Many people, when thinking about their own deaths, hope they will lay their head on their pillow one night and die peacefully in their sleep. The truth is, dying in our sleep is not common. There are some diseases (sleep apnea, heart failure, cardiac arrest, stroke, and seizures) and accidents (carbon monoxide poisoning and drug overdoses) that definitely can cause an unexpected death during sleep. For the most part, actually more than half of us, our deaths will be due to a chronic disease, either heart disease or cancer, in which our health gradually diminishes. 

According to the Centers for Disease Control (CDC), the leading causes of death are heart disease (30.2%), cancer (29.5%), accidents (7.6%), respiratory disease (7.4%) and Alzheimer’s (5.6%).  Following these leading causes are stroke (4.9%), diabetes (3.8%), drug overdose (2.8%), kidney disease (2.7%), influenza/pneumonia (2.5%, remember to get your flu shot!), and suicide (1.8%). 

Why am I brightening your day with this information? Because I would like you to think about this. Our advances in medicine and technology enable earlier diagnosis and treatment which sustains life a lot longer than in previous years. This is great news! Especially if you have a chronic disease. I encourage you to think about this as you make decisions regarding your medical care. Most of us agree that the quality of the extra years is the deciding factor when weighing risks and benefits of medical treatments.

It is necessary to become informed, read all you can about your diagnosis, ask all the questions you have to, in order to truly understand it and the disease process. There will come a time when you’ll wonder about the end process of the disease. And there may not be anyone that is giving you the truth about how it will look, what you can expect or have someone brave enough to have those real conversations with you. But you deserve to know, in order to make informed decisions well in advance; your advance directives.

When my friend Erica was dying, there were so many people that asked me, “How will she die?”, “What will it look like?”, “How will we know when she is dying?”. I was honest and explained the most likely situations that could occur and what that would look like and how we would handle it when it happened, because we knew what Erica wanted. People want to talk about their health and want to know these answers. It is your responsibility to find someone like me to be honest and have that conversation with you. If you have a chronic disease and haven’t had these conversations, do it now.

“It’s not morbid to talk about death.  Most people don’t worry about death, they worry about a bad death.” – Terry Pratchett

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