Mona Hanford, who serves on the board of the Collegeville Institute, is a tireless advocate for end-of-life care, and has just completed a book, The Graceful Exit: Ten Things You Need to Know. We featured an interview with Mona in June, 2017 in which she talked about hope at the end of life, compassionate and reasonable care, and “letting go gracefully.” Since that interview, Mona has herself received a serious cancer diagnosis, and is now the subject of the very issues she spoke about so passionately. We asked Mona to talk with us again, now that her advocacy has taken on this new, even more deeply personal, dimension.
Last year we ran an interview with you, Mona, about your advocacy around end of life issues, and now here you are with a serious cancer diagnosis of your own. You’re now having to put into practice for yourself what you’ve counseled others about.
Yes, it’s ironic, isn’t it? Several months ago, I was encouraged to write a book titled, The Graceful Exit: Ten Things You Need To Know, and now I am facing my own exit. For years now I have been counseling friends with serious health problems to face the reality that we are mortal. I am stunned that death is a word rarely used in hospitals. My very skilled Chinese surgeon asked me, “What is it about Americans that they do not understand aging and death? Here it is all about looking young.”
Often when I talk to friends about considering hospice care for their loved one they say something like, “You have to understand. Mother, who is 95 and has been in and out of the hospital the last six months, is not dying yet. We have the best doctors and no one has mentioned death.” The failure to face the reality of death is the major failing of our medical system, and many of our churches as well.
It is one thing if the medical system can’t recognize death as a possible outcome. We should really be worried, though, if churches and clergy can’t face the reality.
Absolutely. A hospice nurse told me recently that patients at the local hospital were not being referred to hospice until just days before their last breath, and by then it was a terrible shock and crisis for the family. This delay not only causes unnecessary physical pain, which palliative care could ameliorate, but equally tragically, when people deny their mortality, they are not open to spiritual lifelines. Compounding the problem, hospital— even hospice— chaplains are trained to avoid sharing a God-centered perspective.
When even clergy hesitate to mention God, patients and their families suffer through their most challenging and painful times without hope. I am committed more than ever to spread the message of the Hope Initiative, which is an organization I started to help patients and their families face death together. God’s love and mercy are central to my life. They give me hope as I face my own mortality, and I want to spread the Good News.
How are your spiritual lifelines, as you call them, working for you now?
Knowing God is at my side has given me remarkable calm. In practical terms, although I have a serious cancer diagnosis, my body has functioned well. I had a major surgery with a huge 9-inch incision, and yet I left the hospital after just two days, without pain pills or drugs for anxiety or depression. The doctors marvel at my resilience.
I attribute both my emotional equilibrium and my physical recovery to my deep faith in a loving God and the love and support of my friends and family. A young neighbor has created an online sign-up for meals and visits. Friends bring food and fellowship. We eat and pray, and yes—laugh.
I love my life! I love my family and friends, who have been incredible sources of love and support. I want to live as long and as well as I can. My first chemo treatment yesterday went well, and this weekend I am going to be at my granddaughter’s squash tournament cheering her on. Nevertheless, whenever my exit comes, my faith will sustain me as I say goodbye to those I love. There will be peace at last. I do not know what heaven looks like, but I am open to the mystery of God’s love. I am an optimist!
Let’s talk about that book you were asked to write, which is now available on Amazon. Speaking from your present situation, what are ten things you need to know to make a graceful exit from the life we know?
I’m glad you mentioned that the book is available on Amazon, because the most I can do in a brief reply is to give you the bare bones of the list I develop in the book.
You need to be able to talk about death, your own death. That’s what I call the elephant in the room. As I said earlier, it’s shocking to know how much energy is spent in avoiding the obvious.
It’s important to involve yourself in the end of your life as a spiritual journey: it’s not just a descent to the end, it’s an opportunity to go deeper into your own experience of God and spiritual things.
Be aware of what is widely known as the “Five Wishes.” It’s very practical advice about being prepared to face the end of your life. Who do you want to make medical decisions for you when you can’t? What kind of medical treatment do you want, or do you want to avoid? How comfortable do you want to be, specifically? How do you want people to treat you, again, specifically? And what do you want your loved ones to know—about your relationship with them, and about your thoughts about the end of your life?
Redefine what it is to “do everything” medically at the end of your life. Do you really want to go through treatment that may extend your life by a little bit, or not at all, at the cost of a lot of pain and discomfort to both you and your family?
Be aware of, and seek early, the great blessing of hospice care, especially in your own home.
Make use of the great advances in integrative care and pain management made available by modern medicine, including the use of medical marijuana.
Focus on comfort, and enjoy the simple things, most importantly, all the relationships you’ve developed over your lifetime, whether in person, or by remembering all those people who have been important to you.
Say what’s important to the people you care about, and do it now. Don’t delay. And share with others what’s important to you, including books, music, and things. Give things away. Don’t wait for others to sort through what has given you such joy and meaning.
Open the door to God. That’s the title of a chapter. I can’t think of a better way of putting it.
Embrace the next chapter. That’s also the title of the last chapter of the book. For those who believe that nothing can separate us from God’s love, as the Apostle Paul says, then there is another chapter, there is peace at last, and there is hope to embrace.
As I say, this is just a bare bones list. I write more fully in the book about each of the ten things you need to know about making a graceful exit. This is information that has certainly helped me—is helping me—and I’m convinced will be valuable to anyone who’s facing the end of life. It will also benefit their families.