Die Peacefully

Managing emotional and physical pain is the most difficult part of end-of-life care. You can learn to face the worst, when it comes, with dignity and grace. Make the necessary arrangements ahead of time and make the most of the time you have left.

Note: This article covers end-of-life care. If you're struggling with suicidal thoughts, try this article or call 800-273-TALK, the National Suicide Prevention Hotline, if you’re in the United States. If you’re in a different country, please call your nation’s suicide prevention hotline immediately.

Steps

Managing Pain

1. Talk to your doctor about your pain management options. It's important to make your physical comfort a high priority in end-of-life care. Depending on your condition, you may be taking a variety of medications, or undergoing a variety of different procedures, so it's important to discuss all treatment options with your doctor and ensure your comfort is provided in addition to these considerations.
   • Morphine is commonly prescribed to terminal patients, sometimes on a constant need-basis. While there's some debate about whether or not morphine may shorten your life span, it's efficacy as a powerful pain-reliever is proven. If you're in serious pain, talk to your doctor about the option.
   • In some cases, it may be appropriate to pursue additional non-traditional methods of pain management, like holistic medicine, medical marijuana, or other non-western treatments. As long as these treatments don't get in the way of other care you're receiving, it's likely they'll be approved by your doctor, and might be worth a shot.
2. Be at home as much as possible. While not everyone has the luxury of paying for home palliative care, you should think about what will bring you the most comfort and peace in your particular situation. There may be more help available in a hospital but you may feel more comforted and peaceful in your own home.
   • If you're able to leave the hospital, try to get out as much as possible. Even going for short walks can help to get away from the beeping of hospital machines and be a nice change of pace.
3. Address the symptoms of dyspnea quickly. Dyspnea, a general term for end-of-life breathing difficulties, can affect your ability to comfortably communicate, leading to frustration and discomfort. It's something you can address and care for yourself, with some simple techniques.
   • Keep the head of your bed raised and keep the window open, if possible, to keep fresh air circulating as much as possible.
   • Depending on your condition, it may also be recommended to use a vaporizer, or to have additional oxygen supplied directly, through the nose.
   • Sometimes, fluid collection in the throat can result in ragged breathing, which can be aided by turning to one side, or by a quick clearing procedure your doctor can perform.
4. Address skin problems. Facial dryness and irritation from spending lots of time in a prone position can be an unnecessary discomfort in end-of-life scenarios. As we get older, skin problems become more significant, making them important to address swiftly.
   • Keep your skin as clean and moisturized as possible. Use lip balm and non-alcoholic moisturizing lotions to keep chapped skin softened. Sometimes damp cloths and ice chips can also be effective at soothing dry skin or cotton mouth.
   • Sometimes called "bed sores," pressure ulcers can result from prolonged time in a prone position. Watch carefully for discolored spots on the heels, hips, lower back, and neck. Turn from side and back every few hours to help prevent these sores, or try putting a foam pad under sensitive spots to reduce pressure.
5. Try to manage your energy levels. The routine of being in the hospital will take a toll on anyone, and the constant blood pressure checks and IV drip can make it difficult to sleep. Be honest about your energy levels, any nausea, or temperature sensitivity you're experiencing to get as much rest to be as energetic as possible.
   • Occasionally, in end-of-life scenarios, medical staff will discontinue these types of routines, when they become unnecessary. This can make it much easier to relax and get the rest you need to stay energetic and somewhat active.
6. Ask questions and stay informed. It can get quickly overwhelming, confusing, and frustrating to be in the hospital and feel like you're not in control of your own life anymore. It can be very helpful emotionally to stay as informed as possible by using your doctor questions regularly. Try to ask these types of questions to the doctor in charge:
   • What's the next course of action?
   • Why do you recommend this test or treatment?
   • Will this make me more comfortable, or less?
   • Will this speed up or slow down the process?
   • What does the timetable for this look like?

Making Arrangements

1. Prepare an advance directive. An advance directive is basically just a written document or a series of documents explaining what you want to have happen during your end-of-life care. It may outline a variety of topics, including your wishes for your care, should you become incapacitated, as well as naming proxies and a power of attorney.
   • These documents will need to be drawn up by attorneys and notarized. These aren't likely things that you'll want to have to spend a lot of time dealing with yourself, so it's common to delegate these tasks to others.
2. Do Estate Planning. There's a lot of comfort in knowing that you've taken care of everything ahead of time and haven't left big or stressful decisions to be made after you're gone. If you're up to it, it's important to have legal documents drawn up..
   • A living will describes the type of healthcare you hope to receive and whether or not you'd like to remain on life support, and under what circumstances, should you become incapacitated and unable to make your own decisions. Living wills can be prepared by attorneys and should be prepared ahead of time.
   • Last wills are designed to designate property to beneficiaries, assign guardians for minor children, and elucidate any last wishes. This is somewhat different than a living trust, which will transfer property immediately, as opposed to after your death.
3. Write a Medical Power of Attorney. In some cases, it may be good for you to delegate these responsibilities instead to a proxy, in the event that you're unwilling or incapable of making these decisions for yourself. This is often an adult-aged child or spouse, who will be tasked with making choices regarding your health care as things progress.
4. Write a Medical Power of Attorney. In some cases, it may be difficult to choose or assign proxy responsibilities to a private party, and you may wish instead to assign them to an attorney. This is extremely common and can be a relatively stress-free way of turning over technical responsibilities to someone else, allowing you to deal with your own comfort and emotional responsibilities.
   • A health care power of attorney is different than a general power of attorney, which provides for financial assistance after death. While both of these may be appropriate options, it's important to distinguish between them.
5. Plan Your Own Funeral. Though it may be slightly unnerving, it’s important to decide what you want to happen to your body after you die. There are many options and considerations, depending on your culture and religious background.
   • If you want a funeral, or religious ritual to be performed after your death, you may want to arrange the ceremony yourself, or delegate the responsibility to a loved one. Make the arrangements in terms of churches, funeral homes, if it helps you to find closure.
   • If you want to be buried, decide where you want to be buried and which family members you want to be buried near, if you haven’t made those decisions already. Secure a burial plot by making a down payment, and make arrangements with a funeral home in your area, if necessary.
   • If you'd like your body to be donated, make sure your donor status is up to date and accurate, according to your wishes. Contact the university or foundation to which you want your remains donated and make the necessary arrangements.

Making the Most of Your Last Days

1. Do what feels natural. There's no right or wrong way to die. For some people, it may be desirable to spend as much time with friends and family as possible, while others may find comfort in solitude, choosing to face things alone. Some people might want to kick up their heels and make the most of the last days, while others may want to go about the same basic routine.
   • Don't be afraid to have fun, or to spend your time laughing. Nowhere does it say that the end of life is supposed to be a somber affair. If you want to do nothing more than watch your favorite football team and joke with your relatives, do so.
   • It's your life. Surround yourself with the things and the people that you want to be surrounded with. Make your happiness, comfort, and peace your priority.
2. Consider pulling away from your work responsibilities. Few people receive a terminal diagnosis and wish they'd spent more time at the office, and one of the most common near-death regrets is of working too much and missing out. Try not to spend the time you have left, if there isn't much, doing something you don't want to be doing.
   • It's unlikely you'll be making a marked financial difference for your family in a short amount of time, so focus on what will make a difference: addressing the emotional needs of yourself and your family.
   • Alternatively, some people may find energy and comfort in going about the routine of work, especially if you're feeling physically strong enough to do so. If it feels natural and reassuring to keep working, do it.
3. Meet with friends and loved ones. One of the biggest regrets those who are facing death express is not staying in touch with old friends and relatives. Remedy this by taking the opportunity to spend a little time with them, one-on-one if possible, and catch up.
   • You don't have to talk about what you're going through if you don't want to. Talk about your past, or focus on today. try to keep things as positive as you want them to be.
   • If you want to open up, do so. Express what you're going through and release some of the grief you're experiencing with people you trust.
   • Even if you don’t have much energy for laughter or conversation, just having them sit by your side can bring you worlds of comfort.
   • Depending on your family situation, it might be easier to meet with people in big shifts, seeing whole families at once, or you may prefer focusing on individual meetings. These have a tendency to help slow down time, focusing on quality, rather than quantity. This can be a great way of maximizing the time you have left.
4. Focus on unwinding your relationships. It's common for those near death to want to uncomplicate complicated relationships. This can mean a variety of things, but it generally means trying to resolve disputes and go forward less burdened.
   • Make an effort to end any fights, arguments, or misunderstandings so that you can move forward. You shouldn’t engage in arguments and keep fighting, but rather, agree to disagree when necessary and end your relationships on a good note.
   • While you probably can’t be around the people you care about all of the time, you can plan to see them in shifts, so that you rarely feel alone.
   • If you can’t see your loved ones in person, making a phone call to someone you care about can make a difference as well.
5. Decide how much you want to reveal. If your health situation is unknown to your friends and family, you may elect to let everyone know what's going on and keep them up to date, or you may prefer keeping things private. There are advantages and disadvantages to each choice, and it's something you'll have to decide for yourself.
   • Letting people know can help you get closure and feel ready to move on. If you want to grieve together, open up and let your friends family in. You can tell them individually to make it feel more personal, and tell only those people that you really care about, or make it more public. This can make it difficult to avoid the issue and focus on lighter subjects over the next weeks and months, though, which is a negative for many people.
   • Keeping your situation private can help to maintain your dignity and privacy, a desirable thing for many people. While this might make it difficult to share and grieve together, if you feel like this is something you want to take on alone, you might consider keeping it private.
6. Try keeping things as light as possible. Your final days probably shouldn't be spent pouring over Nietzsche and contemplating the void, unless you're the sort of person who finds pleasure in these things. Let yourself experience pleasure. Pour yourself a glass of whiskey, watch the sunset, sit with an old friend. Live your life.
   • When you face death, you don't have to make an extra effort to come to terms with it. It will come to terms with you. Instead, use the time you have left to enjoy the people and things you enjoy, not to focus on death.
7. Be open with what you want from others. One thing you may have to deal with is the fact that the people around you are having trouble coping with your death. They may look even more upset, hurt, and emotional than you feel. Try to be as honest as seems kind with your family, when discussing your feelings and desires.
   • Though you may want nothing more from them than comfort, optimism, support, and love, you may find that they will be having trouble in their own grief. That’s perfectly natural. Accept that people are doing their best and that they’ll need a break sometimes, too. Try your best not to be angry or disappointed at how they’re reacting.
   • You may find that some of your loved ones are showing little emotion at all. Don’t ever think that this means that they don’t care. It just means that they are dealing with your health quietly, in their own way, and that they’re trying not to upset you with how they feel.
8. Talk to a religious advisor, if necessary. Talking to your pastor, rabbi, or other religious leader can help you feel like you’re less alone in the world and that there’s a path laid out for you. Talking to religious friends, reading religious scriptures, or praying can help you find peace. If you’re well enough to attend your church, mosque, or synagogue, you can also find peace by spending more time with people in your religious community.
   • However, if you don’t subscribe to a religion, don’t feel compelled to change your mind and to believe in the afterlife after all if that’s not really true to who you are. End your life as you've lived it.
9. Don't end your life prematurely. If you’re looking for a way to die peacefully because you want to end your life, don't. You should talk to a trusted friend or family member, check yourself into a hospital, and make an effort not to be alone at any cost. You may feel like you have no better option than to end your life. If you want to die peacefully, then you should make the most of your life while you can.
   • If you’re thinking about suicide and need immediate help, please call 800-273-TALK, the National Suicide Prevention Hotline, if you’re in the United States. If you’re in a different country, please call your nation’s suicide prevention hotline ASAP. Remember it is not worth it and nothing good can happen.

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Sources and Citations

See also

• Make Preparations for a Funeral
• Cope with Loss and Pain
• Pay Your Respects when Someone You Know Dies
• Let Someone Go
• Write a Eulogy
• Tell a Good Friend That You Are Dying
• Write a Eulogy Speech
• Dress For a Funeral
• Write a Thank You Note After a Funeral
• Go on Living when Someone You Love Dies

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