Wednesday, January 14, 2009

Enjoy life more by being ready for its end, hospice nurse says

During more than two decades as a hospice nurse, Tucsonan Tani Bahti noticed a consistent and alarming trend: Most of the people she encountered had no clue about death.

She watched, year after year, as that lack of knowledge caused terrible pain, family strife and regrets.
Now she's taking action.

This month Bahti, 54, created Passages, a not-for-profit organization that aims to "normalize" death and dying. She's visiting community centers and groups, giving free talks aimed at changing the culture of dying. The talks are for everyone, as death is something we all share.

Ideally, she said, Passages will grow into a resource center, and eventually, education about grief, loss and dying will have a place in local school curricula.

Bahti is well-equipped to talk about the practical side of death, including living wills and securing a power of attorney. But she said the most important part of being prepared for the end of life is having what she calls "the conversation" with loved ones.

People fear pain, suffering, being a burden and, in general, the unknown aspects of death. But avoidance is not a good way to face those fears, Bahti said.

"If you haven't been living consciously, it's hard to play catch-up at the end," said Bahti, who has written both a book and an award-winning video about death and dying.

The problem is that once someone is dying, loved ones frequently shift into crisis mode, she said. Family members may be unaware of patient advocates. In their grief, they may not understand what the doctor is telling them. They may fear telling each other about a difficult decision, such as wanting to stop treatment.

"There's a fear of telling someone, 'I'm thinking of your funeral,' " Bahti said. "But if you have the conversation, it takes off the scary edge."
Bahti, for example, has had that conversation with her three sons, and her sons now know her end-of-life wishes and she knows theirs. She regards this as a special gift with long-term rewards that parents can give to their children.

And consider these facts cited by Bahti:

● Eighty-five percent of us will have chronic illness before we die.

● Increased violence is connected to an inability to process grief.

● Thirty percent of Medicare patients spend their final 10 days of life in intensive-care units.

● Eighty percent of those facing a potentially terminal illness want to talk about it, yet only 20 percent find a professional or family member who will have that conversation with them.

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