Among the hardest things for the living is talking about death. But experts in pastoral care and funeral homes say such conversations with older or ill people and their families have important spiritual and practical benefits.
Father Noel Hickie, veteran chaplain for PeaceHealth hospice in Lane County, says he often encounters families who resist talking about the inevitable. Frequently, the reticence is part of the culture; death is not discussed opening among many Latin Americans, for example.
Father Hickie once worked with an Argentinian family. The father was dying of cancer, but the daughter appealed to the priest not to let him know. The family had kept it a secret from him. Upon meeting the patient, Father Hickie discovered that the man actually was well aware of his diagnosis, but felt he had to hide it to keep his daughter and other family members from feeling uncomfortable.
"He was anguished because he had no one to talk about it," the priest says. At a Mexican American household, Father Hickie met a 42-year-old man dying of stomach cancer, but who did not know. The chaplain appealed to a son to tell the man the hard truth in Spanish, but the young man could only bring himself to talk about soccer, saying he could not speak about such things, that someone older should deliver the news, if at all.
Other families try to cope with a pending death by incessant action and attention to detail. Father Hickie will ask a question about big matters of life and the universe, and will get answers about late night constipation or what pills are doing what. The problem with hesitation to discuss death is that patients will feel isolated, dealing with the most monumental and grueling of situations alone, the priest says. Pretending matters are better than they are also forestalls the lovely conversations and reconciliations that can accompany the end of life.
"When families don't want to talk about it, it creates a big divide," the priest says. But how to start the conversation? Father Hickie does it by asking in a non-medical way: "Suppose you knew you would not be here in 12 months. What would you be doing?" As the sessions move along, he may ask, "What if you had six months? What then?" The method gets people thinking about what is important without pressuring them for accuracy; they will be speculating, but doing so with a liberating purpose.
Sister Josephine Pelster of the Sisters of St. Mary of Oregon leads pastoral care at Maryville Nursing Home in Beaverton. There, residents face death often. Some avoid the topic while others want to talk, but need help getting started. "Usually they bring something up, because of an illness or a diagnosis," Sister Josephine says. "They come to realize they are not going to live forever. But it is indirect."
That's OK with Sister Josephine, who picks up clues and makes observations to gently draw the person deeper. "It's hard to believe we are getting older," she will say. Then she waits. Silence is often an invitation to open the heart.
"When it gets quiet, they will say something deep, like, 'I don't want to do this to my family. I have cancer. I think I'd better get my affairs in order,'" Sister Josephine says. She has found that people are more willing to talk about death with someone who, in contrast to seeming like a counselor, seems willing simply to go on the journey. Family can help by being attuned to what is on the patient's mind.
"If you talk about death, you have more control," she explains. "That allows you to get affairs in order — emotionally, physically and spiritually."
Part of speaking about death and getting affairs in order might include pre-planning one's funeral arrangements with a professional. Funeral homes offer the service, often by referring interested families to a third-party expert.
J.C. Aubry of Dignity Properties, a professional pre-planner, puts people at ease by telling them they are acting for their loved ones in the future.
"Funeral planning is the responsible way to spare your family the grief of making these tough decisions for you, making the act a loving gift," Aubry says. "The most difficult thing we see is families who are not prepared for the loss of a loved one. The surviving family members are forced to create a plan while they mourn, which can make an emotional situation worse."
Scotti Cabeceiras, manager of Rose City Funeral Home in Northeast Portland, has seen how pre-planning can save stress and pain for family at the time of death. "We have heard time and time again that it is helpful from those who did it and we hear from others that they wish they had," Cabeceiras says.
Cabeceiras asks people two things to get the conversation about death going: "Is there something you always wanted to try?" and "If you could write your own obituary, what would you say?"
Families who have lost a loved one also need help talking about death. Cabeceiras' practice is first to listen and observe. If she notices a family stuck, she speaks up.
"I am here to be compassionate and caring but also to lead them through a difficult situation," she says. "The best way is to be straightforward, not to sugar-coat it." She may refer to the death with dignity but plainly. "If you say it, they get more comfortable," Cabeceiras explains.
Mark Musgrove, of Musgrove Family Mortuary and Mount Calvary Cemetery in Eugene, helps people talk by asking them about funerals they have attended.
Churches like St. Mary's in Eugene now often have funerals linked to weekday Masses so more parishioners can attend. That means more people ponder death and their own funerals.