On May 22, 2013, at 10:30 a.m., my cell phone rang. I don’t usually answer calls during meetings, but I noticed it was from Orchard Manor Nursing Home, where both my parents are residents. Mom had been declining in health after years of struggling with dementia and, as the medical power of attorney for my parents, I was the family contact person.

I excused myself, answered the call and was informed that Mom’s breathing was shallow, and other vital signs indicated that the body was shutting down. This wasn’t unexpected, but I still felt a wave of sadness overtake me. I asked to be kept up to date, contacted another family member and went back to my meeting.

The four people I was meeting with were all good friends.

They are members of Akron (Pa.) Mennonite Church (AMC), where I served as associate pastor 20 years earlier, when we were all younger. We had gotten together to review material this group had developed on end-of-life issues for use at AMC and were now sharing with me to adapt for use in the broader church.

We had a moment of silence, recognizing the sacredness of my mother’s journey. The irony and sacred nature of our being together and talking about end-of- life planning didn’t escape any of us.

Story of AMC’s end-of-life ministry
Members of the AMC planning team have been carefully building this curriculum over the past two years. Since September 2011, 70 people have graduated from the first workshop, Final Arrangements. Many of these individuals have also gone through the second workshop, Natural Dying. To support the effectiveness of these two workshops, annual reunions have been built in for graduates to meet together, review and update the end-of-life plans they have written for themselves.

Everence end-of-life planning curriculum
Taking the material from AMC, which consisted of 18 two-hour sessions and adapting it to a more condensed version was no small task. The curriculum has gone through significant downsizing to make it more accessible to a broader audience. End-of-life, in its current form, leads participants into six key areas of discussion.
A facilitator’s guide provides step-by-step suggestions for the leader and is accompanied by several documents in the appendix that can be printed and handed out at the discretion of the leader. In addition, video clips are available online at everence.com/stewardshipeducation. The facilitator can use the videos to introduce each session.

The topics covered in this six week series include the following:
• the benefits of planning well
• tame and wild dying
• advance care planning for a peaceful departure
• what to do with my body
• necessary conversations
• making your wishes known

The benefits of planning well
Before getting into the more intense issues of end-of-life transition, a case needs to be made that planning is important. There are few of us who have had good modeling on how to plan and discuss plans for our physical death. Right at the beginning of this session the reminder is offered that the death rate is right around 100 percent. That being the case, it seems logical we should plan for this eventuality like any other transition. But this is clearly easier said than done.
Consider all the things in this life that require advance planning.

Most significant life events that take place within the home of a family require planning.

We wouldn’t think of just letting things happen on their own without conversation and preparation such as these:
• deciding about faith and baptism,
• discerning whether to go to college or start a career out of high school,
• deciding whether to marry and whom to marry,
• having a child,
• buying or selling a house,
• when to retire and where to live once I retire.

If we are not yet convinced about the importance of planning, just consider the fact that Jesus himself indicated that he needs time to prepare for our home coming (John 14:1-4). This being the case, maybe we should take some time to prepare for our home going. If you are someone who functions best with a list, below is a draft of what needs to happen before or at the time of your death. And since none of us knows exactly when our time to leave will be, maybe we should start planning now.

Preparation for my earthly departure checklist:
• All is well between my soul and God.
• My relationships with others are where I want them to be.
• My finances are in order (wills, life insurance, financial documents).
• My legal executor and/or power of attorney are in place.
• My medical power of attorney is appointed and I’ve written DNR (do not resuscitate) directives.
• I have a living will so that if I slip into dementia, I’ve stated my wishes concerning natural dying vs. heroic medical procedures.
• My desires for the disposal of my body are decided (organ/body donation, shroud burial, cremation, embalming and burial).
• Plans for my memorial service are written and in the care of a pastor or family member.

How we die
Planning for our departure from this life takes on a different nature for people whose faith is in Jesus Christ versus those who have no faith. There is a hope and a sense of anticipation in what is to come. That doesn’t mean there aren’t anxieties and fears. These are natural with any kind of transition.

In his book The Christian Art of Dying, Allen Verhey makes a distinction between two ways people die. One is “wild” or “medicalized” dying, and the other is “tame” or “natural” dying. Tame dying had been the norm until medical science advanced to the point where the key objective was to keep our bodies alive at all costs—figuratively and literally. Medical professionals were placed at the center of caregiving for those who were ill and dying. The extended family and church communities that provided care in preceding generations were given a back seat to the professional caregivers. Cure of the body took precedence over the healing of the soul in preparation for death.

Verhey states, “At the end of the war in 1945, 40 percent of deaths happened in the hospital; in 1995, 90 percent did.”

According to Verhey, much has been lost with medicalized dying taking the lead. The rituals of tame dying include encouraging the dying person to accept death, saying goodbye to loved ones, the giving and receiving of forgiveness, blessing and instruction by the dying to one’s survivors and commending one’s soul to God. In their place, rituals have been replaced with the denial of death and exclusion of community.

Verhey goes on to say that people still died, of course, but until they did, they were expected to seek medical help and cooperate in the process of getting well. Medicalized dying is characterized by an effort to avoid death.

Verhey further states that beyond trying to avoid death, we avoid even mentioning death. With science taking a more prominent role, doctors sometimes refused to tell their patients they were dying. Often, family and friends willingly cooperated in this deception. When dying patients moved to the hospital, expectations were heightened that somehow the unavoidable could be avoided. Death has become the newest taboo. Since death is not mentioned and science is the new focus on which we place our hope as a society, we no longer feel the need to prepare for death as we might have at one time.

Postponing death
All we really end up accomplishing through heroic medical efforts at the end of life is temporarily postponing death and the grief work that accompanies it. Maybe in the end, grief is what we are just as afraid of as dying itself. Needing to face the sting and pain of separation is a matter of the heart that medicine cannot address. This is emotional work and community work and, most importantly, faith work.

Verhey cites a study of patients with advanced cancer. It was determined that those who identified themselves as people of faith (most of them Christians) were more likely to choose aggressive medical treatment—including mechanical ventilation—at the end of their lives, more likely not to prepare an advance directive for end-of-life care and more likely not to die well. These findings suggest that we need more conversation on how to plan and prepare for our home going within our faith communities.

My mother’s death
My mother died around 9:30 p.m. on May 22, 2013, several hours after my meeting with the AMC group. Our family had agreed in advance to proceed with cremation, since we knew finding a time to get together for a memorial ser­vice would be challenging. My parents had purchased a burial plot many years ago, and that, too, was taken care of.

With our 94-year-old father restricted to a bed or wheelchair, we decided on a nontraditional funeral that would allow us to stay close to the family farm in Medina, N.Y., so Dad could come for the service, meet friends, neighbors and family and return to the comforting routines at Orchard Manor.

A tent was erected on the family farm, tables and chairs were rented, a friend of the family offered to barbeque chicken, and additional food was prepared. We gathered Sunday, June 9, 2013, at 3 p.m. What resulted was a combination tent revival, neighborhood block party and hymn sing memorial service. Mom would have loved it. She loved the farm, her family, the neighbors on Marshall Road, the church and was loved greatly in return.

Not being locked into traditional forms, we were free to focus on each other. Having done some planning in advance, we spent more time considering how to honor Mom and celebrate her life as opposed to the logistics of burial plots and caskets.

End-of-life planning is as important as planning for the other important aspects of life. Having conversations in advance about “how I want to die, how I want to be remembered and what I want done with my body” is a freeing reminder to live life to the fullest here and now.

It’s difficult to talk about dying and death while we are living. But it’s even more difficult for our loved ones to work through these decisions at the time of our home going. Planning for our earthly departure is one of the best ways to say “I love you” to those we leave behind.

Beryl Jantzi, director of Stewardship Education for Everence.