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Understanding the ‘language’ of dying

Tue., May 15, 2012

Q. I’m trying to make some sense of a few things I’m struggling with after my mother’s death. I think I missed my mother’s physical cues as she was dying. She seemed anxious and in pain. I finally held her hand and she calmed down. But I think I really misunderstood my mother’s need for communication. Are there any books you recommend that might help me better understand the dying process?

A. Don’t be too hard on yourself if you felt inadequate. Sherwin Nuland, a medical doctor who has been at the bedside of many dying patients and relatives, expressed his own feelings of inadequacy in “How We Die: Reflections on Life’s Final Chapter,” his 1994 best-seller and a book we often recommend here at EndNotes. The book goes into depth on the process of dying.

Dying is a physiological, psychological and, many believe, a profound spiritual experience. There’s a lot of mystery in the mix and no one is yet fluent in the “language” of the dying.

We are also big fans of “Final Gifts: Understanding the Special Awareness, Needs and Communications of the Dying,” published in 1993 by Patricia Kelley and Maggie Callanan. Rather than tell people how they should behave with dying people, the authors tell stories of people who have held bedside vigils.

Death is a solo journey, and no amount of companionship changes that fact. Spiritual writer Ron Rolheiser recently described visiting a dying man who was surrounded by family and friends. He told Rolheiser: “I’m a stone’s throw away from everyone. I’m dying and they’re not. I’m inside of something into which they can’t reach. It’s awfully lonely, dying.”

You trusted your intuition and held your mother’s hand. Hang on to that memory. It sounds like the most comforting thing you could do for her in those final hours.

Q. Is there any solid research that offers wisdom on how to live a long, healthy life?

A. Each week, it seems, a new study comes out reporting the effects of various foods or lifestyle choices: caffeine, alcohol, exercise, sunlight. Often different studies yield contradictory results.

What’s a person to do? Look beyond the headlines.

In John Robbins’ book, “Healthy at 100,” the author cites a study by world-renowned physician Alexander Leaf who traveled to Abkhazia in southern Russia, one of many places where people live unusually long and healthy lives.

The daily routines of Abkhazians include vigorous physical activity – out of necessity. They walk great distances over steep terrain. Retirement does not really exist. They continue working, but not with great emotional stress.

Abkhazians “distinctly dislike being rushed and have no concept of a deadline. They often joke and sing while working,” Robbins says.

Music, like physical activity, is essential to the Abkhazian culture. Each chore has its own song, and people sing to each other often, including at an ailing person’s bedside.

Abkhazians value fresh food and eat a lacto-vegetarian diet. They grow their own foods, eating fruit off the tree and raw vegetables. They eat nuts at every meal, meals without sugar, little salt and no butter. “Food that is not totally fresh is considered harmful,” Robbins says.

Social attitudes influence longevity, too. Dr. Sula Benet, anthropologist, lived among the Abkhazians for several years, and noted that one’s status and privilege increase with age. An Abkhazian proverb says, “Besides God, we also need our elders.”

Social connections are perhaps the most important longevity factor in any culture. People with strong relationships tend to live longer.

So, eat your vegetables, go outside and play, make friends and let go of worry. It may add healthy years to your life.

Catherine Johnston, a health care professional from Olympia, and Rebecca Nappi, Spokesman-Review features writer, welcome your questions about what to do in times of illness, dying, death and grief. Contact them through their EndNotes blog at

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