Living with Death and Dying

How to Book
Living with Death and Dying: How to communicate with the terminally ill, written by Elisabeth Kubler-Ross, MD, is a 181 page How-To book published by Touchstone in 1997. It was written for grades 9+, ages 14- adult. The author teaches us how to use her tools for understanding how the dying tell their innermost knowledge and needs. She describes the urgency for meaningful dialogue in assisting patients to pass with peace and dignity. We learn how important we are to the person dying and how communication with them helps us in our grieving process.

Another classic on death and dying lol. I preferred this one to on death and dying. It was a bit less outdated and addressed new topics. I was especially interested in the section on automatic drawing, though I do wonder if the interpretations went a little too far. I feel like drawings are better used as a tool to help patients communicate and visualize their own feelings, though the guest author of the section went pretty far into obscure interpretations. I would rather hear from the people who drew them what they see in their work.

Everybody can find something useful from this little piece on psychiatry. The book talks about how to communicate with people who are about to die and mentally prepare the family members for the inevitable. Sounds like a bit gloomy topic but it's factual nonetheless.

What the dying have to teach us. More about denial, acceptance, and attitudes of people that are terminal.

One of the most important books of our time. Read it years ago.

The data and writings of Dr. Elizabeth Kubler-Ross are really perceptive and affecting, because they show the living what can be possible versus what just is, as well as how life can and should be lived: to the fullest and most meaningful way possible. And with all Kubler-Ross's previous books, Living with Death and Dying is no exception. In this, her fifth book, she looks at the progression of palliative care by way of parent-pediatric involvement (see Section III, Parent Care: Total Involvement in the Care of a Dying Child). In it, a mother movingly recounts the dying of her daughter with leukemia and all the stresses that were attached to the situation. But what mitigated the sadness of the inevitable was the direct involvement of the parents in the care of their daughter to the bitter end. And where a loss of this magnitude can often cause separartion and ulitmately divorce, the unified confrontation by the husband and wife and the other healthy child (in this particular case), actually solidified the nucleus of the family; the bond became tighter and unbreakable, which was very nice to know. But though the loss was understandably painful, it was also a gift, for it brought about a heightened acuteness of love and living, not just through words but by actions and the uncommon stepping outside of the 'comfort' zone of their day-to-day reality. Also interesting was the in-depth exploration of drawing-analysis of the soma (the body) and the psyche (the soul) in regards to terminally-ill patients and those deeply psychologically wounded (read Section II, The Use of Drawings Made at Significant Times in One's Life). It is a great illustration of nonverbal communication and truly eye-opening when you explore the 'hidden' messages that are not as concealed as one might think. Because of the merciful candidness, courage and knowledge of patients, families, clergy and medical staff, like Elisabeth Kubler-Ross, among others, they have mentally brought readers to the brink of death by their own experiences and observations. Through death and dying, they have taught that openness and candor are imperative and that compassion and goodness does not have to begin when death and dying enters the scene.

Fascinating! A little dry and research-y, but it's got important insights for dealing with death and dying. It focuses a lot on terminally ill young children.

I read this book for two reasons. First, I am working my way through the lesser-known works of EKR's oeuvre in preparation for a class I am co-teaching on death in the Eastern Orthodox tradition at the Orthodox School of Theology (Toronto). Second, my father-in-law is currently in the middle of a long battle with cancer that doesn't have a good prognosis. I was looking for a practical book that would help me navigate communication, and after attempts with less-than-stellar books, I finally just went back to EKR. It's been half a century since she began pioneering a new way through death and dying and her works are still some of the best and most perceptive out there. I will now be recommending this book as a must-read to my friends with aging parents.

It initiates readers into the topic of death / communication strategies through narrative rather than exposition. I could locate myself in the stories, patients, and families that were described; I both related to and learned from their experiences. While many of the chapters deal explicitly with terminally ill children, the core ideas are applicable to a variety of situations involving caregiving, aging, and mortality in the general medical context.

Here are the main lessons I'll be taking with me, to apply to both my father-in-law and my course:

- Let your loved one talk about their sense of mortality in their own time or in their own way. Don't ask how they feel about dying, just ask how they're feeling (or why they seem sad/ upset) and give them the opportunity to bring up what they want to talk about if they want to talk about it.

- If they do bring up a fear of death, or other difficult thoughts, stay on their level. Let them say what they need to say. Don't make things lighter or more serious than your loved one is expressing.

- Anger (at God, death, nurses, you, etc.) can be a good thing. It is, among other things, a sign that your loved one is moving beyond denial, beginning to recognize the seriousness of his/her reality.

- The difference between acceptance (positive/ healthy) and resignation (not such a good sign). And some warning signs.

- The value of symbolic language. Maybe your loved one isn't talking about death explicitly, like you'd like them to. Maybe instead they are talking about a nightmare they had about being left alone, or a memory of a butterfly they once saw emerge from a cacoon. Don't dismiss such "random" comments abut try to be in that symbolic world with them for a moment. Be curious, ask questions, share in their emotional response to the symbol they've brought up. Death is a mystery and symbols are often the only way people can find to make sense of what they are going through. (And the symbols may be allowing them to work through things on a subconscious level as well, which is just as important as anything else.)

Here's to hoping these tidbits will come in handy in the weeks or months ahead.

But already, the book did what is hard for a work on this topic to do: it left me with hope and a greater sense of awe for the human condition of living, dying, and loving those around us in between. If you know someone who is dying--slowly or rapidly--or you are a living, breathing human being who has ever been preoccupied by the topic of death (which is ALL of us), read it.