 Hello, I'm Larry Graham. Welcome to Don't Just Age, Engage. Today's topic is about you. When, where, and how do you want to die? I am a chaplain, and I have been serving as a chaplain in long-term care and various kinds of contexts, also in hospice care. And so as a result, I've had great experiences of death and dying. And I wanted to share that with you today, some of that, and do that in the context of my other concerns as a coach, which are that I want your elderhood to be an extraordinary and wonderful experience. Don't just age, engage. And that's the name of my program, also the name of my book that I've written, that points people towards my website, which is a greater global community for your extraordinary elderhood. One of my clients struck me with that question. He said, when I crossed 70, I began to think when, where, when, where, and how am I going to die? And behind that question is, of course, the usual idea that we have about death, which is that it comes and grabs us in a way that we cannot anticipate. When, where, and how will I be a victim of the death and dying process? I often ask this question of people, how do you want to die? When do you want to die? Where do you want to die? And most people very much like the usual response is, I don't know. How do I know? So death is really seen as a kind of a foreign experience that comes and grabs us somewhere unexpectedly. I want to maintain with you today that in fact there are options towards which you can guide your life and towards which you can celebrate your own dying process and the dying process of those you love as a completion of life, as a whole part of the whole experience of living. So when, where, and how would you like to die? My interest in this comes, as I've said, after many, many participating in many deaths with hospice patients. And indeed hospice patients oftentimes are in that critical time of death and dying when they have found out that they have a prognosis of six months or less. And so the family and they themselves have a certain urgency and anxiety about dying that becomes clear and becomes a strong force in their life. A really terrific deologian in our midst in the 1960s noted that the thing about death is, the thing about death is it creates anxiety. Now there are lots of changes whenever there's change, even if it's changed for good, even if I retire and want to live the rest of my life in Hawaii, the most amazing change that I could have envisioned, still there is anxiety that goes along with that change and it builds up within us. And we sometimes are conscious of it and most times are not conscious of it. But in our society in particular, I think, we have an anxiety built up about death and dying. And as one, a very important mentor of mine, he wrote a, he has a wonderful program called Grief Walker, go on to YouTube and search for Grief Walker. And in that he makes the comment that we don't have trouble talking about death. We don't have any problem at all talking about death. What we have trouble with is talking about death now and when it becomes urgent, that is when indeed we do get anxious and the anxiety rises and we can't make decisions. We cannot think clearly about what we want and have best to go about this process. So I'm maintaining that the best thing we can do is think about it ahead of time when we don't have the anxiety rising in the urgency of the moment or the last six months of our end of life. I have one interesting question that's already come from one of our viewers and I want to encourage you to send your questions that you may have during this time to questions at thinktecawaii.com and you'll see the email address there. And here's one from a viewer that says this, millennials like to romanticize the idea of memento mori. Remember, you must die. Should we be worried about the younger generation's cynical view on life? This question really leads me into one of the first points that I have about death and that is it is a part of life. And so the way we view death is going to be affected by the way we understand and view life. So I want to approach this question but from maybe another angle if you will coming at it from the question of how do you look at life? Our major cultural attitude towards death is that we are deaf phobic. We are so afraid of death. We foster that fear of death as something foreign in life. That's something that kind of comes and grabs us. In fact, we actually foster a kind of relationship with all of nature that is a hostile and defensive relationship. When I was in Spanish classes in my high school and college years, I was fascinated by reading about the bullfight. The bullfight in Spanish culture was an expression of this conflict between nature and mankind and it was men who did the bullfighting. So nature and mankind had to come together and face to face and one of them had to win and one of them had to die. And the conquest of the bull was symbolic of the conquest of nature. Now we have that show up, that kind of attitude show up in various ways in our language. What do we do sometimes when we're frustrated with people who seem to be unrealistic? We say, you've got to face reality. Come on, face reality or we say, if this is your problem, you've got to take it and face it like a man. I mean, I was told that. Face it like a man when I was a child. And there was always this subtext that I am a foreigner living in a foreign land. I am a stranger to all of nature and nature is something separate from me that I either have to be cautious of or conquer, overcome or escape. And so if we look at life with that kind of attitude about nature, then we also end up looking at death with that same kind of attitude. How can I escape it? How can I avoid it? How can I get away from it? How can I make it smaller? How can I minimize its importance in my life? So to answer this question, should we be concerned, worried about the younger generation's cynical view on life? I think that's a very, very perceptive insight. And I would say, yes, we should be concerned about this view of life that is quite cynical. But also it comes from and maybe feeds upon the kind of orientation towards life that we have had. So I must turn it back to myself and to each of us and say, how am I related to my nature, to nature of which I am a part? Do I see myself and ourselves as a part of nature? Everything that we are, everything that we have learned, everything that we know has come to us through our bodies. We are part of nature. We are made up of water primarily. We are made up of water and minerals and this stuff of flesh that has come from the earth in which we live. Another one that I love, a mentor I love, Alan Watts said, we talk about birth as something that we are, well, we come into the world when we have somebody talk about being born and we say, well, she came into the world at four in the morning and she was weighed so much and such and such. And he said, instead of saying we can't come into the world, it was better for us to say we emerged from the world. We came out of the world because we are of the same substance. We are of the same nature and we are and we can celebrate the beauty and wonder of that life that we've been given. We don't have to be better than what we are. We are who we are and what we are by nature and we celebrate that. So yeah, I think we need to be concerned about cynical approaches to life. I think we need to be concerned about an approach to living that says we are somehow better than the nature or ecological being. We are better than the world in which we live or that we have to somehow escape the dangers that is always something hostile towards us. Can we rather see nature as something amazing that it provides something for us that it provides and we collaborate with nature to to eke out and experience these provisions in our life. So if we have that kind of attitude about nature and our living and our ecosphere, for one thing, what a difference it makes in terms of how we relate to it. Maybe some of you are in the same era that I am in which we remember we remember an ad for butter. The advertisement on TV and the butter was against margarine and the advertisement was mother nature and thunderbolting thunderbolts and the byline was it is not nice to fool mother nature. That is again that kind of feeling that we are at odds with nature that somehow we are in conflict with nature rather than harmony with nature. The harmonious life that we can have if we shift our consciousness to see ourselves as part of rather than apart from this world and this ecosphere of which we are apart then we will find our whole orientation transforms and our love of life becomes more vital. Yes we need to be concerned about the cynicism that is present in other generations and for the fear that may be present in our own generation. Another thing that occurs of course when we talk about death and dying is denial. I think this is part of that orientation towards nature in which we say it is not going to happen to me. I am not going to talk about it now because I am going to put it off until I really have to deal with it. I want to maintain that breaking through that denial is a way of getting close to death and reaping the benefits from that closeness. For instance now this may seem a little extreme but we can learn from this I think. There were monastic communities in which the the abbot of the community, the religious community would say to the novitiates build a coffin and sleep in your coffin occasionally and so those who are becoming monks slept in their own coffins and the question was why what can be benefit from that and that is a closeness to death a sense of permanent impermanence a sense that this life is passing but it is also one that we can celebrate as from the grace of a gift from God which is what grace means in the religious setting that was consciousness of God's gift and dependency totally on God. So coming close to death if it is our own death or the death of a friend being a part of a dying process of a loved one brings us close to death and we see life in a new way. I want to maintain that many of the times I know for myself that I saw death and the process of dying I did see it as part of more integrated into the wholeness of life and then I look around at nature and I say well of course what is nature teaching us well nature is teaching us that things die in order that other things may live that we die new life comes into into being that a tree falls in the forest and it decays and fertilizes the soil for a new tree new trees grow the seed itself falls to the earth and the seed has to die and break open and out of that seed comes a new whole new tree a whole new plant and an acorn is the whole of a new tree. So this process of living dying living again of energy being transformed from a seed to a plant to seeds to plant is part of our learning when we are comfortable with nature. I've been a pastor for a long time and I can say of course that we have have that I've been part of a denigration of death as something that's not to be cherished and I repent of that I now see death as being an opportunity for growth even at the time of my dying I want to be conscious enough to say I can know what's going on I feel that kind of change in transformation occurring within my body so what when where and how do you want to die I maintain that there are some choices that we can make in our imagination mind you that will be pertinent at the time of our dying when I invite my clients always to to identify an age in which they want to die what age do you want to die what do you want to be I asked that of one of my clients and she said oh a hundred I want to be a hundred years old and so she is set on her in her mind to reach that hundred-year-old mark where where is a really difficult decision because there are preparations that need to be made for certain circumstances that may arise that's related to the how but if I choose to die in a kind of easy out I want to have a heart attack I'd like to sort of fall asleep in my dying process and not feel any pain then that's going to determine to some extent where we are going to die well we can die in our home we can opt to die at home we can make that a preference known and certainly when with hospice care we can have our dying in the place of our choice hospice care comes to us as we are dying and enables us to go through the process as family and friends in a meaningful and comfortable way meaning that also if some pain medications are available and they're administered of course in palliative care some wonderful aspects of our of our medical system have come come to bear on enabling the end of life to be comfortable and restful I have also participated now the extreme of this to which we have had on think tech Hawaii before is to consider the option of selecting medication having a physician assist us in dying with medication we can because of the our care our choice act which was passed in Hawaii we are able to say that we would like to have more control over where we where we die and when we die I had this experience with three of my patients over a three-year period of serving here in Hawaii and hospice care one patient was a fairly prominent surgeon in the community and had contracted Parkinson's disease so needless to say with Parkinson's the surgery which was his calling he was unable to pursue and so as his body got more and more decrepit or more and more rigid is when it actually does he began to set the time when he would take medication for the termination of his own life and be able to exit if you will with a sense of dignity and control over it so he did that one night I was able to be with him earlier and offer his request for prayer and to say goodbye to him another patient that I had who also opted for our our care our choice um had had a paralyzing disease to her left side and so her left arm didn't work at all and for her everything was in order mentally and and emotionally she was very sound and had made this decision that she wanted to to bring an end to her her misery because she was actually miserable when I first met her she said looked down at her left arm and said Larry this just isn't me she had been a cook she'd been a culinary artist she'd written a book on culinary on her culinary abilities she'd been a piano player very elegant lady and so she had decided this is not me anymore and for that reason she did in fact choose when where and how and she was able to bring in family and friends around her bed at the time of her dying and to be able to have some control in that in that in that setting she hired a deaf doula to help facilitate things and I was there present although I was not helping her with any of the medication none of our staff do that um provided this opportunity and for she provided this opportunity for everyone to participate with her in the dying process and so since it wasn't her to stick around and just not be able to play the piano or perform culinary arts and do what she loved to do musically in her life she was ready to let go of it uh one of uh one of her friends did a hula right next to the bed just some music that came on she had music throughout the the time the night time the time we were together there were stories told much laughter and celebration of the her life and I was invited to read a poem that she had asked me to to prepare which I did and then she took the medication and she died and we all were there with her tears of course tears of laughter tears of joy tears of sadness and loss but when did we really decide that she was gone it was when she decided she wanted to depart since it was no longer her life that she felt she was living so there are ways that's the extreme way but I'm saying that come back from that more extreme disease experience and say what when when do I want to die where do I want to die and how do I want to die I don't think it's it's all that difficult to come up with some ideas and in fact what I like to do is invite my clients to write it down so I have written mine down and would like to share that with you fairly soon in just a few minutes and part of the important thing here is that how we conceive of things how we imagine things what our belief system is is going to going to determine much about our dying now you heard the word control and I use that word control intentionally because finally we lose control in the final analysis we really don't have much control but we have enough control that we are able to prepare the way so that it becomes meaningful for the best of our ability well here's what I have would like to offer you as my written out plan for my dying I have nearly finished my 72nd year of life and when I crossed my 70 the main thought that I had entered into was this is my final couple of decades on this planet and 20 years seemed like a short time at that moment two years later I wonder will I be able to sustain my life for those years as I generate my post retirement ministry of personal coaching for life and faith chaplaincy has given me access to people at the end of their lives and I be forgiven that my own end of life beckons me I have entered into the end of life process by virtue of this compelling desire to make a plan what would I prefer given the many facets of end of life this is the world of imagination and is certainly informed imagination giving many teachers that I've had I have sustained I have sustained within me the mystery of life and death by the divine love I know in the body of Christ it is that ineffable love that enables me to imagine dying I once did a meditation in which I imagine lying in a coffin being boxed in and buried have been my deepest fear in the meditation I surrendered to the box I gave up trying for a Houdini like escape I died I do not want to consciously dwell there forever but just a little while was as much as I could handle now we're going to be disabled by terminal disease or accident I would want to move as quickly as possible to my death no life prolonging treatments enroll me in hospice care home care is my preference if a loved one wants to assist me in caring I accept otherwise I prefer a professional home care person I will lie down in a hospital bed in my home and do self-care as long as I may be able I'd like to receive visits from my brothers and spouses my children and grandchildren and their spouses and any friends within driving distance who care to come belonging life for that long is good I would opt out for I would opt for our care our choice medical aid and dying act in Hawaii I would plan a celebration of life I would talk with my family about their gifts to me encourage them to continue the lives they are living of conviction empathy and love we would cry together until the tears paused time of leaving arrives next I shall fall asleep as I do every night this time there will be no morning dawn to awaken me unless I am surprised by a resurrection or a rebirth my satisfaction shall be that my life will be finished completed what was begun in my baptism and birth shall be fulfilled the strife will be over the battle one if it be a battle the new life will have begun and I celebrate that so that was my writing within my my within my frame of reference thank you so much to think tech Hawaii for this wonderful experience thank you to all of you who have participated in your question two weeks from now we'll have my next don't just age engage thank you very much and aloha blessings