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The aspect of geriatrics and palliative carewhich never ceases to amaze me is how much I learn from my patients and their families. In many ways I have 24/7 access to an endless ‘university’ of life lessons. I recently came upon a life lesson that, simple as it seems in words, opened a profoundly new perspective on the life-death journey for me.

In so many palliative care teachings on communicating with patients and preparing them and their families for death, I have learned to ask patients what tasks/goals they feel they need to complete/accomplish before they die. The responses have run the breadth of possibilities: reconnecting with an estranged child, handling finances, seeing a wedding/graduation/birth, finishing a painting, finding a home for a beloved pet. I’ve come to always ask my patients this important question. Many of my patients have found comfort in the completion of these goals and tell me prior to their death that they have accomplished everything important they feel they need to prior to dying–and that this gives them a sense of peace.

Last week, making a home visit to one of my patients, I asked her how long she felt she had to live and whether there were important things she needed to do. She replied, “Of course. I have many cakes to bake, gardens to see, books to read. I believe people should leave this earth with things unfinished. It’s important to do things but I believe you don’t want to complete everything. If you do then what is there left to live for and look forward to? I want to have things left to do when I die.”

It was so simple and, perhaps, to others not revelatory. Yet, for me, in that exchange, I realized that for years now in my practice, I have always felt it important for individuals to have completed all they feel they need to complete prior to dying. But now I have learned that having unfinished tasks is just as valuable and powerful. In talking with her about her philosophy, I found peace myself.

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