End of Life

This is an invitation to begin a special sort of conversation – with yourself, with those you love and, if help is needed, with a trained professional.  It’s a conversation which many people postpone or even avoid entirely, but I believe it’s one that not only addresses the inevitable, but one that can also enhance every day of the life you live now.  The subject of this conversation is the end of life.

Perhaps surprisingly, it’s a topic about which you have choices and more control than is usually assumed.  As a Social Worker, I spend time with those who are dying, and counsel partners, family members and friends who are all dealing with the circumstance of terminal illness.  Sometimes the work is sad or difficult, but always it is an opportunity to foster and support what I believe is essential in life – connectedness.

There are many perspectives from which to consider the end of life.  The current healthcare debate looks at the complexities of rights, costs, and delivery of services.  There is the cultural aspect of the end of life which focuses on particular and diverse ways each ethnic group manages death, its customs, rituals and time frames.  There is the spiritual lens which finds some embracing religion; some – nature; others – unsure of whether there is something bigger to hold onto at all.  There is the familial angle, which looks at relationships, nuclear and extended past, present and future, with all its joys, struggles and entanglements.  There is the very personal perspective, each of our very private terrors, regrets, worries and also our satisfactions and assessments of how we’ve done in this life.  There is much to talk about.

The joke is, we are terminal from the moment we are born.  Most of us don’t spend our conscious lives focused on this, although, to be honest, awareness of it does creep into an ongoing life at fairly frequent intervals especially as we advance in years.  We know death is part of life, it happens to everyone and it’s inescapable.  Still, for most of us, it’s not something we choose to dwell on.  And it doesn’t need to be dwelled on, but it does need to be considered, planned for and talked about.

The reasons for speaking about the end of life are many.  On the most obvious level, there’s a mess left to survivors when a loved one hasn’t planned or shared his/her wishes.  Most of us hope to just die, without pain or suffering or complicated arrangements.  Unfortunately, it often doesn’t happen that way.  When it doesn’t, a terrible and unnecessary scramble begins.  The requirement to move quickly in an effort to anchor the free fall that accompanies such news, at a time when everyone involved is devastated and paralyzed, is an overwhelming stressor that doesn’t have to occur.  This life transition could have been anticipated, planned for and set into a natural motion so that those involved would have been calmer, more informed and prepared to carry out what the loved one wanted.  Fear, denial and ignorance about what to do makes a difficult time unbearable when there could have been more room for honest, loving and caring connectedness.

Another reason to have this conversation is inherent in the way we actually like to live our lives.  Most of us prefer to have choices, to have a say where we can.  The self respect that comes from designing our own life can be continued as we take some control of how we want to approach its end.  Many of us have ideas about it, based on each of our particular histories and individual make-up.  Most of us have watched others go through endings. While it’s probably true that ultimately death is not what we want, the way we die can be decided and supported.  Each of us can create a time that reflects who we are and what has meaning to us.  We can have a say about treatment, pain, environment and the emotional climate that surrounds us.  We can determine inheritance, legacy and final wishes.  We can even ask for how we wish to be remembered.

In conversations about the end of life, there is potential for richness.  To share your unique and personal thoughts and feelings with those close to you is to give a gift to them and to yourself.  Really sharing a life means including your loved ones in all of it, right through to the end.  The end of life is not necessarily owned by the old or the sick.  For life to be lived fully, for it to be an experience of connectedness every day, it’s essential to think about all the possibilities.


Laurie Waxler, LCSW, offers bereavement counseling services to individuals and families touched by death directly or indirectly.  Navigating the healthcare system, exploring options and preferences, guidance to resources and relationship counseling are some of the ways she can help. Call (914)-524-9646.

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About the Author: Laurie Waxler L.C.S.W.