The two police officers grinned as they patrolled this section of beach. It was seldom busy on a weekday, and given the cloudy weather, only a few families visited, scattered through the area. What caused their grin wasn’t the moms with their toddlers, but the elderly gentleman stretched on a lounge chair with a beach umbrella hovering over him.
“He’s come here for years,” said the older of the two. “Has a cottage up the hill. I’m sure he brought his family here when they were growing up, but now it’s just him. He sure does love this beach.”
Later that day, the older police officer headed back down the beach toward his patrol car, when he spied the elderly man, still in the same position as that morning. He approached and called out, but with no response. His hand on the man’s shoulder and then his pulse confirmed what he’d feared.
He was dead.
What is a good death? That may seem like an oxymoron. What could possibly be good about death? I’m not planning a theological debate at this point but the fact is, we all die. If we think about it at all, we would probably choose, like this gentleman, to fall asleep in our happy place and slip away. Although it’s shocking for those left behind, that kind of death, after a full, vibrant life, would probably be our 
preference.
It doesn’t often happen like that.
Death, especially among elders, usually involves some disease, medical procedures, lessening abilities and pain. For care partners, time commitments increase and many heart-wrenching decisions are required.
Is a good death possible and what elements would it include?
Pain-free
Pain management may be the single most important area where you need to
advocate as a care partner. We will talk later about the difference between palliative
care and end-of-life, but during the final weeks of an elder’s life, pain management is
key. Medication should be in the correct dosage and monitored. Certain medications,
such as morphine, take on a whole new role at the end of a person’s life. The person
who is dying may not be able to express that they are in pain, but verbal signs
(
groaning, sighing) or physical signs (grimacing, wincing, facial expressions) show
the observant caregiver that pain is present and needs to be treated. Doctors, nurses
and other caregivers who are familiar with caring for the elderly or those involved in
hospice care are gifted in treating pain.
Comfortable
Comfort encompasses a wide variety of physical, emotional, social and spiritual
factors. It may be a special mattress or dressings, mouth care or flanellette close to
the skin. Or, it may mean visits from family and friends, a hymn sung at the bedside,
a family pet–anything that was important in life and may have special meaning or
brings comfort in death. As difficult as it may be, it’s important to talk about these
kinds of things before the information is needed. We’ll look at the broad spectrum of
what “keep comfortable” means in another blog.
Care of the Caregivers
Dying is difficult, and not just for the person who is experiencing it. The family and
friends who are there to support also need support. Have they eaten? Do they need to
leave for a coffee, a shower, a nap? Do they need someone to talk with? Do they
need a break? If you are outside the caregiving situation (such as a friend of the
caregiver) stay tuned to their needs. They are close, and the emotions of the situation
may make it impossible for them to recognise even the most basic needs. Keep in
touch, even if it’s by phone or text. Be there.
A good death requires many conversations and much thought long before end-of-
life. In the next weeks we’ll consider some of these issues. Just like quality of life, a
good death can be planned for and achieved.
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