Ante-thanatos care – a holistic approach for preparing for the end of life

Craig Brown

Published in JHH17.1 – Stories in Medicine

(Greek thanatos= gentle death)

Ante-thanatos care is in many ways similar to ante-natal care. It is a preparation for a transformation; one a new life and the other a departing life. Both benefit from a holistic approach that includes conventional and self-care measures.

I felt I had made adequate preparation for my own ante-thanatos care by making a will, delegating a power of attorney, putting my financial affairs in order and leaving instructions of my various contacts and passwords on my computer. Over the years I had read much around the subject of death and dying, and attended conferences and run workshops on the subject.

On a hiking holiday two months ago with some old university friends I developed an indigestion pain. After several weeks when it did not settle I made an appointment with my GP to get some medication. She felt a mass in my upper abdomen and after investigations, including scans and a biopsy, I was diagnosed with a malignant melanoma with widespread secondariness in the liver, chest and pelvis. It was one month from being fit and healthy to a progressive jaundice. It was a shock to me and my family and my friends.

My initial fear was that I would deteriorate quickly and that I would not have the time or capacity to prepare myself on all levels of my being: physically, mentally, emotionally, spiritually, socially and environmentally.

My immediate physical problem was that I was not able to drink enough fluids and had become dehydrated and needed intravenous fluids to correct that and to drink more myself. I had been taking painkillers as required which was not really controlling the pain. With advice from the community hospice team I started a regime that controlled the pain and I physically began to feel better.

As a result of my physical improvement, I became mentally clearer and was able to work through some urgent tasks such as cancelling meetings and informing
people of my illness. Emotionally I noticed I was in a dark place after being battered by one piece of bad news after another. It was not only me, but family and friends had been thrown off balance too. I needed to realise that I was not responsible for how they felt – although witnessing that was particularly upsetting – but if I began to lift myself it would help them. So through the cloud of darkness I began to perceive a point of light which, when focused upon, slowly grew.

Spiritually I know that it is important to free oneself, which involves forgiveness and loosening attachments. In recent years following my wife’s death I have been practising letting go of resentment. I feel I have made some progress as I do not really feel any anger in the situation. Generally I have not had a great attachment to material goods, but will be disappointed I will never see my newly planted wildflower beds, or be able to go on the holidays I had planned.

The practice of meditation for me is connecting with my own inner peace and also with the universal peace and love. It is central in my preparation for my dying and transition. I do not know what is next, but am curious.

I have never been very good at receiving compliments, but the emails, letters of support and love, receiving of healing and good wishes – many very personal – have been a great condolence. When I am quiet in bed I think of all the kindness and healing sent my way, and it filling my heart and surrounding me.

Socially it is good to have the time to share memories with friends and family and be grateful for such a fortunate and full life in which I have had the opportunity to serve and love. Yet in the time that is left I am fortunate to make the space I need for myself to prepare and find that deep inner peace.

Finally, I would like an environment that is peaceful and calm where I am allowed to let go. I hope this poem I wrote will be read at my funeral.

Send me your love

When you think of me, send me your love.
Grieve if you must, but not for long.
Judge me with forgiveness and remember the good times
Help me pass on easily, by sending me your love.
My body has served me well, and my soul is eternal
Think of me as a bright star in space
Breathe in Natures peace and send me your love
Hold it in your very being
And now breath out and let me go