It is only when we truly“ know and understand that we have a limited time on earth, and that we have no way of knowing when our time is up, that we will begin to live each day to the fullest, as if it were the only one we had.”
- Elizabeth Kübler-Ross
The timeless wisdom of these words by an extraordinary psychiatrist, author and humanitarian still resounds in the consciousness of informed people all over the world today. Her uniquely famous book, On Death and Dying, has a sub-title which underscores the enduring and vital point of a lifetime of dedicated investigation: “What the dying have to teach doctors, nurses, clergy, and their own families”. Kübler-Ross was an ardent supporter of the hospice care movement and proposed the famous Five Stages of Grief, which is by now commonly known as the subconscious pattern we employ when adjusting to the trauma of loss. In order to ensure tranquillity of mind and an ongoing capacity for joy in our valued elderly relatives, it is up to each of us to summon equal insights, care and courage about helping them to change the inevitability of death into a dignified process.
A Shared Experience
The topic of dying is one we tend to want to avoid. This aversion to facing the finality of it is not fair on those approaching it, for it is precisely then that our elderly loved ones most need our shared comprehension and support. Uncertainties and fears about dying only loom larger if they are avoided – discussing death and persuading your loved one to draw up a Living Will can be of enormous benefit. The terms “living will’, “health care directive”, and “advance directive” all refer to the legal document in which people state their wishes for end-of-life medical care. It can provide reassurance and an immense relief to know that professionals like one’s medical doctor, spiritual advisor or attorney are informed about and support one’s final wishes.
The why and how of drawing up such a will shows how essential and simple this process can be.
SAVES: The Living Will Society
Though it no longer exists, the reasons why a Living Will is important is most effectively summarised by the acronym (SAVES) of this non-profit organisation who were instrumental in having a Bill passed in Parliament to ensure that Living Wills have the force of law. According to this Society, a Living Will “SAVES’’:
• Suffering and pain
• Anxiety for loved ones
• Valueless prolongation of terminal illness,
• Existences without quality of life, and
• Spending life savings unnecessarily
Though it is by no means necessary to join SAVES to draw up a Living Will, we will touch on the values on which their organisation was based. These principles still effectively express the universal issues surrounding the stage when the person can no longer communicate his or her wishes about treatment:
• death is a natural phenomenon and should be endured with dignity
• all individuals should have the right to reject medical treatment once they are terminally ill
• artificial life support systems should not be used if they result in inhumane life conditions
• they should be used only for recovery and not to delay death
• any unnecessary mental and physical stress in the patient should be prevented
• neither the patient nor their loved ones should have their suffering prolonged
How to Create a Living Will
One can create such a document in an extremely simple form without the high legal fees of hiring an attorney. The directives in it can be cushioned in words of the individual’s choosing. As long as the instructions it contains are signed by the individual concerned and two witnesses, in each other’s presence, it is considered legally valid. The contents in such directives is fairly standard, therefore one can visit www.dignitysa.org and download what is termed their Advance Directive Form for a planning guide to formulating your own. An excellent, effortless and inexpensive option is to become a member of The Living Will Society (website: www.livingwill.co.za) for a nominal fee. This other organisation provides one with the required pro forma documents and accompanying explanations and advice. The third option is to hire a lawyer to prepare the document according to individual specifications.
Participation in the process
What is most important to remember is that, for the sake of the treasured ones we are about to lose, we need to participate in the process of their dying, to hear their needs in this most vulnerable, intimidating stage of their lives.
Professor Allan Kellehear (the Centre of Death and Society) confirms this in his following comment on Kübler-Ross’ work:
“On Death and Dying encourages ordinary men, women and children to converse with their dying, but also to forcefully widen that engagement to include a dialogue with the scientific, academic and clinical elites responsible for modern day caring of the dying.”
It is apt to end with further infinitely wise words from this compassionate author who dedicated her life to easing the trauma of death:
“People are like stained-glass windows. They sparkle and shine when the sun is out, but when the darkness sets in, their true beauty is revealed only if there is a light from within.”
May we all make sure that the ‘darkness’ of feeling afraid or lonely in the face of death is banished: by applying equal insight and concern, we can ensure that the ‘light’ of love for life continues to glow brightly in the ones we treasure. It is they who are most in need of the reminder that they are no less important and valued for being at the end of their lives, and for whom we should allow the tranquil leave-taking they deserve.
Helderberg Society for the Aged
The Helderberg Society for the Aged provides a variety of secure lifestyle options for elderly people in an environment of mutual support and care. Our Support Centre services are dedicated to providing the palliative care and advice essential to easing the process of dying, both for the elderly and those involved in caring for them. We believe life should be lived to the fullest for all the people within our services which encompass Independent Living, Assisted Living, Home Based Care and Frail Care.
Learn more at: www.hsfa.org.za