What the dying can tell us about how to live: Lessons of palliative care

Don't wait until you are dying to realise you should live life to the full - that's one of the insights learned from two people's experience in palliative care.
PHOTO: Pixabay

Our brains are wired not to dwell upon our own mortality, which is a good thing. That allows us to carry on without worrying about how and when the end may arrive.

But there is some value in acknowledging our inevitable death, bestselling author and motivational speaker Bronnie Ware says. It gives us the chance to find greater purpose and satisfaction in the time we have remaining.

This insight developed during Ware’s eight years working in palliative care, as a live-in carer for terminally ill patients.

Through conversations with people at death’s door, she realised that the regrets they expressed as they looked back on their lives were surprisingly similar despite the differences in their life experiences.

Anyone can apply the lessons Ware learned from those nearing death, if they are willing to make conscious choices while they still have the time.

Bronnie Ware, author of The Top Five Regrets of the Dying. PHOTO: South China Morning Post 
The cover of Ware’s book. PHOTO: South China Morning Post

Ware was inspired to change her own life and pursue her desires to travel, sing and give back to the community, leaving a career in banking and overcoming her fear to perform in bars.

“Working with dying people and developing close relationships with them during their last weeks changed me forever,” says the 54-year-old Australian of the personal and insightful conversations that they shared.

In 2009 Ware started a blog, Inspirations and Chai, and one of the first posts, Regrets of the Dying, has since been read by more than 10 million people.

This prompted Ware to write a memoir, The Top Five Regrets of the Dying (Hay House, 2012), an international bestseller that has been translated into 32 languages.

The top five regrets of the dying she identified are being more genuine; not being consumed by work; expressing one’s true feelings; staying in touch with friends, and; finding more joy in life.

In the book, Ware explains the significance of these regrets and how they can be addressed and avoided while there’s still time.

The most common of all the regrets shared with Ware was that of not having been more genuine and lived a life true to oneself. It was also the one that caused most frustration, as the realisation came too late.

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“When people realise that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honoured even half of their dreams and had to die knowing that it was due to choices they had made, or not made,” says Ware.

“It is very important to try to honour at least some of your dreams along the way. From the moment that you lose your health, it is too late. Health brings a freedom very few realise, until they no longer have it,” she explains.

Frank Ostaseski, a Buddhist teacher, a pioneer in end-of-life care and co-founder of the Zen Hospice Project – the first Buddhist hospice in the United States – explores a similar theme in his book, The Five Invitations: Discovering What Death Can Teach Us About Living Fully (Flatiron Books, 2017).

He too, shares the lessons he learned from interactions with more than 1,000 people as they approached death.

“Death is not waiting for us at the end of a long road. Death is always with us, in the marrow of every passing moment. She is the secret teacher hiding in plain sight. She helps us to discover what matters most.

“And the good news is that we don’t have to wait until the end of our lives to realise the wisdom that death has to offer,” writes Ostaseski, who founded the Metta Institute in 2005 to train health care workers and carers, and build a national network of educators and guides for those facing life-threatening illnesses.

Ostaseski also shares five insights, or invitations as he calls them, in his book.

Frank Ostaseski, author of The Five Invitations. PHOTO: South China Morning Post
The cover of Ostaseski’s book. PHOTO: South China Morning Post

1. Don’t wait

He urges people not to lose the chance to live a more fulfilling life today in pursuit of a better tomorrow.

Marian Wong, a clinical psychologist in Hong Kong who has been working in the mental health field for over a decade and helps cancer patients in the palliative stage, often sees patients worry excessively about what will happen to them.

Marian Wong is a clinical psychologist in Hong Kong. PHOTO: Marian Wong

“It takes them away from the present and makes it hard for them to engage with family and friends. Through our sessions together, they come to realise that constantly dwelling in negative thoughts prevents them being fully present in the moment.

"Training themselves to live in the present is often their biggest lesson.”

2. Welcome everything, push nothing away

This is a call to stop judging people and circumstances and realise that well-being comes from within and not solely from external occurrences.

3. Bring your whole self to the experience

Let go of your inner critic and accept and connect with all parts of yourself, the good as well as what we consider to be bad.

4. Find a place of rest in the middle of things

We can stop to find calmness within us even while in the middle of an arduous task, and we don’t need to consider rest as something that will come to us at the end of everything else.

5. Cultivate a "don’t know" mind

Let go of preconceived notions and the urge to control, and be receptive to meet whatever shows up as it is.

Welcome everything, push nothing away and bring your whole self to the experience. PHOTO: Pixabay 

“For some, dying was a great gift, they made reconciliations with their long-lost families , they freely expressed their love and forgiveness, or they found the kindness and acceptance they had been looking for their whole lives,” Ostaseki says.

“Still others turned towards the wall in withdrawal and hopelessness and never came back again. All of them were my teachers.

"These people invited me into their most vulnerable moments and made it possible for me to get up close and personal with death. In the process they taught me how to live.”

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This article was first published in South China Morning Post.