Both individually and collectively, we are paying an enormous emotional and financial price for being silenced by our society's taboo against talking about death and dying. Other societies educate their members about the reality of death and the processes of dying and grieving. We do not. We are left to figure it out for ourselves, relying on doctors and funeral directors to tell us what to do once we are face to face with death. We don't know what to say, what to do, how to cope or to grieve. Most of us simply let "the experts" lead us around by the nose -- too stunned to take charge of the situation ourselves.
Consider the following observations and facts about the costs we bear for this:
(1) Eighty percent of Americans do not put their personal affairs in order before they die.
(2) In 2009, Medicare paid 55 billion just for doctor and hospital bills for the last two months of patients' lives. That's more than the budget for the Department of Homeland Security or the Department of Education. And, it's been estimated that 20-30 percent of these medical expenses may have had no meaningful impact. Most of the bills are paid for by the Federal Government with few or no questions asked. ("The Cost of Dying," 60 Minutes, 8/8/10
(2) Many doctors view their inability to "cure" a patient as a professional failure and are therefore reluctant to suggest palliative care even when they know there is little to no hope of recovery. Largely as a result, the average stay in Hospice care is just two weeks.
(3) Most hospital patients, relying on doctors to advise them of their healthcare options, fail to take into consideration the vested interests of the doctors and hospitals. As a result, many terminal patients are given false hope by a frenzy of tests and procedures that do little more than protect the doctors and hospitals against potential lawsuits and provide financial benefit to the doctors, hospitals, insurance and drug companies while denying the patient the opportunity to transition into his or her process of dying.
(4) A vast majority of Americans say they want to die at home, but 75 percent die in a hospital or nursing home...18-20 percent of Americans spend their last days in an ICU. (("The Cost of Dying," 60 Minutes, 8/8/10)
(5) Most of us have no idea how to discuss the reality of death with our loved ones and are thereby denied the opportunity to share our thoughts, feelings and fears with each other. As a result, many terminally-ill patients put a smile on their faces and silently suffer in emotional isolation.
(6) The average funeral in the U.S., including a cemetery plot and grave, costs between $10,000 and $12,000. Only about 5 percent of Americans preplan their end of life rituals. The rest leave it to their loved ones to figure out while grieving their loss. Bereft family members rely on funeral directors to tell them what to do. Left to second guess what would have been meaningful to the deceased, loved ones typically overspend for fear of not doing enough. Most of us are not even aware of the many less costly and, in many cases, more emotionally gratifying alternatives that are available for saying our final goodbyes.
(7) Legal fees for a simple will are several hundred dollars. The legal fees associated with finalizing an estate where there is no will or a poorly written will run thousands.
(8) While we silently suffer with each other, the medical, accounting and legal estate planning industries are booming at our expense.
For those who agree with me that we need to make some fundamental changes, I'd like to suggest that we begin by breaking through the taboo against talking about death in this country. A good place to start is to explore our own thoughts, feelings and experiences. Taking ownership of our own point of view empowers us to more fully participate in making meaningful decisions on our own behalf and that of those we love. The alternative is to continue to live in denial, fear, silence and paralysis.
I invite you to consider the following questions. You might want to find a quiet place and write your responses:
1. Which of the following best defines how and what you think/believe happens when we die? (More than one might apply).
- We simply stop being - going out like a fire. Our physical body dies and that is all we are.
- We are spiritual beings having human experiences and at death our body dies, but our spirit or soul lives on.
- We only live this one life.
- Our souls reincarnate, taking on different physical identities to work off karmic imbalances accrued from this life and previous lives.
- We go to heaven, hell or purgatory.
- Other. Please elaborate.
2. Did anyone educate you about death? If so, who was it and what did you learn?
3. Have you experienced the death of a loved one? If so, what was that like for you? How did it change you?
4. do you think and how do you feel about your own death?
By breaking the silence within ourselves on this topic, we set the foundation for making decisions that are in alignment with our deepest beliefs and values about life and death. It is in claiming these values and beliefs that we are best able to meet our death on our own terms - with greater self-determination about such things as our end of life healthcare, the disposition of our belongings and the kind of end of life ritual that would be appropriate for us. It also supports us in coping with the death of our loved ones.
Next week, we'll look at talking with doctors and loved ones about our beliefs and preferences. I encourage you to share your comments below or email me at firstname.lastname@example.org.