Cathy Hough started her presentation by announcing really bad news.
Cathy Hough started her presentation by announcing really bad news.
First, the hospice community bereavement counselor apologized to the 20 or so people gathered at the Office of the Prosecuting Attorney for Hawaii County on Kilauea Avenue in Hilo.
Then, she announced everyone in the audience will die.
“We are all terminal,” she said. “We know that, on some level. But we don’t want to talk about it.”
Hough presented “Why is it so Difficult to Talk about Death and Dying?” on Thursday as part of a monthly Brown Bag Lunch Series sponsored by Ku‘ikahi Mediation Center with funding from the Atherton Family Foundation.
Talking about death with loved ones can be difficult. Many families don’t — and end up in turmoil at some of their most vulnerable moments.
If a loved one enters the dying process without expressing end-of-life wishes, it can be torturous to quickly figure out what needs to be done.
If you get hit by a car tomorrow, will you want to be placed on a ventilator, temporarily, to stay alive long enough to heal and return to your normal activities? Will you want the ventilator if you’ll be bed bound and comatose for the rest of your life? Who will make that decision for you? Have you told that person your wishes? Does that person have a medical power of attorney so health providers — and family members — will follow your wishes?
During the late 1800s, Hough said, most people died at home, surrounded by family.
It was normal for families, including children, to witness people dying.
When someone died, family members wore black for a specific period of time, typically a year.
“You knew they were in mourning,” Hough said.
Men and women wore jewelry to memorialize the person. It often included hair from the decedent.
Today, Hough said, death is different “in a get-up and get-on-with-it, Type A society.”
Most people want to die at home.
But, too often, they die at a hospital or nursing home. Family members visit the room, the mortuary removes the body, the funeral passes — and then loved ones are expected to get on with life.
In the 1800s, the family would instead spend time with the body and prepare it for burial.
Accepting the reality of loss is the first step in grieving, Hough said, and the opportunity to let the reality of death sink in is often missing.
“We’ve really become afraid to face death,” she said.
She said her husband, now deceased, would randomly call her at work.
“This is Cathy, how may I help you?” she’d answer with her work voice.
“And my husband’s voice would come on and he would say, ‘Did I remember to tell you I love you today?’”
Appreciating such moments when they occur and loving life as it happens, while also recognizing our time on earth is limited, Hough said, is essential.
That’s because “we never know when our lives will change in an instant.”
As a hospice provider, she said, she too often sees a terminally ill person hanging on because loved ones aren’t ready. That’s why it’s so important for families to talk ahead of time.
There are long-term health consequences for survivors if there is turmoil at the end of life, such as family squabbles or uncertainty about a loved one’s wishes, Hough said. Often, she said, survivors will say, “I wish I had said …” or “If only I had known … .”
When a person tries to initiate a conversation about dying and is greeted with “stop talking that way — you’re not going to die!” it leaves “important things left unsaid.”
Instead, Hough said, “we need to be able share our decisions with out loved ones.”
Talk with loved ones about your wishes, and theirs, she said. Write your wishes in an advance directive and get a medical power of attorney.
Faith Payne of Hilo, a Hilo youth counselor and state Department of Education worker, said such conversations are “really difficult to have … .”
“For the children and the whole family,” her sister, Grace, a full-time mom from Maui, said, finishing the thought.
Payne said she appreciates the Brown Bag Lunch Series.
“I’m really glad that they have this kind of thing that you can go to on your lunch break,” she said.
The next one, titled “Taking the Scariness Out of Conflict,” is scheduled for noon Thursday, March 16, at the prosecuting attorney’s office at 655 Kilauea Ave.
Email Jeff Hansel at jhansel@hawaiitribune-herald.com.