January 27, 2012
The Psychology of Death and Dying
That’s the name of one of the classes I’m taking this semester. So far it’s truly excellent. Beyond words, really. If I can find a way to post some of our readings without violating copyright, I’ll do it. In the meantime, have you read these? They’re a couple of my favorites.
The Long Goodbye
In those days, extended family cared for the oldest. Now, in an age when family members are separated by hundreds of miles, we leave it up to nursing homes and assisted-living facilities. And the need has never been greater. The fastest-growing age group in America is the eighty-five-and-older cohort. As the population ages, healthcare costs continue to outpace inflation. Many older people have seen a sharp decline in their retirement investments since the 2008 economic collapse and are rapidly losing value in their homes. American political leaders are not preparing adequately for the huge demographic shift caused by the aging of the boomers, who began turning sixty-five in 2011. Many of them are retiring at the same time they are dealing with parents who are still alive.
Costs for long-term care are skyrocketing because only 3 percent of adults carry long-term care insurance. As a result, middle-class people without Daddy’s pension income are bankrupting themselves and then applying for Medicaid to pay for a nursing home in which they may languish for years.
End.
Whoever you are and wherever you live, you will go. You will not be you anymore. Not exactly. You will be a corpse, a cadaver, a decedent, a “loved one.” You will be remains. The death industry employs more euphemisms than politicians do. Someone will find what’s left of you. A child, spouse, or parent. A nurse or passerby. Whoever it is will call for help. At home, at work, or in the street, he or she will dial 911. In a hospital, hospice, or nursing home, someone will call your doctor, who will check one last time for vital signs, declare you dead, and fill out the proper forms. A nurse will remove your clothes and close your eyes. (Not just for modesty’s sake: Rigor mortis hits the eyelids fast.) He or she will tie a tag bearing your name, which you can no longer speak, onto one of your toes, cover you with a plastic shroud, and wheel you to an elevator and thence to the morgue. In most hospitals it is in the basement. You will be rolled from the gurney into a refrigerated drawer. The door will close behind you. It will be dark and cold, but you won’t care.
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Some of the topics of conversation covered tonight: the inadvertent privilege of hospice, Viktor Frankl, Siddhartha’s spiritual emergency, and the emotional cost of caregiving.
This is reminding me, vaguely, of the Holocaust class I took in college. It’s a subject once you dip your toe into, it becomes increasingly difficult for it not to color everything else. Are you finding that to be the case? Is it allowing for another perspective?
Another perspective from what?
From: Oh My God, this is fucking depressing.
I don’t know if death has ever not colored my perspective. My sister was in and out of a hospital when I was very young, my best friend in childhood was slowly dying of cystic fibrosis, and my grandmother has been trying to snuff out like a candle since her husband died almost 20 years ago. This class only seems to be giving me a sense of freedom. There isn’t much that’s depressing, but we aren’t discussing the politics around insurance companies and medicare.
Part of the work of psychotherapy is in knowing your personal biases well enough not to superimpose them on another human being. Are perspectives on death that different from other biases?
That’s a really good point, Kelsey. I found the Holocaust class to be simply overwhelming. Once I looked at the world through that lens, I didn’t want to look at the world. On the other hand, one has to evaluate, as you say, a response to death that will help a client navigate the experiences surrounding it for himself. I was just curious what effect the class had, and it sounds to be a good one.
That last bit I recognize as being my own platform, and has little to do with anything you said.
Yeah, I think I got a taste for that overwhelm when we went to the Fort Worth cattle drive. That day is so clear in my mind. Facing the awful truth of man’s ability to be aggressively stupid.
Oh fuck. I’m sorry.
No, no. It’s good. Living with blinders on isn’t living.
Yeah, but a lot of that was personal anger I was working through.
I’m far more scared of getting old than I am of dying.
I’m with Joel. Aging or debilitating mental disease. Death is but an end, but being trapped inside of myself is frightening.
Exactly.
Hey, is there any way we could maybe find out what the readings are and p’raps those of us with the interest may… peruse our local libraries… or something. Yeah. That.
We’ve just started with How We Die, by Sherwin Nuland, and I can already recommend that. We’re also working our way through the Handbook of Thanatology, which I’m not sure is of use unless grief counseling is of interest.
Soon we’ll be taking up:
The Hospice Choice: In Pursuit of a Peaceful Death
Palliative Care Perspectives
The Last Dance
Facing Death and Finding Hope
These are only the start. We have a course reader, with chapters and selections from each of these. After I’ve read more, I’ll recommend more. My professor’s perspective is all-encompassing, which means she wants us to see the topic from as many angles as we can — especially those we may not agree with. Inevitably, we can’t overlook spirituality here.
One caveat about How We Die: it was written a while ago, and feels dated.
Also, if you haven’t read Becker’s The Denial of Death, that’s a really good place to start.