if you are facing a terminal illness...
Some of the challenges that accompany the death and dying process include:
- Coping with physical pain;
- Coping with fear, anxiety and emotional or spiritual distress;
- Concern about separation from loved ones or transition to the unknown; and
- Angst about what can one expect when death comes.
Coping with physical pain
Modern medicine has developed a spectrum of advanced techniques for pain management. There are innovative pharmaceuticals to reduce most of the pain associated with a terminal illness. In addition, there are excellent complementary treatments that can help mitigate pain without the side effects of some medications. And often the combination of both traditional and complementary medicine offers the most successful treatment plan.
Hospice by and large does an excellent job of helping the patients manage pain in a tolerable way, while maintaining lucidity and consciousness during the last days. This enables a patient and his or her loved ones to enjoy the benefit of continued meaningful interaction for as long as possible. Hospice offers additional resources to assist with other practical needs that arise during a terminal illness, such as putting affairs in order. Their programs consider the patient and his or her family to be the unit of care, for the process of dying involves challenges not only for the person who is ill, but for all loved ones and caregivers as well. They also offer ongoing bereavement support to surviving loved ones.
No one should die alone or in fear or in pain given the availability of hospice care in nearly every community across the United States. To find the location of a hospice near you, please contact:
National Hospice & Palliative Care Organization 800-658-8898 or www.nhpco.org.
Your physician can help you determine if and when hospice care may be appropriate, and most can facilitate a referral to a local hospice for consultation.
Coping with emotional or spiritual distress
It is natural that fear, anxiety, or emotional or spiritual distress can arise as one faces the end of one’s lifetime. Dr. Kübler-Ross, the Swiss-born psychiatrist who started the hospice movement in the United States, wrote several best-selling books about death and dying. She devoted much of her celebrated career to treating the needs of dying patients. She was among the first medical doctors, if not the first, to develop specialized expertise in caring for the psychological, emotional and spiritual needs of terminally ill patients.
In counseling her dying patients, and often in her public lectures, Dr. Kübler-Ross made frequent use of the metaphor of a butterfly. She said:
“What the caterpillar calls disaster, the butterfly calls liberation.”
The plain truth is that your perspective is all-important in how you view or react to impending death. Dr. Kübler-Ross would inform her patients that by shifting their perspective on what happens as death nears, they can effectively resolve or retire fear, anxiety, sadness and depression.
Using the butterfly metaphor, Dr. Kübler-Ross would explain to her patients and students that the caterpillar does not know it is about to become a beautiful butterfly, so it fears, resists and fights the natural transformation it is undergoing simply because it does not know any better. It only knows existence as a caterpillar and it clings to that particular identity.
However, she said, if the caterpillar could somehow know it is about to enjoy rebirth as a magnificent butterfly, its transition into that form would be a welcomed, happy and joyous occasion. The butterfly is no longer earthbound like the caterpillar. It takes flight and enjoys a whole new refreshing view of things. And, so it is when the spirit leaves the physical body, shedding its cocoon, to take flight and climb to an entirely different vantage point on the whole of existence and ultimate reality.
The poet Kahlil Gibran expressed the same sentiment in his classic book The Prophet:
You are not enclosed within your bodies, nor confined to houses or fields. That which is you dwells above the mountain and roves with the wind. It is not a thing that crawls into the sun for warmth or digs holes into darkness for safety, but a thing free, a spirit that envelops the earth and moves in the ether.
As death approaches, people sometimes fall into spiritual distress characterized by a deep state of resignation, withdrawal, sadness and depression. They can be overtaken by a profound identity crisis, realizing the body will soon cease to exist. If they are like the caterpillar, they may believe that they are only their bodies; their self-worth may be based on financial status and material possessions, or on social and lifetime accomplishments. And when these things begin to slip away, some may wonder what is left? What becomes of “me” if “I” can no longer define “myself” in these terms?
Most religions offer deeply rooted perspectives about these questions, which can provide comfort for those who share their respective beliefs. Additionally, the messages from those who have had near-death experiences, from a broad range of cultures and religions or non-religious backgrounds, when taken in aggregate form, can offer a measure of hope and a glimpse into the afterlife.
An arguably universal agreement is that death is the great equalizer and that which transforms us from earthbound physical existence – caterpillars if you will – into spiritual beings – or butterflies no longer encumbered by the cocoon, liberated to take flight and explore domains and dimensions not imaginable from the earthbound perspective.
Dr. Kübler-Ross has suggested that we can allay the fear, anxiety, sadness, and depression that may come about when facing death by turning the dial of our inner mind’s eye to a different frequency. By shifting the perspective about who we really are, focusing upon our larger, truer, eternal “butterfly identity” instead of our earthbound, temporal, physical “caterpillar identity,” we can triumph over the ordeal of physical death, seeing it as a beautiful transition rather than finality.
The challenge, and the source of hope, is in understanding the spiritual self. And, while it is not easy for anyone to hear a doctor’s diagnosis that “you only have a short time left to live,” or “that you are going to die from a terminal illness,” that is the precise time to recognize that such statements apply only to the physical body and not to the true spiritual self. We are not solely our physical bodies, and death is not the end. As Dr. Wayne Dyer often said, “we are spiritual beings having a human experience.”
We encourage you to read and consider the information posted on this website. See if it resonates with you. Explore your own beliefs, and whether they should be modified in light of the personal accounts of others. Explore the possibility of new perspectives.
Consider more ponderings of Kahlil Gibran, writing in The Prophet:
If you would indeed behold the spirit of death, open your heart wide unto the body of life, for life and death are one, even as the river and the sea are one. In the depth of your hopes and desires lies your silent knowledge of the beyond. And like seeds dreaming beneath the snow, your heart dreams of spring. Trust the dreams, for in them is hidden the gate to eternity. Your fear of death is but the trembling of the shepherd when he stands before the king whose hand is to be laid upon him in honour. Is the shepherd not joyful beneath his trembling, that he shall wear the mark of the king? Yet is he not more mindful of his trembling? For what is it to die but to stand naked in the wind and to melt into the sun? And what is it to cease breathing but to free the breath from its restless tides, that it may rise and expand and seek God unencumbered? Only when you drink from the river of silence shall you indeed sing. And when you have reached the mountain top, then you shall begin to climb. And when the earth shall claim your limbs, then shall you truly dance.
Concern about loved ones and about transition to the unknown
Even if one feels prepared spiritually and mentally for death, it is natural to be concerned about loved ones and to have questions about what to expect at the moment of death. For insight into these matters, we can look to consistency in reports from those who have had STEs of one kind or another, which are defined and explained on this website. These types of experiences offer us the best information regarding the process of dying and separation of consciousness from the body.
People who have reported NDEs have not actually died in a legal or medical sense, in that they returned to life. They were characterized as being “near-death” because they lost cardiac and respiratory abilities for a time, rendering them unconscious. In that sense they have been closer to actual irreversible death than the rest of the population. There have been millions of reported NDEs from all over the world, and historical accounts that closely mirror contemporary accounts dating back to Plato and ancient Greece. These accounts are hopeful and should be considered seriously.
What Can One Expect When Death Comes?
In the cases described by Dr. Raymond Moody in his classic pioneering book entitled Life After Life, most people reporting NDEs indicated that the dying process begins with a profound sense of peace and well-being. This is soon followed by a floating sensation in which the consciousness or spirit separates from one’s physical body, ascending above it. In this out-of-body state, they report hearing and seeing all that is taking place around them.
Next, a guide or angel appears, sometimes a deceased loved one or close friend. Many report being escorted by the guide or angel through a tunnel or vortex of some kind. At the end of it, they emerge into a place of indescribable beauty, a realm of brilliant light, where they encounter deceased loved ones and friends who come to greet them in what they describe as a joyous reunion. They also report encountering a radiant Being of Light, who they describe as a supreme divine presence. This Being of Light welcomes them with unconditional love…a love which they say is inexpressibly profound.
Upon encountering the Being of Light, they are shown a panoramic review of their lifetime—everything they ever thought, said, or did being instantaneously and simultaneously presented or shown to them, as well as the ramifications or consequences of same in the lives of others. Where they brought love and joy to others, they experience the same feelings, exponentially. Where they caused pain or harm, they feel this too, as if the pain or harm they caused is happening directly to themselves. They say that no external judgment takes place during this life review. Rather, they say they judge themselves in the presence of absolute truth, knowledge and love. Where they were the cause of harm or pain, they instantly and genuinely feel the need to atone.
Following the life review, typically, the Being of Light or a guide or an angel informs them that they must return to their bodies to serve some unfulfilled purpose on earth. In some instances, individuals are given a choice to stay or return. Most who return undergo a dramatic change or transformation. They become more kind, compassionate and altruistic. They lose the fear of death entirely. Their belief in a Creator and in eternal existence is solidified as well.
In nearing-death awareness cases, observers by the bedside of a dying person report a myriad of extraordinary occurrences. Oftentimes, they report that the dying person, although unconscious and in the throes of death, will utter words or names as if greeting some invisible entity that has entered the room. Sometimes the dying person will speak in a language no one knew they could speak, or may speak aloud to answer questions only they can hear. Commonly, observers at the bedside of the dying person may notice that a clearly discernable glow or halo settles over the dying person just as he or she makes their transition. They also frequently report dramatic changes in the facial countenance of the dying patient as death approaches, often casting a deep smile, looking quite relaxed and peaceful.
What can be inferred from this discussion is that death is nothing to fear. It is as natural as being born. This is not to say it is easy or effortless. Dying is a monumental affair and this discussion is not intended to minimize it. Bidding farewell to one’s body, one’s earthly identity, and one’s loved ones and pets, can be very painful and sad. But as Gibran poetically states, it is when we reach the mountaintop that we truly begin to climb, dance and soar.