Includes already familiar issues, and new ones; shifting perspectives; loss of meaning, unfinished emotional business; emotional changes; pain; telling your story; acceptance and denial.
The comic Woody Allen says: It’s not that I’m afraid to die; I just don’t want to be there when it happens. He’s probably not alone in feeling like that. Yet maybe the fear of death and our superstitions about dying distort the reality. What if death isn’t all it’s cracked up to be? What if, as the mystics suggest, death is in fact the peak of life? Even, a transcendent experience?
You have to wonder when you read Philip Gould’s musings. Diagnosed with oesophageal cancer, and only weeks away from his death in 2011, he notes (When I Die: lessons from the death zone).
‘This is the most exciting and extraordinary journey of my life…. Death is sad but it is also a process of transformation and change and excitement. I have had more moments of happiness in the last five months than in the last five years…more moments of private ecstasy than for a very long time. I feel at peace with the world. Without doubt, for me the gain has been greater than the pain.”
What do these two very different attitudes – Allen’s and Gould’s – tell us about dying? That, as with any other experience we pass through in life, it’s up to us – to absent ourselves or to be present to whatever is happening. It’s our individual choice to focus on certain aspects on the situation and not others. To ‘rage against the night,’ or to arrive at a point of acceptance.
The OSHO Sammasati understanding is based on the reality of dying being as much a part of our existence as is living, and that whatever our experience, we can bring awareness to it; we can learn and grow through it. This approach is the foundation for all the support you can find on our website.
Below we identify the kind of challenges that might come up in the dying process, and provide links to resources to support you.
What we have addressed elsewhere is the huge benefit and potential in dying consciously; that is, in preparing oneself on all levels. See How to Die Consciously.
The phase in life when we or our loved ones are dying, can be a very challenging time and, simultaneously, extraordinarily enriching. Having an idea of some of the issues that may come up can be useful.
The range, intensity and duration of any issuewill vary from individual to individual, One significant factor will be whether the dying person is young or elderly and basically healthy but gradually becoming weaker, less engaged with life and having a sense that they are on their way out; or they have a health condition and have received a terminal prognosis due to serious illness or injury.
‘When adversity arises as a life-threatening illness…it is a heroic journey that is not respected as such, any more than the potentially life-threatening and always life-altering experience of pregnancy, labour and delivery…. In both circumstances, people find fortitude, courage the ability to endure pain, and strengths they never dreamed they had.’ 
When a person realises that they are dying, some of the issues that they face will be the same ones that they have been dealing with (or perhaps trying to avoid) for their entire lifetime. Except that now they may visit them with an unknown intensity. Among the feelings that come up there might be abandonment, fear of pain or of not being in control, and so on.
On the other hand, priorities can shift when someone is encountering their mortality and so some issues they had been dealing with before – the drive to achieve or the stress of multi-tasking, for example – may now simply dissolve.
And, as a third possibility: some issues will reveal themselves for the first time. These may include the loss of meaning; the loss of self-image now that the body is increasingly dysfunctional and is perhaps judged as unattractive…now that the roles and activities through which the dying person identified themselves become redundant… now that they are no longer a member of the world of health, no longer a participant in an active world.
There may be a sense of having not lived fully; of regrets and having ‘unfinished business’ with others. There may be the loss of certain friends, the love they provided and the shared experiences. Of those who do stick by them, the dying person might have expectations that are not being met; there may be a mismatch between what they feel they need and what they are given.
Many of the issues that the dying might encounter may be the same as those that arise when one is passing through a serious illness including the impact of hospitalisation, connection with carers and professionals, making meaning out of your experience, loss of control and independence, dehumanizing, alienation, changing sense of self, the need to feel loved, feeling out of touch and changing perception of time. See When Health is Challenged.
In addition, there are issues that are more specific to when someone is dying:
These vary according to the individual’s situation but can be particularly intense when they are given a terminal diagnosis. See Receiving a Terminal Diagnosis.
When you are told that you have an illness from which no recovery is expected, that you are at a point where your doctor can do nothing more for you, a whole mix of feelings may emerge.
For example, from an initial sense of numbness and disbelief, there might be denial or anger, or sadness, fear and anxiety. Over the next days or weeks you might feel ambivalent about your prognosis. That is, there may be days when you accept what you have been told that are followed by periods of resistance and a determination to fight. There may also be times of insecurity, of doubt and not-knowing; of shame and of guilt. There may also be quite different feelings – such as relief, acceptance, love, and gratitude. Those last four do not tend to be problematic, so let’s focus on those emotions that do.
In all the confusion, it’s good to know:
* Such feelings are perfectly normal
* They will not follow any particular order
* They do pass
* Whatever you are feeling there are methods to support you
To understand more about what you might be feeling and for related meditative strategies see Emotional Changes in Sickness and/or Dying.
For Dealing with Pain see Illness and Pain.
No doubt about it, most of us find that being in a situation where certain elements are just unknown is uncomfortable. Not-knowing – whether we are the person dying, a loved one and/or a carer – can trigger anxiety and a sense of not being in control.
Some of the uncertainty and anxiety may be reflected in the following questions:
* How much longer do I have?
* How will my family/employees/pet manage without me?
* Are my legal, financial and personal papers all in order?
* Will I suffer pain?
* How will it be to die?
* Is there an afterlife? If there is, what is going to happen to me?
* Have I been wrong, to believe that someone else can save me from whatever is to come?
* Have I been wrong, not to have any religious beliefs?
The Need to tell your Story – a Life Review
Once someone has accepted their impending death, there’s a natural tendency to want to begin looking back on their life and to talk about it with someone, to have a witness to who they have been and to the life they have lived. Looking through an old photo album or hearing a certain song may trigger the feeling to start reviewing their life and through that to find some sense and significance in it. They might ask themselves: What was it all about? What did I achieve? Was I loved? Did I love? and so on.
With this review, feelings of regret may come up over things done or not done; or of unfinished business with certain people (see below); and anticipatory grief for the loss of everything they have known.
You might feel to support someone in this, whether by just listening to them or perhaps by helping them to create a collage of their life, a photo/memorabilia album or making an audio or video recording of them, perhaps with messages for their family and other loved ones.
Completion of Unfinished Business
As noted above, when we realise that death is inevitable, we might need to address and bring to some kind of closure whatever remains incomplete or which we regret. Unfinished issues and regrets will often rise to the surface particularly if we are inactive, weakened and demoralized with little else to engage us. The mind is uncomfortable with issues left unresolved. Once we have some sense of resolution, or even acceptance that ,in spite of our best intentions, there are things we cannot bring to a satisfactory conclusion, we are more likely to be able to leave this life with some degree of peace.
It may be that you are able to contact the person(s) with whom you have unfinished emotional business. Then you might invite them to visit you, telephone them or express your feelings through a letter or email. It may be that the person doesn’t wish to connect with you, or that you have no means by which to reconnect or they have died. In this case you can still unburden yourself by talking to a compassionate listener or putting all that you wish to say in a letter that you don’t send but dispose of in some way.
Your journey through dying is as individual as your living
No-one has lived your life nor can they. In just the same way, the manner in which you pass through your dying will be uniquely yours. So rather than trying to provide a map of what your experience will be, we consider it more helpful to remind you of your existing resources and to help you develop new ones: strengths that help you respond in ways that work for you in whatever you encounter.
Accepting that you are dying
Some of us accept the inevitability of our death early on in our sickness and others of us, never at all. Health professionals have opposing views regarding acceptance – some feeling you must accept your dying, while others feel that you don’t have to, but that it is ‘generally better’ if you do.
From a personal growth perspective, it is vital. ‘Spiritually, the transformation in consciousness has the opportunity to begin in earnest only after the stage of acceptance.’ 
With true acceptance, any remnants of resistance have dissolved and, in contrast to the collapsed state of resignation, there is a surrender to where life has brought us. Inevitably, with that sense of ‘So be it!’ there is relief and relaxation. See also To Fight or Flow. All too aware of the fleetingness of life, there’s a heightened sense of its preciousness, a joy in the simplest of pleasures, and a sense gratitude. See Philip Gould on dying with acceptance.
The Canadian singer, actress and comedian, Carla Zilberman, diagnosed with Lou Gehrig’s disease, writes …
‘Thanks to my illness my life is high-definition Dolby surround sound! I am moved by this life with the single-minded intensity of two teenagers in love for the first time. I want to crawl into the back seat with life and steam up all the windows. I want to stop everyone on the street and tell them about my love…. I’m in love with living and I think that’s the way I will feel until I die. I don’t want to waste one moment.
‘Lately, more of the hours of each day are filled with suffering rather than joy but I will not stop inviting in joy until my last breath. I will not spend my hours bemoaning something which cannot be changed. I am an incurable illness. And I am dying….'
Carla also found the time and energy to create a Blog from Heaven in which she reassures us that even though she is ‘badly, badly dead, the afterlife is a tasty cup of awesome.’
What influences the way we respond to stressors and react to crisis? Identifying and accessing the strengths you have and on which you can build.
What is resilience? How to strengthen and activate it so it can help me in times of need?
Meditation as key to building or maintaining your emotional integrity and strength – in everyday life and in trying situations.
This toolkit is primarily for the person who is dying although it has many resources which will be of help to those caring for someone who is dying. For Carers please see our Carer Toolkit.
1) Close to the Bone: life-threatening illness in a soul journey Jean Shinoda-Bolen, M.D.
2) The Grace in Dying: a message of hope, comfort, and spiritual transformation Kathleen Dowling Singh (HarperOne)
3) Leave them Laughing C. Zilberman (The Natural Death Centre)