Monday, March 30, 2020

COVID-19 and The Fear of Dying

Image by Gerd Altmann from Pixabay
[Reviewed and updated April 9, 2020]

The future belongs to those who prepare for it today.  ~ Malcolm X

A reader writes: How do we get people talking about their fear of dying and how to live fully now and being prepared??? 

My response: I’m not sure which people you’re talking about, but given the current concern about COVID-19 and all the anxiety surrounding it, I certainly do appreciate your question, especially in these uncertain times. Fortunately the Internet offers a vast array of answers, and I hope I can point you to some resources you’ll find useful, regardless of the circumstances. Here are some I invite you to explore:
Coronafirus shows us why the time to decide on end-of-life care is when you're not sick - "More than ever, this is time to have conversations you never wanted to have about what parts of living are most important to you."

Coronavirus: Doctors urge 'difficult conversations' about death - 
"People should talk to loved ones about their wishes if they were to become critically ill with coronavirus, a palliative care expert has said."

The coronavirus is a chance to have the end-of-life conversations we need -
Gordon Rubenfeld is an intensive-care physician at Sunnybrook Health Sciences Center and Professor of Medicine in the Interdepartmental Division of Critical Care Medicine, University of Toronto. He writes: "These are tense and uncertain times, and we are all looking for ways to prepare for what is likely to be a different world, at least temporarily. But this is a discussion you should have anyway, and so the coronavirus represents an opportunity to speak to your parents, grandparents, aunts, uncles and loved ones with chronic illnesses about life support. Because if you do not talk with them about this now, you may have to have a much more difficult conversation with me later."

As coronavirus spreads, more people thinking about end-of-life directives - "Many are considering medical instructions, guardianship designations and other legal contingency plans."

The Heightened Importance of Advance Care Planning Now - "Amid the chaos and constant news coverage surrounding the coronavirus lies an underlying fear of death and the realization that life is fleeting — yet very few of us talk about how we want to die. Pregnant women go to the hospital armed with 'birth plans.' How many of us have ever detailed a 'death plan?' The coronavirus pandemic, however, has made drafting advance directives and holding end-of-life planning conversations even more essential."

Talking About Death During COVID-19 - "With fear and uncertainty at a fever pitch, it’s absolutely understandable that people would want to soothe themselves by pretending death isn’t real for them. However, we’ve seen over and over again that long term, lasting peace of mind comes from talking about death, voicing one’s concerns, and making plans for end of life – whether it’s yours or your loved one’s." 

Fear Can Spread from Person to Person Faster Than Coronavirus -- But There Are Ways to Slow It Down - University of Michigan Department of Psychiatry's Jacek Debiec discusses how fear about coronavirus can be spread very easily, and describes how it can have negative effects on our society, if people do not recognize how powerful.

Rethinking Advance Directives in the Time of Coronavirus  – End-of-Life University Podcast with Karen Wyatt, MD: “Learn why it is important right now to revisit your own advance directives and those of your loved ones. In this solo episode I share some resources for surviving and thriving during the coronavirus quarantine. Then I discuss some important issues to consider regarding your own advance directives and those of your loved ones as we face a medical crisis that is unprecedented in our lifetimes. This is a difficult conversation to have but one that is of utmost importance right now.”

Death Over Dinner - “How we want to die – represents the most important and costly conversation America isn’t having. We have gathered dozens of medical and wellness leaders to cast an unflinching eye at end of life, and we have created an uplifting interactive adventure that transforms this seemingly difficult conversation into one of deep engagement, insight and empowerment. We invite you to gather friends and family and fill a table. Click Get Started to plan a test dinner. We call it a test dinner because trying out this process in no way commits you to follow through with an actual dinner. Learn More."

The Conversation Project – “The Conversation Project is dedicated to helping people talk about their wishes for end-of-life care.” The Project hopes to transform our culture so that we shift from not talking about dying to talking about it. The patient's wishes about death are elicited, expressed, and respected. It provides free tools and advice, including a Conversation Starter Kit you can download and save to your computer:

People Are Playing Games to Help Them Talk About Death - Recently the folks at SevenPonds tested and reviewed nine different end-of-life conversation starter games. “[T]he past two decades have seen death conversation-starters popping up all across the globe. And now there are even more options to choose from — a virtual avalanche, in fact, of card and board games that prompt participants to talk about death . . . And while it’s a given that all of these games offer some value — after all, anything that gets us thinking about the fact that we are all going to die is a good thing — we surmised that some would be more successful than others at getting people to talk about what matters most to them now and what they think will matter most as their lives come to an end. So to test that hypothesis, we sat down with a group of friends (several groups, in fact) and played nine of the top end-of-life games to see what panned out. Here’s a summary of what we learned.”

Anticipatory Grief and Mourning “Grief does not wait for death to happen; it occurs both in anticipation of and following a loss. Extended illness, disability, severe accidental injury, a terminal diagnosis or the aging and decline of an elderly family member can produce what is known as anticipatory grief and mourning. We find ourselves reacting and continually adapting not only to an expected loss, but to all the losses – past, present, and future – that are encountered in that experience. Anticipatory mourning begins as soon as we become aware that death may happen.” 

When Your Fears About Dying Are Unhealthy - Angela Morrow breaks down our general fear of death into several specific types of fears, including fear of pain and suffering; fear of the unknown; fear of non-existence; fear of eternal punishment; fear of loss of control; and fear of what will become of our loved ones if we die. In this article she describes how the fear of death can affect us in both healthy and unhealthy ways.

6 Positive Ways To Overcome Your Fear Of Death - “Talking with the members of Sixty and Me and Boomerly, I am always amazed how some people are afraid of death, while others find it easy to accept their mortality. So, to help those of you who have a fear of death, I asked them for their advice. Here are a few tips, based on the advice of other people over 50 who have conquered their fear of dying.”

Facts to Calm Your Fear of Death and Dying - “There are many rational things to worry about when we contemplate our own death—perhaps foremost among those is the concern about how our surviving loved ones will cope emotionally and materially without us. But many of our worst fears about death are less realistic and based more on how we imagine death to be. This article is about those unfounded fears.”

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© by Marty Tousley, RN, MS, FT, BC-TMH

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