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What you need to know for 12/11/2017

Gatherings aim to make death a less-taboo topic

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Gatherings aim to make death a less-taboo topic

In 25 years of practice, elder law attorney Del Salmon has counseled countless people through things
Gatherings aim to make death a less-taboo topic
Irene Morrison, 73, is photographed at her home in Gloversville a week after attending a Death Over Dinner event at the city's senior center that encouraged open discussions of end-of-life care and wishes. "Don't wait" to plan, said Morrison, who lost ...
Photographer: Kyle Adams

In 25 years of practice, elder law attorney Del Salmon has counseled countless people through things like estate planning, wills and trusts, and Medicaid qualification. And even while planning for death, he said, clients will sit in his office and say, “I’m not going to die.”

“And I want you to know that I’ve been to every one of their funerals,” he said.

The line drew laughter from about 100 mostly elderly guests at a Death Over Dinner event at the Gloversville Senior Center on Feb. 25 hosted by Mountain Valley Hospice in partnership with Fulton-Montgomery Community College service-learning students.

Salmon sold the idea of estate planning in his matter-of-fact speech — repeatedly raising the specter of something more frightening than death: the thought of the government dispersing your things — but he also set the tone for the evening, one of frankness and humor.

Death, here, was not to be spoken of in whispers and euphemisms.

After listening to a few presentations over a spaghetti dinner, Irene Morrison of Gloversville began talking with the women sitting across from her.

The conversation ranged from how they want to die (bad ways to go: in a nursing home, in pain, pushed out to sea on an ice floe; good ways to go: drift away while sleeping), to the complicated task of codifying in which situations they would want family to pull the plug.

“You can’t just say, ‘I don’t want a feeding tube,’ ” said Beth Douglass, 61. “It depends on where you’re at.”

Can you still talk? Is your mind sharp? Can you move, or walk? Which limbs can you move? Which would you be willing to give up? How do you decide when life is no longer worth living? It’s the most difficult game of Would-You-Rather they’ve ever had to play.

But Morrison, 73, knows where she stands.

“I don’t want tests, I don’t want all of that stuff, I don’t want pain,” she said. “I just want to die naturally.”

One of the women, a 60-year-old who asked not to be identified, went through it with her father. He had a “do not resuscitate” order in place, but a hospital wanted to give him a feeding tube, which would have required lifting the DNR. She and her siblings refused, fighting the hospital at every step.

“It was such a horrible experience,” she said. “We all knew what he wanted.”

Morrison doesn’t want her family to go through that.

“I want my girls to realize that pulling the plug is not murder,” she said. “It’s simply letting nature do what it should do.”

’You don’t know’

The Death Over Dinner event, explained Lisa McCoy of Mountain Valley Hospice, is part of a growing international movement that encourages the open discussion of death. It’s similar to Death Cafes, another movement to provide safe spaces for a topic that families and friends rarely want to discuss.

In opening the evening, McCoy shared some figures from The Conversation Project, an organization that encourages conversations about end-of-life care. According to their research, 90 percent of survey respondents think it’s important to have these conversations but less than 30 percent actually do; 70 percent say they’d prefer to die at home, but the same percentage actually die in nursing homes, hospitals or other care facilities; and so on.

“These are things that we want but don’t actually take steps to make happen,” McCoy said.

The event provided detailed, practical information about end-of-life care and planning for death, but it also provided an almost palpable sense of relief at being able to discuss it all without the weight that can accompany these conversations at home.

Dawn Warren of Gloversville came because she knows she can’t have this conversation with her husband. Many others were there for similar reasons.

“I’m fortunate,” she said. “I’m healthy, I take no medications. And that’s not true of a lot of 78-year-olds. But I could trip and fall and hit my head tomorrow and be gone. You don’t know. You have to plan for these things.”

When the time came to take questions, Warren was the only one who raised her hand. She asked about donating her body to science after death.

“It’s the last gift you can give,” she said later with a chuckle. “I can’t use it once I’m dead.”

’200 years of chaos’

At the A.G. Cole Funeral Home in Johnstown, funeral director Nicholas Cannizzo Jr. said he has seen a trend toward more cremations since he bought the home in 1990.

There are likely many reasons for that, he said, but he thinks part of it is the separation: “It didn’t happen,” he said. “I didn’t see it, so it didn’t happen.” The body goes away, and a neat little jar comes back.

“It’s not like the old days when people took care of their own,” he said. “Now we want to separate ourselves from that.”

Sheldon Solomon, a professor of psychology at Skidmore College, takes the long view on this topic. Last year, he published “The Worm at the Core,” a book that explores the role of death in life.

“For most of human history, there were humanly constructed social rituals that helped people come to terms with their mortality,” he said in an interview in early March. For most people, those rituals came in the form of religion.

Then came a lot of rapid-fire changes starting in about the 18th century: the Industrial Revolution, Charles Darwin’s Theory of Evolution, the rise of capitalism as a dominant system of social order. These all led philosopher Friedrich Nietzsche to famously proclaim, in 1882, that God was dead— meaning, more precisely, that traditional religious institutions were no longer keeping up with social change.

“He wasn’t being cynical, he was pointing out that the beliefs that have united and sustained people for thousands of years were not changing to accommodate the modern world that we were about to enter,” Solomon said.

Nietzche predicted “200 years of chaos and uncertainty” before we got things straightened out.

Today, Solomon said, most people in the U.S. have seen few, if any, dead bodies up close. We “go to extraordinary lengths” to separate elderly people from the general population. We spend billions on cosmetics and surgery to make ourselves look young. And we refuse to talk about the one thing we all absolutely have in common: that we will die.

We often even avoid the word, taking pains to find alternatives: passed away, passed on, went to a better place, shed her mortal coil, etc.

“I think the sum total of those rather futile and shallow efforts to deny death have left a gaping psychological hole in our world where most people no longer have anyone or anything to turn to,” Solomon said. “So I see the death cafes as a contemporary, secular reaction to this tremendous need, and I think it’s a step in the right direction.”

’You’re taking care’

At one time, wakes were held in the parlor of a home, and the family would take care of the deceased. Cannizzo said the funeral director he succeeded would spend days with a family at a country home as they prepared their dead for burial.

Celebrant Ronald Hunt, who has been organizing small death cafes in the Schenectady area for the past few years, said he knows colleagues who still do home services in Vermont. The practice is illegal in New York.

“The family gets to kind of take care of the body,” he said last June a few weeks before hosting a death cafe. “And that begins the mourning process in a healthier way for the families who do that. . . . It’s very loving. You’re taking care, you’re cleaning somebody. It’s ritual.”

Like Solomon, Hunt attributes the rise of death cafes, at least in part, to the disintegration of traditional religious rituals surrounding death.

The discussions at the cafes are also a matter of practicality. On the night his father died, he said, his mother had spread all of his financial records on the dining room table, in left-to-right order. But out of a couple hundred shares of stock, three were missing.

“And she was freaking out,” he said. “She couldn’t get past that. And it was so crazy that this was part of her grieving process. And it doesn’t have to be.”

As Salmon, the Amsterdam attorney said, people spend their whole lives planning, but often refuse to plan for what happens after they die — or what happens to their family.

We need to talk about it

As a psychologist, much of Solomon’s research has focused on what happens when we think about death. And in a shallow context— quick exposure, like being interviewed outside a funeral home or a subtle reminder — death brings out the worst in us, he says.

The dread of death forces us to take shelter in cultural fortresses like strong group allegiances— nationality, maybe, or racial identity— that promise something bigger than our single, fragile human life.

“It’s not death anxiety per se that brings out the worst in people, it’s when we try to deny death and psychologically repress that anxiety that we tend to bury it under the psychological bushes, and then it comes back to bear bitter fruit in the forms of prejudice against people who are different, allegiance to charismatic leaders— the Hitlers and Donald Trumps of the world— disregard for the environment, discomfort with our body, mindless conspicuous consumption,” he said. “I think those are the prices we have paid for not dealing with death openly and honestly.”

The kind of death reminder he and his colleagues used is very different from what the death cafes do, he said, which is to open a sustained, critical dialogue about death.

In that, the cafes and dinners are more in line with some older philosophies that stress long contemplation about mortality as a route to happiness.

“We do have some people doing work with Buddhist monks and they don’t appear to respond defensively to death reminders, suggesting that there are cultural prototypes that would be more convivial to accepting our finitude,” he said. “We think it has a lot to do with what we spoke about earlier, and that is not to immerse ourselves in a culturally constructed belief system that goes to great lengths to banish the awareness of death at all costs.”

In other words, we need to talk about it.

Control over your legacy

At her home in Gloversville a week after the Death Over Dinner event, Irene Morrison considered joining BeRemembered.com, a website that promises control over your legacy.

The site allows you to upload photos, stories and videos, plan your own funeral, make a bucket list, even record or write private messages that can be delivered to loved ones after your death.

The site is free for users, supported by payments from funeral homes. Speaking about the site at the Death Over Dinner event, Cannizzo said it helps “eliminate confusion and conflict at a very trying time.”

“Your last goodbye will be the way you want it,” he said.

Morrison, a writer, brought the idea to her regular writers’ circle meeting a few days after the Death Over Dinner event. Reactions were mixed, she said, but somewhat on the negative side.

But Morrison likes the idea of recording her personal history. Her daughters, she said, don’t know most of her biography, like the fact that she wrote the manual for blending fuel for the Cassini-Huygens probe that was sent to Saturn in 1997.

She hadn’t thought of any specific last words yet, but said she would want to make sure her loved ones knew how she felt about them. “And where you hid the family silver,” she joked. “And who not to trust.”

The 73-year-old isn’t expecting to die soon, and said she’s enjoying the freedom of her age. But when she does die, she wants to go out naturally.

And she knows where she wants her ashes strewn.

“There is a dock behind the information center in Inlet [New York] and I go there maybe twice every month in summer,” she said. “I just love that place.”

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