The end of life for all of us is inescapable, with the only questions being when and under what circumstances.  Yet dying is so terrifying to so many people that we avoid the subject.

Most of our efforts surrounding death are directed at trying to postpone it, and medical science has been fairly successful in doing so.  A century ago the average age of death was in the mid forties.  Today, we enjoy about 27 years of extra life. We've become so accustomed to medical advances prolonging life, that we're often surprised when, at last, there is nothing to be done.  As a result, we can be woefully unprepared to make end-of-life decisions.  

If we are to die on our own terms, we need to know what those terms are.  How far should doctors go with medical intervention?  You may not want to be kept alive or endure invasive procedures if there is no hope. But what if there is some hope?  What's your goal after treatment is over?  What quality of life is acceptable?  Will it vary depending on circumstances?  For example, the impending birth of a grandchild might give an edge to quantity over quality.  Where do you want to be when you die?  Under what circumstances might that change?
 
These are weighty issues and you may need help in coming to terms with them.  It's not easy in the best of circumstances and it's especially difficult if you're addressing them after having been diagnosed with a terminal disease.  It's normal to be sad, angry and afraid and it takes time to grapple with the overwhelming emotions.  Sometimes talking to a counselor, minister or physician can help.   

At some point, however, a frank discussion with loved ones is essential.  Every day in hospitals across America, countless families face difficult choices without knowing what their loved one would want.  They need to be prepared to make decisions for you when you cannot and simultaneously cope with their own fear, anxiety and grief.  To avoid confusion and minimize disagreements between your family or your family and physicians, it's best to write advance directives.  Advance directives, such as a Living Will, Durable Power of Attorney, a Do-Not-Resuscitate (DNR) Order and Health Care Proxy, are legal documents which allow you to formally convey your decisions about end-of-life care.

One of the hardest parts about dying can be the effect it has on your family. Open conversation about how you feel about death can help prepare both you and your loved ones to let go when the time comes.  Helping them deal with your death can also help you find peace and comfort.

Planning ahead is a gift you can give yourself and your loved ones.  The pain of separation and loss can never be made easy, but it can be made more bearable.  With candid communication you can find valuable opportunities to share loving feelings, to reconcile differences, and to discover meaning.