Q: This book addresses the mental, emotional, psychological, and spiritual needs of dying individuals. How does it address these?

A: I remember once being with a woman who regularly had many visitors in Palliative Care. I recall one day being there as all the others left and the woman clutched my hand tightly and said she was exhausted by all the good cheer and the need almost to entertain her visitors. She knew she was dying and wanted desperately to talk about it. So, I listened. She poured out her longings and questions with me and, after a time, asked me to pray for her, there and then, asking that death come soon because she was more than ready for it. This book is my attempt to provide others who are dying with the kind of validation of feelings and a venue for exploration of death that this woman so longed for. When the end of life is near, at least some of us need to acknowledge it, name it, and have our experience normalized, if at all possible. This
book offers an opening for this to happen, at the reader’s own pace and on their own terms, as it were.

SOURCE OF INSPIRATION FOR BOOK

Q: How did you develop the idea for this book?

A: The initial inspiration for collecting messages like this was the news that my sister had been given 6 weeks to live. I had found things to say at times with others who were dying and they seemed to be well received, but my sister lived too far away for me to spend the time with her to say the same things in person. So I wrote some of them down and was pleased that she seemed to find them meaningful and helpful. The
idea of putting them into a form that allows a wide distribution wasn’t my own, but once it was suggested I worked over the material again, consulting favorite authors and scrounging through my own journals and even a few sermons from over the years. When I thought of the idea of adding images to the words, it was my adult children who suggested partnering with a friend of many years, Maggie Sale. Together we worked to match photos to text in ways that would make the book a rare treasure.

Q: How important was your personal experience to the development of the final version? How did you know it would appeal to others in varying circumstances?

A: Since different people have different needs and face different challenges, it is no easy task to create something to meet every need. However, I do know that these messages seem to resonate with many people according to feedback I have received for the book so far. I would say, also, that the fact that I have faced a life-threatening illness myself certainly clarified my thinking about what was helpful and what was
not. It also made me aware of what resources are out there and where there are gaps. I feel that this book fills one of those gaps by providing an appropriate resource for people who no longer have the physical or mental stamina to access more demanding materials.

LAYOUT OF BOOK

Q: You describe three broad categories that encompass the content of the book. What are they and why are they relevant to dying individuals?

A: The material in this book encompasses three rough classifications: some practical, instructional content; some messages that deliberately validate feelings; and passages that offer comfort, encouragement, and hope. First, the practical, instructional content relates to outward things, to concrete arrangements that need attention and to relationship matters that need addressing – matters requiring communication with others. Indeed, the book comes with a ready-made way to communicate such messages in the journaling section. Second, I’ve emphasized messages that validate the feelings that go along with looking death in the face. These feelings can take up all the oxygen in the room, metaphorically at least, unless they are acknowledged and, if possible, shared. I know that a person can think they are going crazy unless their
experience is normalized somehow, and I’ve tried to do that in this book. Third, I have included what I consider inspirational content. These are the messages that are most "spiritual," and I have been careful to include quotes from a variety of spiritual traditions. Some of the meaning-making around the death experience has to do with valuing life: the life that has been lived, the life that will go on without us, the life that we are living now however reduced in scope, and the life that may await us on the
other side of death. Much of the inspirational content is focused upon such things.

Q: What is your intention behind the nature photographs in the book?

A: My first intention with the photographs is to bring beauty into the end-of-life experience. It is also to inspire, to comfort, to provoke memories, to indicate a context in which all our living and dying takes place, and even to provide a distraction from incapacity and other grim realities. Maggie Sale and I made a particular effort not only to do the best we could to match images to messages, but also to represent images
from many different locales. We did this with the express hope that many readers might find at least one image that could be associated with a good memory or familiar landscape. Nature images made the best sense to me because the experience of nature is a common denominator for us. It is often associated with a sense of peace or even a special closeness to the divine. Personally, I love what the photographs add. You could just look at those images for hours and hours.

Q: A couple of times you have mentioned how this book can be personalized. Could you describe this?

A: Absolutely. First, the book can be personalized in several ways as a gift. There is space at the front of the book for a message from a person who might make a gift of this book to someone who is dying. That message may be every bit as meaningful as the other material in the book. Second, there are four pages in the book with images but no words. The person giving the book, or the dying person themselves, could insert
meaningful words on those pages and suddenly the book would be customized! In addition to the four pages with photos and no text, there is another section of the book with lined pages and small thumbnail prints of the images used elsewhere. These pages are designed to allow personal expression, to encourage an accounting of experience, and to allow specific messages to be recorded for those who will be left behind. Finally, the very last section contains blank pages to which photographs or note cards, prayer cards, or tokens might be attached. In the end, the book can be highly personalized and become all the more valuable.

USE OF BOOK

Q: How can this book be used?

A: It was my vision to create a book that could be used in many ways. Between the two covers of this book are messages, nature images, pages for journaling, and a section to which personal photographs or notes can be added. This is a book that can become a customized treasure-trove for the person using it and possibly a cherished keepsake for others later. Those who are personally facing the end of life might just like
to sample this book from time-to-time, when the mood strikes them. Some will enjoy prowling the main photo pages from start to finish over and over. Others will identify a message or image that they like and prop the book open to it on a bedside table. The journaling can be an outlet and a way to come to terms with some of what is internal by writing it down. In addition, because I know how hard it can be to talk about death and dying with the people most affected, this book can also be shared. Maybe a dying woman asks her son to read the passages aloud for her one evening when they are alone and thus she is finally able to tell him how she really feels about what is happening to her. Or maybe it would work the other way around and it would be the son offering the book to his mother, hoping to open up discussion of the topic. In addition, it is my hope that professionals, or even volunteer visitors who are around the person who is dying, might use this book to open up an exchange about the realities at the end of life. It is a meaningful gift and a useful tool.

Q: Who will benefit most from using this book?

A: First and foremost, the person who will benefit from this book is someone facing the end of life. It might be most useful to someone who is already able to acknowledge the fact that death is near, but then again, it might assist a person in getting to that place. I have been told by early reviewers that family members and friends might benefit from the content of the book as much as the person who is, in fact, facing death personally.

Q: There are some blank pages in the book that readers are encouraged to use. How do you want people to use these?

A: This may end up being one of the best parts of the book! I can imagine people pasting in photographs of a favourite place: a cottage, a farmstead, a lake, or the view from their bedroom window. Maybe there would be pictures of people: grandchildren, a family reunion, or a coffee group that met together for years. I can imagine people tucking into these pages especially touching cards, letters, drawings by young children, prayer cards, or poems with special meaning. The content of these pages can be very personal reminders of memories made and love extended. Having a way to collect these sorts of things in one place will make the book intensely valuable to the person who is dying.

CAREGIVING

Q: It can be very difficult for family and friends to talk with a dying loved one. How does Facing Death facilitate communication between them?

A: Facing Death has the potential to facilitate communication just by being there. The title itself and the presence of the volume on a nearby table or bookshelf could provoke inquiry and open up opportunities to talk about the things that really matter. The book could be shared more deliberately – as a gift, or with a request for the other person to look it over and share their thoughts about it. It might be possible for caregivers or loved ones to use it for their own initiation into what might be going on inside a less
communicative person who is dying. Very often, death can be "the white elephant in the room"—something enormous and potent that everyone pretends isn’t there. Having a valuable resource like this book can help break the cycle of discomfort and open up a much-needed dialogue.

Q: How can a professional caregiver or medical provider use this book?

A: The World Health Organization has specified that appropriate palliative care "integrates the psychological and spiritual aspects of patient care." That is a good principle, but what that translates into may be difficult to pinpoint. Even the most sympathetic medical professional may have so many demands on their time that
ensuring that they have that “special talk” with a dying patient may be an elusive dream. In addition, just because a person is an excellent hospice nurse, social worker, or chaplain, doesn’t mean they necessarily know how to initiate a conversation with a stranger about dying. Enter: this book. Even the busiest professional can provide Facing Death to a patient or client, perhaps with a promise to talk about it together
when next they meet. It is also a resource to be recommended to family and other visitors who are having trouble knowing how best to companion a person who is facing their own death. One thing I love about this book is that it can be there when care professionals cannot. As someone who has faced a life-threatening illness myself, I know that some of my most intense questioning and laments occurred in the middle of the night, when nobody else was around. A caregiver can provide a meaningful gift to such a person just by ensuring this book is there for such occasions.

END-OF-LIFE CARE

Q: What aspects of end-of-life care are addressed within this book?

A: I have to say that I am not an expert on end-of-life care but I do understand some of the principles that guide it. These include respecting the dignity of the person as a unique individual; honoring both the value of life and the natural process of death; working to improve both the quality of life and the quality of death; and serving the whole person. The content of this book respects the value of life and the process of dying. It also dignifies the reader by allowing them to choose what is of use to them and their personal situation. Most important, it has the potential to allow for a focus upon the spiritual and meaning-making dimensions of life, and makes space for "completion" to be accomplished — the process of tying up loose ends with respect to
personal history and relationships — thus improving quality of life in the moment.

SPIRITUALITY

Q: Your book has a spiritual quality but it is not specifically religious. Tell us about this aspect.

A: The spiritual quality described within this book concerns the concept of completion. When the ragged edges of life’s fabric have been tidied up adequately, a certain relaxation of concerns becomes possible. Completion is about something much more than simply “taking care of business” and has a potential to provoke deep meaning and profound healing. If spirituality is understood as that which concerns ultimate meaning and the movement toward wholeness, completion definitely has a spiritual quality. Both people who define themselves as religious and those who do not will be better off for having achieved this spiritual completion.

Q: Is it possible to address the needs of people with diverse religious backgrounds in a single book?

A: I'm glad you've asked this question because it allows me to be clear about the fact that I don’t see my book as supplying all that anyone would need at the end of life on its own. What I have tried to provide is a book that addresses certain predictable human needs around the end of life in a way that can be woven, by individuals themselves, into something that makes sense of, and sense with, their own belief structures. One of the wonderful things about this project is that people can take away from it what is of value to them personally and very literally leave the rest alone. There may be people for whom the text messages, for example, are not nearly as important as the images. Others may end up with bookmarks sprouting out of the
pages so they can quickly locate the sections they want to return to and avoid the rest. Those who do identify with a specific religious tradition may place it alongside resources from their tradition, while also drawing upon the care of members of their tradition. Facing Death is a well to draw from that can be used alone or with other resources.