Is a “good death” possible?

We get lots of advice on how to live a good life, but who teaches us to die well?

The discussion of death is still largely taboo and when we are forced to talk about it, it tends to be in sterile hospital corridors with doctors who are trained to help us heal, not to help us die. And yet, theirs may be the only voice many of us will hear when we make end-of-life decisions with a family member.

After helping my mother through her own passing, and then writing a novel inspired by the experience, here are a few bits of wisdom I learned along the way:

1) Recognize the signs

It takes nine months to be ready to come into the world and it often takes that long to be ready to leave it. There is a pathway to a natural death and it may start up to a year in advance. You may see signs that your dad is disinterested, resigned or depressed. He might withdraw and stop participating. Understand this is natural and is his way of preparing to say goodbye.

2) Talk

You might find that mom wants to talk about the end of her life, and no matter how uncomfortable it is for you, let her. Ask her how she feels about dying. Talk about what kind of passage she imagines. Many people don’t imagine dying in the hospital intensive care unit tied to machines, but over 60 percent of us will.

3) Remember to ask yourself: Whose life is it, anyway?

Over the last century, Americans turned death over to medical institutions. In doing so, we give up our personal and spiritual freedom at a time when we most need it. When I wrote my book, “Finding Frances” (Winston-Higgins Press, 2010), I realized how strong the pull is to take medical treatment at all costs, right up until the end, regardless of religious or personal beliefs. In the book, William, one of the main characters, struggles to help his mother die in accordance with her own beliefs, even though they conflict with his own. But here is what my own experience taught me: If we believe our loved ones are entitled to their own choices, their dying becomes easier.

4) Consider your loved one’s quality of life

In our litigious, high-tech society, doctors offer increasingly improbable solutions when the most obvious solutions prove ineffective. When one method doesn't work, it's often followed by the words: “But we can try blank.” Help your family member make the best decisions for them by understanding the probabilities of success, the amount of damage the solution will cause, and the probable quality of life if the new treatment is successful. Let them know it’s their choice whether or not to proceed. Their answer may surprise you.

5) Help them communicate their wishes.

Everyone knows they should have a will, but between 40 and 60 percent of us do not have advance-care directives, which are legal documents that spell out our wishes for the end-of-life experience. You can get a valid one for your state online or from your lawyer. There are also organizations like Project Grace (www.projectgrace.org) that offer easy, innovative ways to capture those last requests. Help your loved one fill his out and give copies to family members and doctors.

Janice M. Van Dyck is an award-winning novelist. Her fiction provides insight into families, relationships and the conflict of being human. “Finding Frances,” explores whether it’s possible to have a good death in today’s medical system. It’s a novel about a woman’s choice to deny aggressive treatment and die a peaceful death in hospice care. It has been widely praised by the medical community, baby boomers and senior citizens for its frank yet gentle exploration of end-of-life choices. For further information or to purchase her book, click on www.janicevandyck.com