Quality of life and serious illness

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When faced with a serious illness, one is often called upon to evaluate core values and beliefs: What makes life worth living? Are there elements you are unwilling to live without?

The key to living well with dying is to identify what it is that you value most about your physical, mental, and spiritual well being. Should your family need to make decisions for you, it will help them to know about your values. Even if life-sustaining procedures are not an issue, clarifying what it is you cherish about life will enable you to focus on those qualities in the time you have remaining. Some questions to consider are:

  • Which symptoms bother you the most? Perhaps they can be managed more effectively.
  • What favored activities have been limited by your illness? Perhaps adjustments can be made so you can capture the qualities of those activities even if you are not able to perform them as you did in the past.
  • How have relations with your friends and family changed because of your illness? Perhaps talking about it could clear the air for closer interactions.
  • What are your worries, fears, or concerns? Rather than bottle them up inside, who can you speak to about them? Who is a good listener? Who has the resources to help you come to a greater understanding about your concerns?
  • What does your spiritual path offer in terms of support and ritual to help you through these times? Perhaps there are people you can call upon to help you access this support.
  • What gives your life purpose? Perhaps you would find it useful to reflect on the meaning of your life so far, identify your achievements, and acknowledge your shortcomings.
  • What gives you hope at this time in your life? The dying have wishes for the future, too. Perhaps you can think about your hopes and what tasks remain before you to complete your life in a positive way.

Obviously, each of us must answer these questions for ourselves. At rock bottom, what is the minimum quality of physical comfort, functional ability, social interaction, emotional peace, spiritual support, and existential satisfaction that would still make your life worth living? If you were not able to speak for yourself, are there circumstances in which the quality of life would be so low that it would be worse than dying?

Share your answers with your caregivers to clarify your values and your priorities. If you can translate these values into an advance directive, you will be doing them a great service. You will spare the people who love you the angst of guessing your wishes if they are faced with having to make decisions about life support. Knowing what you cherish most about life will also help ensure that the quality of your days is as rich as possible.