It can be very difficult to come to terms with the diagnosis of a terminal illness. Acceptance of death involves spiritual and practical preparation and a search for life’s meaning.
Most of us like to think we’re in control of our life. We make choices and decisions and, at best, take responsibility for them. But if you discover you have a terminal illness, it can feel like you’ve been robbed of control, are suddenly powerless, and unable to be accepting of death.
It is undeniably hard to accept death, and you may wonder whether there was any point to your life. You may be plunged into grief and despair, nevertheless it is possible to find a way forward.
Speaking of patients with advanced cancer, Palliative Care Consultant, Dr Kathryn Mannix says: “Grieving for a lost future with its plans, expectations and time with dear ones becomes bereavement for self that patients work through.”
In fact it’s normal to feel hurt, anger, even a sense of denial that you are dying. Indeed one of the great theologians of the twentieth century, the Dominican Herbert McCabe (1926-2001), believed it was right to be angry with God about death:
“It is just as appropriate to be angry with God as it is to beg his forgiveness or to ask him for anything in prayer. If you think this is shocking and irreligious, go back to the Bible. Read the psalms, read Jeremiah, read the words of Jesus on the cross: ‘My God, my God, why have you forsaken me?’1.
Gradually you should find that you begin to accept your death and to prepare for it. You may arrive at this point before members of your family and friends.
Lucy O’Donnell from West Sussex was diagnosed with incurable breast cancer in 2011 when she was 47. On receiving her diagnosis, she said her first thought was: “Why me? What I did I do wrong?”
After a time, Lucy found she was ready to make plans, but those close to her were reluctant. Lucy observes: “People don’t really want to talk about it, that’s what I’ve found, so I think about it myself. I think about preparations; how I would like to die; how I would like my funeral to be; where I want to be buried.”
If you’re able to concentrate on planning the practical side, the process of dying can become something through which you and those around you grow closer and stronger.
This can also help relieve some of the stress that you may feel about tying up loose ends. Or thoughts about how your family will cope after you have died.
Gerry O’Hanlon, a father of two from Newcastle, lost his mother after her health gradually declined. Speaking about the time leading up to her death, he said: “I think the fact that we had reflected beforehand – where Mum would be buried; how we would do the funeral – helped me. And the fact that the family were involved, the boys were there, that was a real help for me.”
The process of dying will be different for everyone, but it’s impossible to predict exactly what will happen, or how you will feel.
Diagnosis of a terminal illness doesn’t have to be the end of conversations about different possibilities. There will be conversations with your family, friends and care team about all of the things you’d like to do in the time you have left. You will have many beautiful memories along this journey, as well as more difficult and challenging times.
Dr Liz Toy, a cancer specialist and end of life lead at an NHS Trust hospital in Exeter, believes it’s important for very sick patients to share their fears and anxieties with those closest to them.
Dr Toy says: “For family members and friends to understand how each person is feeling brings the family closer together, and can provide an opportunity to be more supportive of each other.”
Acceptance of death is not simply facing the truth that you will die but comes from finding some positive meaning in it. For Christians, this is seen as the hope found in Christ’s cross.
Finding some good for yourself or for others, in or through your death, can help you to accept it. You may think of how best to leave a good memory for those you leave behind.
Christians often speak about acceptance of death in terms of letting go of this mortal life. There is a tension here as Christians also believe that life is a precious gift from God that should cherished. Ultimately, finding meaning in life and accepting death is about trusting God.
David Albert Jones, Director of the Anscombe Bioethics Centre in Oxford, puts it like this:
“Acceptance of your death can be helped if you can start to let go of your plans or ambitions in life. And if you can put your trust in a Power greater than yourself.
“From a Christian perspective, acceptance is about seeing your death not as your destruction but as a return to the One who made you, falling into the hands of the Living God who raised Jesus from the dead.”
Practical preparations like making a will and planning your funeral can help you retain a sense of being in the midst of uncertainty. However, Dr Jones believes it will only take you so far. He says: “Acceptance of death ultimately involves a recognition that not everything is under your control.
The process of mourning and letting go of our mortal lives as we prepare to die is described in a booklet published by the Catholic Bishops of England and Wales.
In a section entitled Respecting the mystery of Dying, James Hanvey S.J. writes: “At some point, if I have the time and the space, I have to learn to say my goodbyes. As well as the goodbyes to people and places there is the goodbye to self, the self I have been, the self I wanted to be; I must mourn these ‘selves’ and these ‘lives’.”