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Last Breath Awareness for Intentional Living

This month we look at the advantages of having an Advance Directive, but not as you might expect. Filling one out will undoubtedly serve you and your family at the end. But can the document help you now? Taking an unfamiliar twist, I'll demonstrate its contributing factors to the practice of last breath awareness. Also, we'll look at a mental exercise that promises some worthwhile reflections.
An Advance Directive is a legal document that preserves your final wishes for that irreversible moment when you can no longer make such decisions. But can the form help you now?
Last month, I flew to Austin, Dallas, and then McAllen Texas to speak to medical professionals on how the Advance Directive can serve as a model for the practice of impermanence. Rather than seeing the legal document solely as a representation of one's wishes, I proposed to the audience that the document can serve as a rough sketch on cultivating last breath awareness practice for the serious student.
For instance, the document has a couple of ways to approach the theme of death. On the one hand, its legal dress code supplies a soft, indirect approach that we can employ when we feel apprehensive about tackling the subject (ex. “If you have a terminal illness”). On the other hand, the form contains a blunt manner that shatters cemented patterns of denial (ex. “autopsy”, “cremation or burial”, etc). Since our practice constantly fluctuates, this variety can help prove handy.
The document also normalizes  the language of death (ex. “natural death”, “my body”, etc) and encourages conversation around the inevitable (ex. the need for witnesses). Although not popular in our culture, these methods can have enormous relational gains, more so at times than some of today's self- help and therapeutic techniques for promoting intimacy.
Whether or not you have filled out an Advance Directive, become familiar with its delivery. While the document provides clear instructions on your last wishes, it also gives you a bare but helpful outline that can guide an important practice.
What if you had one year left to live? This is no new reflection. Stephen Levine and others have proposed designing such a mindset to counteract the practical lifestyle of permanence or continuity promoted by a death-phobia culture.
Some have proposed a shorter framework. In hospice, for instance, the medical model measures six months or less. Others who personally practice the perception of impermanence push for just one day. While each measuring rod differs, the outcome is still the same, namely, to bring home the reality that life is indeed short. And because it is so, we should live each day with greater intentionality.
The thought of having a limited amount of time does something to the habitual western mind that is immersed in a magical forever. Contemplating impermanence using the mindset of having one year left creates a set of penetrating thoughts: If you had one year left, how would you live today? What would your priorities look like? How would you conduct yourself at home? At the office? How would you divide your time? How would your relationships to people and things change?
Weighing out the benefits, one is hard-pressed to argue against a limited frame of reference to living. Moreover, we have never  been promised a year or even a day, for that matter.


“Accepting the inevitability of death is healthier emotionally and spiritually than living in delusion.”
--Bhante Gunaratana

Guest blog post by Kevin Quiles, M.Div., M.A., LPC practices mindfulness and psychotherapy in Roswell, Georgia.

He is the author of Spiritual Care to Elderly and Dying Loved Ones and Conversing with Death: to Build a Better Now and Future. He also developed the practice of Conversing with Death Therapy ®. For more information, go to kevinquiles.com.

Kevin has authored 2 online continuing education courses for Pedagogy Education.

The Role of the Hospice Caregiver, this online course reevaluates the basic understanding of caregiving to achieve balance in this altruistic trade and provides the necessary tools to help the caregiver maintain a healthy balance in the field while providing quality service to patients and their family members.

Whether one is moving into the field of hospice for the first time or is well-seasoned as a professional caregiver, he or she has a significant chance of encountering some surprising hindrances that could mentally eradicate the caregiver’s emotional balance.

The Spiritual and Religious Makeup of the Hospice Caregiver, the purpose of this course is to examine how the healthcare professional’s spiritual and religious makeup influences the role he or she plays in the field of hospice. In studying the fabric of knowledge that transcends science, the course neither labels one religion or practice as good or bad, nor does it deny any claims of spiritual experiences or awakenings. The primary objective of this course is to lay credence to the psychological and cultural factors on spiritual and religious development, and to understand its strengths and limitations as it interacts with the prioritizing value hospice takes in serving a religiously diverse community. Questions the study will entertain here are as follows:
  • How do the professional’s absolute beliefs come about in the first place? Here the development of religious or spiritual ideas is explored only from cultural and psychological perspectives.
  • Are there strengths and limitations to any one perceived universal spiritual or religious belief as it works alongside an organizations’ mindset to deliver equal care to all faiths?
  • How can the professional work around an organization’s mission to a religiously or spiritually diverse community without feeling like he or she has compromised convictions?

While the subject of spirituality or religion is often handed down in hospice to the chaplain, every discipline is still at the forefront of the tugs and pulls fueled by one’s set of beliefs. Thus while this course can benefit all the disciplines, including the chaplain, the audience here is primarily the licensed nurse.

To learn more about Kevin’s courses click on the course titles above, education may also be purchased for an organization by emailing sales@pedagogy-inc.com or giving us a call at 903-871-2150.  Facility purchases of education always include the use of our Learning Management System that allows you complete control and oversight of education.
Posted: 9/2/2015 8:43:24 AM
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