End of Life: An Important Part of the Journey
Opportunities and Challenges as One Approaches Death

Martha F. Simpson, Ph.D.

It has been said that dying is the second most important thing you do in life, second only to being born. In American culture there is still much fear and secrecy surrounding this natural, universal step we all take. Many of us live as though death is something that will only happen to someone else, and we change the subject automatically when thinking about our own.

The period approaching death can be, for many, an extraordinary time of growing, resolving and reconnecting. The literal, physical process of moving toward completion can allow one to pick up the psychological “dropped stitches” of strands of earlier life that have been put on hold, ignored or painted around. But--comfort first. There is a rich storehouse of knowledge about managing physical comfort during this period, and Western and integrative medicine approaches have much to offer. As the natural process of winding down and shutting down occurs, it is important to remember that our bodies know how to die—there is a known sequence of what happens as the body faces whatever health problems have heralded the end of life.

As these natural processes are occurring, then the mental/emotional processes of completion can occur. While medications may obscure awareness to some degree, often people find a remarkable clarity that visits unexpectedly. For those whose ability to be mentally present is sustained, and for those who want to, the period approaching death can truly be an opportunity to wrestle with big questions---the meanings of one’s life, the life review that puts things into perspective, the connection to a spiritual ground of being if that fits one’s framework. For others, the big questions may have already been answered, or be less relevant than the compelling need to address relationships—saying what hasn’t been said, contacting those on the long list of “One day I will”, allowing others to do the same. And for many, this part of the journey can be a time of simple awareness of the ordinary, details of daily living that are experienced with new appreciation once they are freed from the matrix of “taken for granted ”.

For many, the challenge is to face fear, grief and loneliness, and good “companioning” can be extraordinary medicine for the person wrestling with them. An accepting, listening presence can allow someone in a dying process to rest in the moment. Those people surrounding the person who is in a dying process may find many gifts—as well as tremendous challenges to their beliefs, their courage and their patience as they help to row the boat to shore.

The complexities, the richness, the difficulties are all present at end of life and each person’s transition is part of the whole journey—to be supported, honored and facilitated in every way possible.