Friday, July 5, 2013

Preparing for a Good End of Life

SCRIPTURE: Hebrews 11:22
Written by: Dr Conrade Yap
Date: July 5th, 2013

"By faith Joseph, when he was dying, made mention of the exodus of the sons of Israel, and gave orders concerning his bones." (Heb 11:22, NAS)

If a person dies at 100, his half-point was 50. If a person dies at 90, his half-point of life was 45. If a person dies at 80, his half-point life time was at 40. My dad died at the age of 70. His half point was 35. According to a United Nations study in 2012 about global life expectancy, the highest average life expectancy for men happens to be 80 years of age. For women, it is slightly higher at 87 years of age. That brings the longest average mid-point for human beings to be around 40 to 43 years. Living in Canada and with 79 years as an average life expectancy, I have already gone past my mid-point of 39.5 years of age! With many of us so eager to talk about "living well," we have unfortunately avoided the topic of "dying well." The truth is, we are all dying. As the clock ticks, so do our lifespan. In fact, I will venture to argue that the longer we live, the more we ought to be appreciative of the past, and to lay up treasures for things of greater and eternal value. That is why I am convicted about being Christlike. That is why I share my faith. That is why I blog and write regularly. If my writings can touch lives in some manner, and to help share and point toward hope for people, I think I have accomplished my aim.

We all like to talk about living well. For some reason, very few people like to talk about dying well. This week, I want to argue that in order to live well, we need to learn to think and talk about what it means to die well. This is especially so when we all do not know exactly when our end of life is going to be. It is better to be prepared than to be sorry that we are not prepared at all.

Find out how life expectancy in the United States compares to other countries, in this LiveScience infographic.

A) Living Well

For those of us who have grown up in a modern society, we have been pampered with many goodies. In many countries, we have easy availability to fresh water, public transport, good schools, stable governments, and so on. Young mothers have many different formula milk to choose from.  For entertainment, with the wide availability of the Internet, we are a-washed with options from social media to video on demand. With real life Twitter updates and social media, who needs CNN to get the latest information? In education, there are more than one universities to choose from. If local options are insufficient, many people can choose to go overseas, even though it can be more expensive. Cars too come not only in different shapes, colours, and sizes, they are also offered at different price points. Go into any modern supermarket, and one easily sees many options for any food choice. The idea of living a good life permeates society. Until one gets the bad news.

Like many stories I have heard, once the march toward prosperity and comfort gets rudely interrupted, so does the perception of the quality of life.

B) Dying Well

Judy MacDonald Johnston recently gave a TED Talk entitled: "Prepare for a Good End of Life." In it she shares about two friends, Jim and Shirley Modini, and their journey through their last days. The key argument that Johnston makes is that the quality of life in the next half of life can remain high. That is, as long as one adopts one or more of the five recommended practices.

First, one needs to have a plan. This plan essentially giving straight answers to questions like:

  • Where do you want to be when you are no longer independent as before?
  • What about getting ready for any kind of medical intervention?
  • What are the ways we can do to ensure our plans are followed up and followed through?
Such plans involve some kind of a "will" that in the event we cannot perform our basic tasks, how can our goals be met even when we are no longer around.

Second, we need to recruit advocates. This step requires us to make an earnest attempt to have a "public face" in our behalf to follow through on our intent and plans. Johnston urges us to have more than one advocates in order to ensure maximum follow up. That said, we cannot presume our immediate family be available to help us do that. That is why we need to be particular about who we choose, and be open about choosing someone who can be committed but not necessarily a family member.

Third, we need to be "hospital ready." This is an important step as we never know when emergencies will occur. We know we will die one day, but sometimes we just leave it to the last minute before we press the panic button.  Just like new mothers to be getting advised about preparing a "goody bag" to be ready to deliver their babies anytime, we need to have a "goody bag" in case we need to be rushed to hospital. It can be our medical history, our identification papers, or our precious momentos. For people in their last breathing moments, having a last glimpse at the most precious things in our lives, even a priceless photo of someone we love, is invaluable.

Four, choose a place as well as our caregivers. This step is not as easy as it seems. There may be several available, but it takes hard work to discern and to decide the right one and the right fit for our needs. 

Five, Johnston urges us to "discuss last words." This step is about communicating our deepest desires and dreams to our loved ones, our caregivers, or anyone we want to share with. For parents, it can be their children. For married couples, it can be their spouses. For others, it can be their closest friends or family members. Whatever it is, it is never too late to talk about our last words, especially when we recognize we can die at any time.

C) Of Faith

One thing that Johnston fails to explicitly mention is that of faith. What does it mean to live for others? What does it mean to live out a purpose much bigger than our own? Johnston leaves it pretty much open for anyone to put in their biggest dreams. For a platform such as TED, I understand. After all, talks there must be as wide ranging and as all encompassing as possible. Hebrews 11 is a powerful list of spiritual heroes of faith, who clung on to hope in God, even when they failed to see the promises of God fully fulfilled in their lifetime. Faith is not about them seeing all the fruits fulfilled. It is about believing God will fulfill, whether they see it or not, and whether they live or die. Joseph the illustrious Patriarch knows full well when his end was near. In Genesis 50:24-25, Joseph is seen blessing his descendants after reminding them about the faithfulness of God. It is a pattern of looking back with gratitude, and reminding the living about God's faithfulness, even as one is dying. It does not matter if one dies. It matters that the living ones continue to live for God as long as they live. With faith, one does not fear dying. In faith, one will be bold to face the dying moments with strength and joyful anticipation of good things that is to come.

The problem with many people who have a fear of death and dying is because they fail to capture the goodness and glory of seeing God. Look at it this way. Children endure long car rides on their way to Disneyland. Parents looking forward to seeing their children and their grandchildren are willing to travel and endure long hours on a jet plane. Mountain climbers with an expert guide press hard ahead when when their bodies agonize from the grueling terrain, simply because they know they will get to the summit and make a shout of achievement. Joseph has this glorious view of God's kingdom, and is able to pass on to his descendants. He then "gave orders for his bones" giving precise instructions on what to do with his remains after he dies.

D) A Spiritual Obituary

What about us? Do we have a prepared obituary? Do we have a Bible passage for our own tombstones that our loved ones will know? Are we prepared to die well, and not be too caught up with living well? Are we ready to brave death, even as we face life? Let me offer three tips on building our spiritual obituary.

First, begin with a Bible passage in mind. Memorize them. Share about it. For me, there are many. Some of it includes:

  • "I have fought the good fight, I have finished the race, I have kept the faith. Now there is in store for me the crown of righteousness, which the Lord, the righteous Judge, will award to me on that day - and not only to me, but also to all who have longed for his appearing." (2 Tim 4:7-8)
  • "But he said to me, 'My grace is sufficient for you, for my power is made perfect in weakness.' Therefore I will boast all the more gladly about my weaknesses, so that Christ's power may rest on me." (2 Corinthians 12:9)
  • "One thing I ask of the LORD, this is what I seek: that I may dwell in the house of the LORD all the days of my life, to gaze upon the beauty of the LORD and to seek him in his temple." (Ps 27:4)
  • "My flesh and my heart may fail, but God is the strength of my heart and my portion forever." (Ps 73:26)
  • ...

Second, write out or share out your own history, will, hopes and dreams. What are your biggest accomplishments in life? What are your hopes for your children? Is there something that you have been dying (pun unintended) to share with your loved ones? Are you in a position that your loved ones may not be ready to hear even if you are ready to share? Write it down somewhere. Then either give good clues on where to find them, or to leave behind a note on where they are found. Like the famous last lecture of Randy Pausch, he leaves a legacy for others, especially his children to pursue their dreams with passion. For me, it is about pursuing faith in God with passion and conviction. May my life of following Christ, fuel my loved ones' pursuit of Christ. Our responsibility is to share about the histories and the past we have lived, with those who are living, just like Joseph of old, who shared about the history of Israel with his descendants.

Third, have something to live for. This will help us face life as well as death boldly. Have something to live for means a purpose in living. If there is no purpose in our own lives, then we will end up regretting about not having a more meaningful or purposeful life. For whatever criticisms people may have about Rick Warren's "Purpose Driven Life," we can take a leaf of wisdom from the book, which has since been republished as "What on Earth am I Here For?".

"It's not about you. The purpose of your life is far greater than your own personal fulfillment, your peace of mind, or even your happiness. It’s far greater than your family, your career, or even your wildest dreams and ambitions. If you want to know why you were placed on this planet, you must begin with God. You were born by his purpose and for his purpose." (Rick Warren, What on Earth Am I Here For? Grand Rapids, MI: Zondervan, 2012, p23)

Yes. It is not enough to simply have something that is as small as our self-driven, self-focused, or self-centered objective. Learning to give of our lives for something or Someone far greater than ourselves is the best possible way to live. No one remembers grumpy old men who complains all the time about them not having enough. Everyone remembers great persons like Mother Teresa, St Francis of Assisi, Martin Luther King Jr, and many others.  Though we may not be remembered famously like them, we can still touch people around us.  They lived for a purpose higher than themselves. So can we. We all need to have a higher purpose. Now, having a higher purpose does not necessarily mean we need to fulfill it completely. It simply means we continue to work toward it, regardless of results. This is essentially life on a crucible of faith.

Perhaps, in order for us to live well, we need to think and talk more about what it means to be dying well.

THOUGHT: "Living on purpose is the only way to really live. Everything else is just existing. Most people struggle with three basic issues in life. The first is identity: 'Who am I?' The second is importance: 'Do I matter?' The third is impact: 'What is my place in life?'" (Rick Warren)


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