When Advance Directives Are Ignored

Even when elderly patients have clearly expressed wishes about the kinds of medical treatment they want (or don’t want) at the end of life, they are often ignored. Paula Span at the New York Times’ New Old Age blog (June 24, 2014) writes that many factors, including family members disagreeing, can override what patients want.

How A Woman's Plan To Kill Herself Helped Her Family Grieve

Five years ago, after doctors told her that she had Alzheimer's disease that would eventually steal her ability to read, write and recognize people, Sandy Bem decided to kill herself.

Sandy was 65 years old, an unsentimental woman and strong willed. For her, a life without books and the ability to recognize the people she loved wasn't a life she wanted.

And so she decided there was only one thing to do. Sandy's plan was to wait until the last conceivable moment that it was physically possible for her to commit suicide alone, then go off and kill herself.

Dr. Bem wasn't a stranger to suicide. She and her husband, , were both psychologists, professors emeritus at Cornell University in Ithaca, N.Y. Both had volunteered at a suicide hotline, and so had an intimate appreciation of just how destructive the act of suicide could be.

This NPR piece is worth listening to. (June 2014)  8 minutes.

About Sandra Bem.

Funeral "Fun"

A NY Times article, Rite of the Sitting Dead: Funeral Poses Mimic Life, describes a practice, probably started in Puerto Rico, which arranges cadavers in poses of their choice for viewing at home or funeral parlors.

While this may seem bizarre, it is a trend that deserves some attention.  This photo accompanied the article.

 At the family’s request, a funeral home in New Orleans posed the body of Miriam Burbank for her service.

Course Synopsis

PSYC 18  Knocking on Heaven's Door: Thanatology 101

COURSE DESCRIPTION: Of the two great themes that peoples of all cultures have reflected upon since the dawn of time, Love and Death, the latter has only been recently addressed in undergraduate curricula. In this important and ground-breaking program we will attend to central issues dealing with the experiences of dying people, grieving relatives and the care givers that attend them.  Our source material will be drawn from literature, film, psychology, philosophy, religion, ethics and the law.  Some of our sessions will feature first person narratives of individuals discussing real-world scenarios. 

Students will be expected to interview someone who has lost a loved one and learn about their grief experience, or spend one-on-one time with a funeral director.  We will have a field trip to a local funeral home.  Your study of a death system will be an opportunity to explore your local area and learn what policies and resources are in place that affect the death and dying experiences in your community.

As we reflect upon the dying process we will consider our reactions to our own mortality and that of those close to us.

METHOD OF EVALUATION: Evaluation will be based on class participation, one in-class presentation, and the final ten-page essay

PREREQUISITES: None

ENROLLMENT LIMIT: 20

METHOD OF SELECTION: Preference will be given to students who have a special interest in. or experience with, death and dying.

COST: $30 - 40

MEETING TIME: other

EXPLANATION OF MEETING TIME: We will meet two or three afternoons a week.

INSTRUCTORS: Deborah Alecson and David Elpern

ADJUNCT BIOs: Deborah Golden Alecson, M.S. is a thanatologist and author who teaches, lectures, and writes about death, dying and bereavement. Her books include Lost Lullaby (University of California Press, 1995) and We Are So Lightly Here: A Story About Conscious  Dying (Goldenwords, Ink 2010).

David J. Elpern, M.D is a Williamstown physician who has written and taught courses about the medical humanities for the past thirty years. 

You may contact us at: DGA or DJE

Tolstoy on Death and Dying (Anna Karenina)

In Part Five, Chapters 19 - 20, Tolstoy holds forth on death and dying.  These are eloquent chapters with much wisdom.

Levin could not help knowing that he had more intellect than his wife and Agafea Mihalovna, and he could not help knowing that when he thought of death, he thought with all the force of his intellect. He knew too that the brains of many great men, whose thoughts he had read, had brooded over death and yet knew not a hundredth part of what his wife and Agafea Mihalovna knew about it.

[The women] knew for a certainty the nature of death lay in the fact that they knew without a second of hesitation how to deal with the dying, and were not frightened of them. Levin and other men like him, though they could have said a great deal about death, obviously did not know this since they were afraid of death, and were absolutely at a loss what to do when people were dying.  

Much, much more... Anna Karenina on Death and Dying.

My Father, Body and Soul by Josh Max

"It’s  been eight years since I last saw my father, lying in his reclining chair in his living room, as perfectly still as the half-filled coffee cups on the side table…

Dad’s sudden death at 81 — not long after he’d announced he’d live another 10 years — was a devastating surprise. His mother had lived to 93, so his prediction wasn’t such a stretch. It was just impossible to think that a guy who’d made it through 36 missions over Europe as a bombardier in the Air Corps by the time he was 20 could be here one day, gone the next, without some kind of fierce fight."

This is a fine, meditative essay published on Father’s Day 2014 in the NY Times.  Not too much schmaltz for this day.

Cancer in Kids

The film, "The Fault In Our Stars" brings the problem of cancer in children and adolescents to the forefront.  Susan Gubar, a distinguished emerita professor of English at Indiana University and the author of "Memoir of a Debulked Woman“ which explores her experience with ovarian cancer, discusses the books on which the movie was based.

Gubar's NY Times article, June 14, 2014

Books:
The Fault in Our Stars by John Green

This Star Won't Go Out by Ester Earl and others.

Movie
The Fault in Our Stars - Movie Trailer.

Dying Matters

Dying Matters is a broad based and inclusive national U.K. coalition of 30,000 members, which aims to change public knowledge, attitudes and behaviours towards dying, death and bereavement.

In 2009, the National Council for Palliative Care (NCPC) set up the Dying Matters Coalition to promote public awareness of dying, death and bereavement. It is chaired by Professor Mayur Lakhani, who is a practising GP. The work of the Coalition is supported by NCPC’s Board of Trustees.

The Dying Matters Coalition is working to address this by encouraging people to talk about their wishes towards the end of their lives, including where they want to die and their funeral plans with friends, family and loved ones.

See their survey: Millions leaving it too late to discuss dying wishes.