The place of our death is the precise location of our final breath in life; the point at which we were “last alive.” A death site is filled with the quality of reverence and resonates with the echo of our disappearance as well as the numinous vibration of our continuing significance in the hearts and minds of those we have left behind. A common hope is to die peacefully in the comfort of our own home surrounded by our family and friends. We also know that we do not have absolute control over life’s variables. The place of our death remains veiled in the future and is infused with both uncertainty and mystery.
A planned, expected home death where an individual has chosen to die at home with the support of family and plans have been clearly made and documented beforehand… Individuals have the right to choose to die at home and to expect to receive support and coordinated care at home.
– Joint Protocol for Expected/Planned Home Deaths in British Columbia (PDF)
A Planned, Expected Home Death
A “planned, expected home death” symbolizes the preference to die in the comfort of our own home. It has also gained the status of an “individual right” in the province of British Columbia. In other words, every person in the province has been granted the right to choose their home as their place of death.
A planned and expected death means that the individual has made the decision to die at home and these plans have been documented ahead of time. Their death is “expected” in that it is the result of normal ageing or the progression of a disease or illness.
To plan our own death is an act of courage and an expression of gratitude; it requires each one of us to engage in a conversation that we don’t want to have. It is also an important way to free our loved ones from the enormous burden of responsibility and decision-making.
Ideally, no one should have to endure the emotional suffering and trauma associated with making end-of-life decisions for another person. In this sense, to openly express how we wish to bring our life to a natural conclusion is an enduring act of compassion toward others.
The wisdom of a planned, expected home death provides a stark contrast to the treatment of death in modern society. Death is often viewed as an inconvenience to economic progress. Our humanity has been deeply wounded by cultural notions of success that has been hijacked by an addiction to materialism and consumption. Economic innovation has been reduced to the status of an obsessive-compulsive disorder in which invention only creates the illusion of creativity, power, and security.
The right to die at home and a planned, expected home death will challenge our assumptions about success. When death is brought back into the home, our assumptions about success originate in our basic humanity, rather than an obsession with consumption. Death effortlessly clarifies even the most hardened view and perhaps it will help us to redefine the underlying meaning of success.
Outsourcing and Exporting Death
We tend to outsource death. It is common practice to move the dying into institutions where the place of our death can be, in a sense, “controlled” and handled by medical professionals. Inside these intuitions we lose our identity and assume the anonymity of the “patient.” Perhaps death is easier to “control” when everyone has the same name.
Institutions have largely sanitized the experience of death in an attempt to render it invisible.
In the twentieth century, however, Western society became dominated by the concept of success. Death represented the failure of medical science… the pathos of the deathbed scene was removed; compassion was shown by denying to a person that death was imminent…
The scene shifted from the family home and familiar bedside to the sterility of a hospital in which medical science prolonged life to the point of ugliness… The medical profession, becoming so skilled in prolonging life, took over death and sanitized it with white coats and medical smells.
The individual no longer had the identity of his or her own death.
– Marilyn Hadad in The Ultimate Challenge: Coping with Death, Dying, and Bereavement.
The sanitization of death is an attempt to render it “clean” by avoiding the emotional trauma and pain that surrounds it. In characterizing death as a kind of “failure” we lose our own humanity.
Some countries sanitize death on a much larger scale by encouraging the “exportation” of their elders. In embarrassing cultural displays of negligence, abuse, and discrimination, elders are characterized as an economic liability. Why have some countries failed to make adequate provision for their elders to remain at home?
Perhaps we will find a means to overcome our struggles with advanced aging and end-of-life care through the continued development of the wisdom of the hospice-palliative care movement.
The Architecture of a Good Death
The palliative care movement is a promising source of inspiration, strength, and wisdom in the face of death. It embraces a philosophy of care that views death as a completely natural event.
The focus of palliative care is on providing holistic care for the dying through the relief of pain and suffering (physical, psychological, emotional, and spiritual) without attempting to medically extend life beyond its natural course. Palliative care can take place in any setting and is of great benefit inside the home or, when a home death is not possible, inside a hospice.
Hospice-palliative care is designed to immerse the dying and their loved ones in a supportive home-like environment imbued with compassion, belonging, and gratitude. The hospice environment is infused with palliative care and is a meaningful alternative to dying at home.
The focus of hospice-palliative care is on achieving comfort, ensuring respect and dignity for the person nearing death, and maximizing quality of life for the patient, family and loved ones. This includes the provision of physical, social, psychological, cultural, emotional, spiritual support for the dying and their family, and grief and bereavement support for the survivors in the aftermath of death.
According to the Canadian Hospice Palliative Care Association, only 16 percent to 30 percent of Canadians who die currently have access to or receive hospice palliative and end-of-life care services and even fewer receive grief and bereavement services. In other words, for 70 percent or more of the Canadian population no palliative care assistance is available, a deficiency that will become a major focus of public policy making and funding in the future.
An Unexpected, Tragic Death
Unfortunately, some people experience a sudden and tragic death. The site of a tragic death can become a commemorative memorial of the last place alive. In one sense, marking the site of a tragic death site can be a painful remembrance of our loss. In a more important and vibrant sense, commemorating the site of a tragic death inspires the wisdom of “continuing significance” and of “affirming the value of human life.”
To memorialize the place of a tragic death is to honour the life that was lost in a specific location, to inspire the remembrance of our belonging and universal bond, and to carry forward the continuing significance in the hearts and minds of those who live on. More than merely being a symbol of a painful memory, these markers are powerful reminders of our belonging and our humanity.
When a tragic loss occurs, the energy of that loss infuses the surrounding landscape with a sense of reverence. In this sense, the external surround of the landscape and the deep interior realm of our memories become completely unified and integrated. A terrain that was previously anonymous becomes an inseparable element of our identity and a lifelong habitat of remembrance.
Commemorative markers are symbols of our humanity. They inspire the continuing significance of a human life lost tragically and unexpectedly. In this sense, they are reminders to literally “seize the day” and to respect the fragility of all life. They can commemorate the loss of a single life, or millions of lives:
- Roadside Memorials: On a recent trip into Northern Ontario, I was reminded of the fragility of our life in passing a number of roadside memorials. A roadside memorial marks the location of a tragic death resulting from an automobile accident.
- Pedestrian Memorial Marker: On February 14, 2014 a pedestrian was struck and killed at the intersection of Waller Street and Rideau Street in Ottawa, Ontario. On April 2, 2014, a pedestrian memorial marker was placed at the intersection to, “to bring attention to pedestrian safety and to act as a physical reminder that a life was lost at this location.” The marker is the result of the work of Walk Ottawa, an advocacy group for pedestrian safety and walkable communities throughout the City of Ottawa.
- A Trail of Death: The Potawatomi Trail of Death marks the horrific 660 mile journey of more than 830 Potawatomi Indians in 1838. The Potawatomi were victims of a forced relocation, and more than forty died along the trail during the two month journey. The Trail of Death has been declared a Regional Historic Trail and numerous commemorative markers have been installed at various locations along the trail.
- The 9/11 Memorial: The National September 11 Memorial commemorates the loss of some 3,000 lives in the 9/11 tragedy, as well as the 6 lives lost in the World Trade Center bombings in 1993. The memorial is enhanced through the development of the 9/11 Memorial Museum, which is dedicated to preserving the continuing significance of the tragedy and to affirm the fundamental value of human life.
- The Holocaust Memorial: The Auschwitz-Birkenau Museum is a universal symbol of the holocaust. This museum is built on the site of the largest death camp and its purpose is, “the preservation of memory in order to build a legacy of continuing significance.” The museum symbolizes the wisdom of creating a world that is safer, peaceful, and welcoming.
The essence of memorials and commemorative markers is to discover the lessons within tragic and sometimes horrific death that can serve not only as a means to prevent a recurrence, but as a source of inspiration to constantly broaden and expand our own humanity.
A Memorial Parting Stone symbolizes the precise location in which a person was last met alive. In other words, it does not mark the actual place of death. The Brothers’ Parting Stone marks the precise location in which William Wordsworth last met his brother John on September 29, 1800. John Wordsworth died at sea on February 6, 1805.
The Brothers’ Parting Stone was installed by the Wordsworth Society approximately thirty-two years after the poet’s death in 1850. The inscription on the stone, selected from the last of William Wordsworth’s Elegiac Verses, reads:
“Here did we stop; and here looked round
While each into himself descends,
For that last thought of parting Friends
That is not to be found.
Brother and friend, if verse of mine
Have power to make thy virtues known,
Here let a monumental Stone
Stand–sacred as a Shrine.”
– William Wordsworth, Elegiac Verses
A point of parting represents the last place on earth that we met with a person before they died. In this sense, the last place alive, or the place of our final parting, becomes imbued with the memory and continuing significance of the deceased.
There are places in our lives that are sacred because they are the terrain of a deep and intimate experience with impermanence.