Starting the educational process with the young - the very young, in fact - can help people to better understand the processes of aging and dying.
That's the belief of Tani Bahti, 55-year-old Tucson veteran hospice nurse who is on a crusade of sorts to take the fear out of end-of-life decisions.
"We really should be involving our children from kindergarten age and up," says Bahti, principal of Passages: Support and Education in End of Life Issues. "They have relatives die, young friends die, pets die. If we can intervene earlier with education, we can take much of the fear out of the dying process."
Over the past 26 years, she's found younger and middle age persons more fearful of death than their older counterparts, mainly because of lack of knowledge.
Two groups – the 71- to 81-year-old and the 61- to 71-year-old segments — usually dominate those attending her no-cost community seminars throughout the Greater Tucson area, according to Bahti, who also works with professional groups, individuals and families.
Sometime in the future, her hope is to do a pilot test on end-of-life issues education, leading to an ongoing, community-wide model. She does admit funding for such a project is difficult because "it's not a very sexy subject."
Bahti has received the majority of her end-of-life knowledge from first-hand experience working with patients at three Greater Tucson hospices.
"When I went to college (in the mid-1970s to get a registered nursing degree), there was about one paragraph of information on death and dying in our textbooks," Bahti said. "My patients have been phenomenal teachers for me."
She authored a book, "Dying to Know – Straight Talk About Death and Dying," in 2006, in addition to a series of educational DVDs on the same subject. In them, Bahti emphasizes three key points:
• Develop navigational skills. "You need to understand you have rights and choices" as end of life nears. "And you have to ask questions – the right questions."
• Knowledge of the body's process of dying. "Many times, we can confuse that process with a variety of medical procedures. If your body wants to shut down in an orderly process, it goes to sleep."
• Discover meaning in impending death. "Often, it can cause us to live more fearlessly – say things to friends and relatives that haven't been said and do things we've always wanted to do."
The most important document for an aging person to have is a written medical power of attorney document signed by both the person and the future decision-maker. The person's doctor and the future decision-maker need to have copies.
Bahti says living wills unfortunately have failed us. "There are so many 'shades of gray' (depending on a person's sometimes ever-changing physical condition) – and don't account for the changing condition of patients. The decisions just are not that easy."
She also notes studies have indicated relative decisions (regarding treatment) are "wrong 42 percent of the time."
Bahti is passionate about spreading end-of-life issues education, noting she's experienced suicide deaths by 10 friends and relatives – including her father, well-known Tucson artist/poet Tom Bahti, in 1972.
Why does she believe people attend her seminar series?
"For the lay person, they tell me that they've been frightened" by a relative or friend's process of dying. "They don't want to have the same thing (fear) happen to them again.
"For medical professionals, they say (attending the sessions) helps them work with patients more effectively. The education can bring them back as healers."