Many patients tell me that they are “ready to go” and then struggle when they realize that making that momentous decision is not the deal-breaker for dying. Don’t get me wrong, it is important, but they often have not taken into consideration the importance of the mind-body connection in the act of dying.

This is particularly true for the most spiritual patients whom have spent a life developing their spirituality within their religion or those who have spent their life working with their high-functioning mind in fields such as science or mathematics. Our minds are amazing tools we use each and every day,  but sometimes at the end of a life, it is very difficult to turn that tool off and let it go. Particularly when we believe it has maintained order in a chaotic world and for many, the end of life is the most chaotic time they can imagine and so they clutch to their mind at that time. Using it to take control of their weakening body.

Now you would think that people that were very athletic in life would fare well in this physical feat of dying, but alas, they too have used their mind to help get the most out of their body, often pushing it to the limits. They too struggle in their final days as the very thing that gave them vitality in life keeps them going on, defying every physical challenge that comes along. Family will often state proudly, “…oh they are such a fighter!”, not realizing how fighting death is a negative.

The Buddhists have wisely understood the mind’s powerful lock on our ability to let go and created one of the most effective practices in preparation for the time of death; that being meditation.  Meditation is a life-long discipline we practice over and over again, with our own death very much as motivation.  The Tibetan Book of the Dead  is all about this very idea but it is not an easy text for a westerner to understand and in the Buddhist tradition it is thought to take a lifetime of practice to master its instructions.

Prayer is certainly a form of mediation for many but not always the dependable discipline that meditation seems to be. Regardless of of your religious or philosophical practice, the underlying fact for us is that when we die, we must be at peace with our body and switch off our mind.

Acknowledging that our body is going to die is something we must all do at some point. Often our body can no longer go on due to a disease process and despite our best efforts to halt the disease, the body will die. That means the mind too.  Yet the mind, with fear fueling it along, can keep a body going much longer than it need do and it can seem like unnecessary suffering as the dying person hangs on and on and on. The family becomes fatigued and overwhelmed by the question of “…why hasn’t our loved one died when they said they were so ready?”

I have always felt that death is the reverse of being born and equally demands the physical exertions of labor with its different stages, transitions, peaks and troughs. The hospice RN is the mid-wife, guiding the dying person to their final breath. I often try to check in with my patient to find out how their mind-body connection is. If they are struggling, I will speak gently with the dying patient of giving thanks to their body for all it has done in this lifetime and to take this time to say goodbye to it with peace. Sometimes just talking of what is likely to happen as the person is dying can help give them a guide for what is to come and allow them to get rid of their fear of the unknown. Finding out what form their fear is can help guide what is needed.

Often we use medications to help the person with the pains of their labor. Pain can be caused by many physical forms due to disease process and shortness of breath as respiratory and circulation function slows down. Other forms of pain can be due to the mind-interference of fear generated by hallucinations and other mental disturbances caused by chemical imbalances as the body attempts to  shut down. Dying is a very physical act and everyone will do it in their own unique way, just as every birth is unique.

How is your mind-body connection? How will you prepare your mind to let go when the time comes?

Of course the other aspects of dying such as spiritual, emotional  and mystical (none of us knows what is happening) will always be with a person as they die but first and foremost, death is physical and it is a good start as we prepare for our final days.

Jan R