Hi, nice to meet you. Let’s talk about death.

I’m here to talk about death. Yours, mine, the deaths of people we know and love. The common experience that all of us are going to have (unless you are a Greenland Shark, in which case please keep the smug comments to yourself) sooner or later. We will talk about how to think about and plan for your own demise, and also offer help and advice in caring for loved ones who are dying. I want to cover the stuff I think it is important for you to know even though you don’t know it yet, the stuff that you think is important, and the stuff you may think is important that isn’t as important as you thought. Do I have a point of view? Oh HELL yes. I have so much POV that I need several semi-trailers just to store them in between rants. But the most important part of my job, and the job of any of us caring for others is that our POV is irrelevant most of the time because our role is to be supportive of the family and the patient. We need to understand our views and prejudices, our beliefs and fears – but that is so that we can recognize when they might be trying to assert themselves inappropriately. We are here to witness, to support, to share our knowledge and expertise in the mission of providing comfort and peace to the dying in their own terms. Of course this is my blog so what I am going to share is a LOT of my POV and opinions. I am going to do my very best to offer plenty of examples and quite a few of those will illustrate alternative views and unexpected or even undesired outcomes.
My goal is to post starting with an intro to the concepts and what they look like in the US (which is what I am familiar with), discussions of advanced directives, discussing care plans and talking a lot about common misconceptions regarding medicine and end of life care. Then advance into some specific discussions about what the end stage of various disease processes look like, what things we watch for in each case, and particular symptom management (in a general sense). General caregiving tips and things to watch for and recognize as the dying process progresses. The biggest thing you are going to see is weasel words. So. Many. Weasel. Words. Because YMMV does not even begin to cover it. I will also provide resources and links to help both before and after a death. I feel very strongly about my responsibility not just to my patients, but to families and loved ones. I have seen again and again how the experiences that folks have, especially traumatic ones, become a part of the fabric and lore of that family. Misunderstandings or bad experiences become the wisdom that families use to make decisions later on. So it is important to me to point out and explain things that I have seen misinterpreted in the past.
Things I won’t talk about: specific patients or any experiences of family, friends or acquaintances without specific permission. Any cases I discuss will be composites of patients with all names changed. I do not get into discussions about “what is the worst death”, “what is the worst you have seen”, “what diagnosis would you kill yourself if you got” or any such nonsense. Because A. That is nobody’s business and B. Why the HELL would I scare people who might get whatever diagnosis I spouted off about? Besides, my job is ensuring people are as comfortable as they choose to be (more on that later) no matter what their diagnosis is. Part of my responsibility is to consider everyone who is listening to what I say and how the information I provide is going to be carried forward in their lives. This will come up again in discussing advanced directives.
My other goal is to provide a place to ask questions and look for resources. So please feel free to comment. Comments will be moderated for relevance, content and respect. So don’t be a dick. And take a look at the ‘about me’ as well as the disclaimer page.

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