Accepting Death in Old age the inevitable truth

Do we plan our death as we plan our future? How many of us raise the topic of death at the dinner table? The harsh reality is we fear death and thus dread to talk about it. Death and dying is a taboo and humans are in denial of the inevitable condition. The term itself give rises to the feeling of gloom, agony and separation from the loved ones. Death has never been personal, throughout ages as the rituals attached to it in different cultures and religions have made it collective, shared by public. However, the personal loss remains at its peak. The transition, not only reap the physical loss but also psychological loss. The condolences from the society act as a strength to the bereaved family in the tough times.
Old age is indeed the time where people prepare for their demise which evoke a gamut of psychological distress. Nonetheless, the connotation has never been stress-free for any of the family members to accept it with open arms. This particular topic gives a leeway to ponder on the Erikson’s eight stages of psychosocial development.He suggested how the virtues at different stages make up the psychological well-being of an individual. Ego integrity v/s despair, which commences at 65 years and ends at death, is the final stage. This stage surrounds human on a single intra battleground   which is ‘Was my life meaningful’? This stage often marks with the new life after retirement, loss of partner, friends, family or other major event. They relive their past life and try to find purpose of their existence and asks oneself whether it was filled with contentment or disgruntlement. The sense of satisfaction helps them to achieve wisdom even after their demise and failing to attain leads to despair. As one confronts the end of their life, they welcome their death with peace and serenity if they have lead a gratified life. Conversely, inability to resolve the conflict leaves an individual with the feeling of desolation and awaits death in despair.

Why do people fear death when it is the most certain thing in our lives? Death is not only the end of a physical life but also the psychological, emotional separation from their loved ones. The termination of life includes the end of all distress but also the end of all accolades, good will. Are we ready to renounce all those? To die is to leave all the mortal things behind, the reminiscences, the experiences of life, qualms, desires, the bad habits, the good habits, and probably every petty things and to head towards a world of unknown, unseen. But isn’t the beauty lies in the mystery of death. Death is the part of old people but different individual deal with in a different way. Some feel ready to go in welcoming gesture and some wait for it desperately in despair. Religion also plays a vital role in accepting death. Life is considered as separation whereas death is been viewed as reunion with self. 

In Hinduism, death is considered as the spiritual awakening for an individual. In Hindu mythology, Mahabharata, Krishna is seen to be explaining Arjuna about the existence of soul which is real and the body being unreal. He enlightens that both of these are not to be lamented upon as the soul never ceases to exist and body is ever unpreserved. He further clarifies that body will die one day but the soul or self continues to remain undamaged. The childhood dies when it gives birth to youth and youth perishes when it give rises to old age.As one does not feel bad to transform from one stage of development to other, similarly, one should not cry over the death of a body of an individual. The Hindu focusses on four major goals of life: artha, kama, dharma and moksha. The artha and kama are considered to be the physical and psychological goals whereas dharma and moksha are the moral and spiritual goals. The meaning of moksha is liberation or ‘to let go’.  Few of the practices are being adopted by people to attain the ultimate liberation or moksha. This could be massively seen in one of the oldest city of India, Varanasi. People believe that anybody who takes his last breath in this city attains moksha. Humans from world, every year, come to Varanasi to attain moksha. They are known as mumukshu (aspirants for moksha). They stay in mumukshu bhawan till their death. Even the terminally ill patients spend their rest of the days, offering prayers to God, doing charity to attain liberation, an end of the cycle of life and death. People who indulge in these kind of behaviours are in pursuit of spiritual accomplishment. They leave behind their material possessions, loved ones and surrender themselves in the feet of God.
Studies have stated that there is a direct link between religiosity/spirituality and reduced death anxiety. Quality of life, subjective wellbeing have been markedly improved of the people who devoted their remaining life under the shelter of God.
Furthermore, they attempt to explore the latent sacred meaning of life and death, the purpose of life and the essentials and non-essentials for life. A painless death is what they expect in return. Knowing the occurrence of death helps to prepare them for a better coping strategy of the entire dying process. End-of-life discussions becomes more prevalent and planning about their predecessors becomes their major concern.
Studies have revealed that old people were more concerned with the circumstance that their departure would not be taken in good will by their children, grandchildren and other acquaintances. 
However, death of dear ones have been the most vulnerable situation of any one’s life, regardless in the view of the deceased one or their family members. Many researches have founded that the old people in their late 80’s have needed therapeutic help to deal with the thought of death. During the last days, utmost care and protection are the most indispensable need by the care givers. 

Palliative care is the care which is provided to the old people or terminally ill patients to provide a better quality of life. It could be provided at any place like in hospitals, old age homes or at home. Not only, physical care but psychological help is also the need of the hour. Talking about mental health is been stigmatised in our society, hence they avoid seeking psychological help.  Studies have been reported that due to the cognitive decline in old age, the old people tend to suffer from a lot of mental health issues. Death anxiety, dementia, depression are the major mental health issues to name a few. Mental health experts are in dire need to attain such patients with utmost care.

1. Comfortable environment/support groups should be provided to ease out loneliness.
2. Planning of proper food/nutrition as their appetite tend to decline
3. Proper sleep cycle should be maintained
4. Frequent counseling sessions could be provided to de clutter their distorted thoughts about self and others.
5. Brisk walk should be encouraged to stay fit and mobile.

The members of family could also act as a co-therapist as could provide with all the comfort at home. It is also difficult for family members to accept the inevitable condition of life. It is imperative to understand the priorities of the old people who are near to the end of their life. However, raising the topic is also very crucial as it is inescapable. The process of dying in itself is the most challenging part of life thus proper planning, unfathomable conversation with family members is the prerequisite. The open discussions on this topic helps to understand more about the wishes which are yet to be fulfilled. Death does not happen to only old people but to everyone so it is vital to discuss on a par with both ways on plans, coping strategies. Nevertheless, these discussions could not be done in an abrupt way as it needs a subtle cues to start the talk, as we tend to dodge talking about such themes.In my opinion, the subject should be raised by both the participants but conveying their thoughts to each other becomes a task. Both the carers and the dying person needs to be emotionally accepted if such parleys are been exchanged.
Succinctly, the word death and dying has been taken in such negative context that it has started to become a taboo and a stigmatised subject to talk frequently about it. The concluding stage of life which is the old age is the culmination of the childhood and adulthood. The outlook of the subject is been perceived by the old people in a different way, some welcome it with positive attitude while some accept it in despair. The final stage is been reflected upon and the older adults try to find meaning and purpose of life. Despite its stigmatisation, the older people are trying to accept the unforgiving reality and preparing themselves to bid the final good bye. Knowing that the agony of separation deeply affects the domestic affiliates but talking about it has helped to establish a safer and supportive environment, making the dying process much easier and with less distress.