In the video accompaniment to Atul Gawande’s book, Being Mortal, one of the stories shared is that of a grandfather who, upon learning his treatment was unsuccessful, decides to die at home.

A bed was placed by a sunny window in his comfortable New England house, overlooking a beautifully landscaped yard. A hospice team made regular visits. 

He grew weaker, but it seemed his pain was mostly under control. Grandchildren climbed into bed next to him for conversation and cuddles. 

Watching the video, my fellow seminar participants agreed that this was the picture of a good death.

A good death.

In the mid-1960s when Dr. Elisabeth Kubler-Ross began working with hospital chaplain Carl Nighswonger in his newly established Death and Dying program, dying patients routinely were not told they were dying. (The original Death and Dying program was begun as part of the clinical Pastoral Education program of the hospital.) As part of the program, Kubler-Ross began interviewing dying patients, which was both a revelation and a scandal.

In some respects, we’ve come a long way. We can say no to medical interventions that will do little but prolong suffering. 

We may receive hospice support for our loved ones or ourselves. We can pivot from trying to cure or “beat” whatever illness is having its way to focusing on a “good death.” 

And there’s the rub.

Who wouldn’t want to be able to give their loved ones that kind of good death? The problem is that it’s not always possible. 

Quality care facilities may not be available or are priced beyond what a family can manage. Caregivers are too exhausted from juggling doctors, prescriptions, jobs, other family members, keeping up a home and other matters of life to have a tender afternoon with their loved one.

Without even considering the death that comes as a result of trauma or the pain that cannot be managed, a “good death” can be beyond the ability of even the most deeply loving family to provide. And they know it.

As both a hospital chaplain and a therapist, I’ve listened to family members carrying deep guilt for not having “done better” by their loved ones. It’s part of what Kubler-Ross called “unfinished business,” and there’s no way for them to go back and make it right.

Here the church has an opportunity to offer a substantive and healing gift. In tending to a family’s grief, attentive ministers can listen for expressions of regret and guilt.

“I should have”…
“We should have”…
“I feel so bad for not…”

Family members may confess “what they have left undone,” regardless of whether it was in their power to do it. They may feel deeply ashamed for having fallen short when it mattered the most.

This kind of guilt doesn’t go away with platitudes but requires honest conversation about hard things and limited options. It requires the gentle disentangling of what they wanted to do and what was humanly possible to do. It requires hearing a confession of what was “left undone.”

We may offer words of forgiveness for that which, in reality, carries no true guilt, but our words of forgiveness may open the door for them to forgive themselves.

In a group like “Navigating GriefLand,” participants can both get a reality check from the teaching as well as discover in group discussions that they are not alone in struggling with this. Sometimes, it’s easier to see the truth of it all in someone else’s story.

When we can let go of the guilt for not having done more than we had the power to do, we are then freed to grieve both the death and all that we wish could have been different in that death.