knows How to Die

The body instinctively knows what to do as it approaches death, Dr. Pertsch says. “Just like the body adapts for childbirth, wonderful physiologic mechanisms are built into our biology that make death a very easy process for most people,” Dr. Pertsch says. “Almost every death I have been present for has been the most beautiful, peaceful, comforting, spiritual experience that you can imagine. It’s not something that we should fear.”

End-of-Life Resources

Palliative care and hospice help ease physical symptoms and also provide resources to address the mental, emotional and spiritual aspects of dying.
The National Institute of Health has a helpful booklet for caregivers with detailed information about what you can expect as a person approaches death and how you can provide comfort.
The Association for Death Education and Counseling has articles on coping with grief and loss, and links to many additional resources.
The Conversation Project offers guides to help people talk about their end-of-life wishes.