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Forgiveness, reconciliation, and growth at end of life

By Terre Mirsch

Last week, my colleague Ron talked about the work of dying well, aptly describing the hard work we face when we know that our own or our loved one’s days are limited. This work involves physical, emotional, and spiritual milestones that define and shape the end of life experience. As caregivers, our own understanding of the work of the dying can support the opportunities our loved ones need for peaceful life closure. During my many years as a hospice nurse I have witnessed families take advantage of these opportunities, bringing value and meaning during life’s transitions.

The term “dying well”, a seeming oxymoron, was coined by Dr. Ira Byock, a palliative medicine specialist and professor at Dartmouth Medical School. In Dr. Byock’s work and in his book “Dying Well: Peace and Possibilities at the End of Life”, dying well refers to the potential for growth, reconciliation, love, and healing through the process of dying, and is carefully differentiated from the term good death, which is often limited in understanding and scope to management of pain and other symptoms.

Dying well is a unique experience, meaning different things to different people. While there is no right or wrong way to die well, Dr. Byock provides a framework for consideration- one that describes end of life developmental landmarks and tasks that represent challenges and opportunities for the dying:

  • Sense of completion with worldly affairs
  • Sense of completion in relationships in the community
  • Sense of meaning about ones’ individual life
  • Experienced love of self
  • Experienced love of others
  • Sense of completion in relationships with family and friends
  • Acceptance of the finality of life- of one’s existence as an individual
  • Sense of new self (personhood) beyond personal loss
  • Sense of meaning about life in general
  • Surrender to the transcendent, to the unknown- “letting go”

I remember Harry, an elderly man who abandoned his wife and children early in life. For Harry, dying well meant experiencing self forgiveness.

As Jeannette approached her final months of life, confronting her husband regarding his infidelity and, ultimately, offering her forgiveness and acceptance was critical for her own peace, comfort, and ability to die well. 

When Mark expressed words of appreciation and gratitude to his family and friends, doors opened for them to also express admiration and gratefulness to Mark for all he added to their lives and the ways in which his legacy would continue.

Each of these experiences, while quite different in content and even intent, led to growth and new possibilities. I invite you to share your stories in the comment section below. Stories of forgiveness, reconciliation, and appreciation happen every day and –when shared- provide others with the courage to explore the same during their own experience as a caregiver.

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