Grief and Bereavement

Preparing for a Good Death: Saying Goodbye

BY LOH YAN ZHU

26 November 2020  |   5 min read

My first experience with death impacted me significantly. I was a caregiver for my younger brother who was born with a congenital heart defect. He had two holes in his heart and had several surgeries as a baby.

Since then, he was homebound and had special needs. The Severe Acute Respiratory Syndrome (SARS) outbreak in 2003 caused hospitals to be wary of unnecessary visits. As a result, he could not receive timely medical support and passed away at the age of 15.

I remembered being furious with myself for not looking out for him or observing his health status closely and blamed the many SARS precautionary measures for causing the death of my beloved brother.

“Little did I expect that this experience would impact me as I battled with guilt and regret for not being able to say goodbye during his last moments.”

I often wondered if he had a peaceful death and why he had not said any parting words to me. Was he angry at me for not caring for him enough? Till today, I do not have answers to any of these questions.

The COVID-19 outbreak brought a floodgate of memories of him back to my mind. This time around, I reflected as a counselor and started to think about families who may be undergoing similar experiences. I wondered what would have helped my brother to have a good death and for caregivers (like myself) to feel less guilt and hurt so the pains and regrets during the grieving process are minimized.

The answer is to make a conscious choice in preparing our loved ones and ourselves for departure.

Death is inevitable but we can prepare for a good death.

 

From my experience with palliative clients and caregivers, the common answers on what a good death constitutes are lesser suffering, manageable pain, and being free from avoidable stressors for self, family, and friends.  Hence, to achieve a good death, we can think of it in four main areas:

1. Biological aspect

This comprises reducing physiological sufferings such as pain and discomfort. We can plan for end-of-life care arrangements, complete our Advance Care Planning (ACP), and Lasting Power for Attorney (LPA). This ensures that our loved ones know our preferences of care and what to expect so they can act in our best interest.

2. Social aspect

Communicate with our family and friends about our end-of-life needs and preferences. Do we want visitations? Whose company do we hope for and what can our loved ones do for us? Do we even want to prepare gifts for our loved ones? This can help alleviate unnecessary stressors and anxieties towards the last goodbye.

3. Spiritual aspect

Discuss funeral arrangements and religious rites preferences. Communicating with all our loved ones our choice of hymn or sutra, funeral environment, type of burial, and placement of tablets can provide a sense of comfort and peace.

4. Psychological aspect

This focuses on managing anxieties, fears, and uncertainties towards death. It is important to foster meaningful end-of-life conversations between our loved ones and us. This will help prepare not just you, but also your loved ones to be ready when the time comes to say goodbye.

Ironically, most of us only start to think of what we did not do or have not done enough upon reaching the end of our lives.

During my counseling experiences with palliative clients, I often hear these top three regrets from my clients:

  1. Not saying “I love you” enough.
  2. Not spending enough quality time with loved ones and friends.
  3. Not forgiving/seeking forgiveness from others.

Ironically, most of us only start to think of what we did not do or have not done enough upon reaching the end of our lives. By then, we may be grappling with our bodily symptoms and often fighting against time to fulfill each of our wishes and to find the desired closure.

Often, the death of a loved one shapes how we view life and death thereafter. If our experiences were positive, we would be able to view and accept death as a way of life or celebration of a good life. Conversely, if our experiences were negative, we would view death as something fearful and unmanageable.

With Covid-19 and Phase II of the economy re-opening, most of us are operating on a slightly different mode and pace. We should start taking some time to reflect and begin being curious about how we want our final days to be — we can then work towards accepting death as a way of life and find peace within ourselves. Seek the closure and resolution of earlier experiences that have significantly impacted you and your loved ones (be it through apologies or appreciation), share and show your family and friends your love and wishes for them, and do the things that make you feel at peace. Good end-of-life conversations would allow our loved ones to feel comforted and assured that they had done enough and aid them to feel and heal better during the grieving process.

With that, I would like to end this article with a short reflection list for all to work on. Do spend some time to reflect upon these questions and possibly to act on them today.

Before I leave this world:

  1. I wish to thank…….
  2. I wish to forgive…….
  3. I wish to seek forgiveness from……
  4. I wish to convey my love to……
  5. I wish to say goodbye to……

 

The contributor is a Senior Counsellor at Hua Mei Counselling and Coaching, Tsao Foundation.