My friend of 30+ years is going through it big time. Her partner of 20+ years is dying. In two weeks- or perhaps two months- she will join the growing ranks of solo elders. After age 75, an astonishing 43% of women live alone. My friend is understandably anticipating his death just as much as she is bargaining with his illness to move to the back burner, giving them more time together. She is sleeping at a hotel near the hospital so she doesn't have to do the daily hour long drive. Her adult son is helping. She has a strong community. She accompanied her former husband, her best friend and her mom to the gates of death. But still.  There is no way around this. This is it.  A good partnership is ending; there is grief; there is pain; there is fatigue; there is love. The road is narrowing and the end is in sight. The days are so very long for her, the caregiver, and the remaining time she has left with her partner so short. She talked for a long time and I listened. They had done so much end of life planning and had made tough decisions.  I wondered aloud if they had said their goodbyes. If they had shared their gratitude, their forgiveness and breathed words of love together. If there was anything left undone that could result in regret for her after his death. When there is so much focus on the body and its sometimes dramatic but often stealthy demise, it is easy to put off those conversations for a better time. In the wise words of American Buddhist teacher Frank Ostaseski in his book, The Five Invitations, holding on to and leaning hard into these five things can help: 1. Don't wait, live fully now;   2. Welcome everything, push away nothing, accept all experiences without judgment;   3. Bring your whole self to the experience, be authentically present;   4. Find a place of rest in the middle of things, cultivate calm amidst chaos;   5. Cultivate don't know mind, practice openness and not-knowing to allow for growth. I wish him peace on his journey. She knows she will be okay after he dies. She wants to travel with a close, new widow friend. I wish her peace on her way.  May we all know peace at the end of our lives.

If you hate poetry, you will love Andrea Gibson, who died in July at age 49. I dare you to read this! Love Letter from the Afterlife By Andrea Gibson My love, I was so wrong. Dying is the opposite of leaving. When I left my body, I did not go away. That portal of light was not a portal to elsewhere, but a portal to here. I am more here than I ever was before. I am more with you than I ever could have imagined. So close you look past me when wondering where I am. It’s Ok. I know that to be human is to be farsighted. But feel me now, walking the chambers of your heart, pressing my palms to the soft walls of your living. Why did no one tell us that to die is to be reincarnated in those we love while they are still alive? Ask me the altitude of heaven, and I will answer, “How tall are you?” In my back pocket is a love note with every word you wish you’d said. At night I sit ecstatic at the loom weaving forgiveness into our worldly regrets. All day I listen to the radio of your memories. Yes, I know every secret you thought too dark to tell me and love you more for everything you feared might make me love you less. When you cry I guide your tears toward the garden of kisses I once planted on your cheek, so you know they are all perennials. Forgive me, for not being able to weep with you. One day you will understand. One day you will know why I read the poetry of your grief to those waiting to be born, and they are all the more excited. There is nothing I want for now that we are so close I open the curtain of your eyelids with my own smile every morning. I wish you could see the beauty your spirit is right now making of your pain, your deep seated fears playing musical chairs, laughing about how real they are not. My love, I want to sing it through the rafters of your bones, Dying is the opposite of leaving. I want to echo it through the corridor of your temples, I am more with you than I ever was before. Do you understand? It was me who beckoned the stranger who caught you in her arms when you forgot not to order for two at the coffee shop. It was me who was up all night gathering sunflowers into your chest the last day you feared you would never again wake up feeling lighthearted. I know it’s hard to believe, but I promise it’s the truth. I promise one day you will say it too– I can’t believe I ever thought I could lose you.

Here are 10 little-known signs your body is screaming for estrogen These signs are identified by Dr. Michelle Sands. I indicated on each line how much I resonate with each symptom. Which ones do you resonate with?  Dry, itchy eyes (yes a bit) Joint pain and stiffness (yes a bit) Urinary urgency or leakage (yes a lot) Frequent UTIs (yes, sometimes) Insomnia (yes, sometimes) Loss of motivation and drive (yes, a bit) Electric shock sensations (yes, a bit) Ringing in your ears or tinnitus (nope) Restless legs (yes, a bit) Burning mouth or tongue sensation (yes, a bit) There is finally a huge amount of functional and integrative health information that understands menopause. So many smart women doing the research and developing the science that finally grasps the significance of menopause in our lives.

One day last month, I coughed 276 times in a day. And peed 16 times, 5 of which demanded that I rise from sleep. It was a bad day. I had been having a lot of bad days. For about three months my asthma and interstitial cystitis had gotten signficantly worse. A constant cough and overactive bladder have plagued me for thirty-ish years. The natural herbs, acupuncture, bee pollen, occasional albuterol and pyridium no longer worked. I felt defeated and hopeless. Living well until we die is my motto. That was feeling pretty hard to do when every day my physical quality of life was seriously compromised. What is a death doula to do? Since then I have gotten on an inhaler, tried a heavy drug that wiped me out, and seen a speech therapist who taught me to slow my spasms to cough by exhaling slowly instead of giving in to the spasm.  I also have met with a pelvic floor physical therapist and taken an online pelvic floor strengthening class and completely changed my normal breathing to contract and pull up my pelvic floor upon exhalation.  I also have been getting treatments on a medically approved and designed system for strengthening the pelvic floor and decreasing urinary incontinence called Emcella.  The exhalation of my breath seems to help both my coughing and my bladder, leading me to believe that the root cause of both problems , could be related to my nervous system. I have seen a huge improvement. I still have a long ways to go. But yesterday I coughed only 16 times. I had to get up only twice at night to use the bathroom the last three nights. Things are looking up! I feel hopeful again! Here is to healthy aging and helpful practices! Here's to calming exhalations! And here's to living fully until we die!

My mom got her wish for death on April 25th, 2017, exactly 5 years and 2 hours after her eldest daughter, one of my two sisters, died. She was 94 years old.  She had a great death. A brilliant, life-affirming death. She wanted to die. She embraced it. She was ready and open. A few weeks earlier I begged her, tongue in cheek, not to die while I was out of town in NYC for a week. Two days after I returned, she took to her death bed after ‘a cardiac event’. I rushed to her side and she looked at me and said weakly, “ See? I gave you New York! Now its my time.” I had moved her out to be near me four years earlier from Florida, also known as “God’s Waiting Room”. She gave up her house, car, cooking and cleaning. Her 3rd husband had died a few months earlier. She had taken care of him and my sister for the prior year. She was worn out from caregiving with advancing COPD.  When she arrived at her new home near me in the Bay area, she was convinced she had a year left to live. She remarked, "Can you believe I've lived this long?" She was warm and very loving, always with a big smile for everyone, especially if they had chocolate. Every Saturday I took her to get her hair done, followed by a family dinner. She loved pastrami sandwiches and hamburgers. A wheelchair lived in my trunk so we could go to the coast or to a museum or Macy’s for bargain tops for her. She was on hospice for 2.5 years. The hospice nurses fought over who would get to see her each week as they all loved her so much. She loved getting showers the aides provided and chatting with the man who delivered her oxygen. The other residents adored her stylish clothes and jewelry. But in her last year, her ability to hear faded, walking exhausted her, and her COPD progressed. She slept for 8, 10, even 12 hours. She fell six times in as many months and started to complain about outliving her body. We had to have the facility’s nursing team administer her meds, which she had until then proudly taken care of herself, due to her short term memory loss.  My mom started to feel her life lacked purpose or meaning. Her desire to live was waning. Her fear of death became secondary to her desire for it. She started the process for medical aid in dying.  I got to sit with her for most of those eight days on her deathbed and tell her how much I loved her. She sang me the song, “Don’t cry for me Argentina” and told me she loved me 'with all her might.' She was so full of love and positively glowed. She gradually became less responsive and needed more meds. She was ready to go and was at peace. She took a breath and then there simply were no more. When I miss my mom, I am quickly filled with the love we shared in those last days. Her readiness and willingness to meet death moves me still. I miss her with a tender and quietly joyful love. My mom gave me life and the gift of unconditional love for all her days. She gave me an amazing and awesome gift in how she died. I am forever grateful.

Do you have someone who cuts your hair just the way you like it?  Or a massage therapist that you see when you need some healing touch?  Or a trusted psychotherapist or lawyer or doctor that you call upon as needed? That's what an end of life doula is for- someone you know and trust, who can be there if you are going through the loss of someone you love or if you become sick.  Someone you can review your advance care directive with; who understands your end of life wishes; who knows your closest family and friends, who gets that you need space and time to grieve loss in your own way.  Someone who will be there the way you want to be supported, as you end your time here on earth. I think everyone should have a doula, as birth doulas usher in new life, death doulas help accompany us out. It helps everyone in the circle of life and death.

"I wish I'd let myself be happier." One of the top five regrets of the dying is this desire for happiness.  Some people have the awareness that happiness was within their grasp if they had only been able to let themselves have it. It took me a long time to find my place of joy. I don't worry any more that I will have that regret. That reminds me of the old story of the Buddhist monk who asks their students as they strolled in nature how heavy they thought the large rock they passed was. The student replied, "Oh very, very heavy. I doubt I could lift it." The monk replied, "But it is very, very light if you do not pick it up." I always felt compelled to pick up every rock, even every boulder. Somehow, somewhere along the way, I stopped picking them up. I find myself less and less interested in picking up even the pebbles anymore.  I consider it a perk of eldering. I just prefer going for the path of ease. Alot of things that used to matter don't anymore.  I haven't given up; I just have shifted slightly. I like this place. What rocks can you put back down? What boulders can you pass up? Can you use the pebbles to seed your garden?

It is 13 years since my sister died. and In a few hours it will be 8 years since my mom died. In my tiny backyard, I wave to the cannisters that hold their ashes. The third cannister holds the ashes of my father. Earlier today I lit a candle for them to memorialize their death anniversary, also known as a yehrzeit candle.  I texted my kids so they could remember their grandma and their aunt. They sent back heart emojis. Their college education was largely paid for by their grandma and their aunt. I yearn to talk to my mom these days, more than I have in the 8 years since she died. I feel like she would have some wisdom for me.  Something I need to hear.  Something I want to know. I don't feel in touch with her spirit, but I am going to ask her to grant me her wisdom, tonight when I go to sleep. She loved chocolate cake. This was her last birthday cake 8 years and 3 months ago. She loved it. And at 94 years old, she giggled with glee as she ate it.  She knew the sweetness and deep pain of life. She knew you can't have one without the other. I had a good mom. My kids had a good grandma.  To Hikey and Barb, your memories are a blessing

So many amazing, hot women! Seventeen years ago when I went through menopause, I was hard pressed to find information about it, through holistic and conventional channels. Everything is different now!  One of the best outcomes of feminism is women in medicine and sciences. They are moving the field forward with their intelligence, synthetic thinking, humanistic approach, and making all sorts of discoveries. Now the field of perimenopause and menopause has exploded and there are so many great women scientists at the helm! Here are some of these badass women docs who have great podcasts and books that I have learned so much from: Lindsey Berkson Esther Blum Amy Killen Gabriella Lyon Rena Malik Tyna Moore Cynthia Thurlow I listen to their podcasts and have learned so much! I am so happy that my beloved daughters in 30 years will have even more information. Since I am an end of life doula and a holistic health coach, I believe in living fully until we die! Its aspirational of course but its truth. #menopause   #womendoctors   #deathdoula   #livinganddying

I am not a 12-Step person but there are two 12-Step axioms that I just love. In my 60's, I think I finally get what they mean. "Self-seeking will slip away."  and  "Half measures availed us nothing."  (on pages 84 and 59 respectively of the Big Book, thanks to my pal JTM!) If I am not always trying so hard to fix something I see as broken within myself, and can find a please of ease with myself, I can fully show up for the right here and right now. and I stopped doing things half-assed, because either I have more time to do them properly at this time in my life or I can just let them go because they are not necessary. I have choice. Doing things half-assed gets me nowhere fast.  Here is one more that I love: "Don't give up before the miracles happen!" Things are always changing and amazing things happen if you hang in there. Which axioms do you love and live by?

A woman cried in my arms when we finished her advanced care directive. "You have no idea what this means to me. I have been trying to do this for ten years. Its been so emotional for me that I haven't been able to. This is a huge relief for me." Most of the time, advance care directives (ACD) are not needed. They are there in case you cannot speak for yourself.  They define your wishes. In what scenarios would you want life saving measures? When would you prefer to die peacefully without intervention? What do you want if you have cognitive decline?  90% of us agree ACD's are very important. Only about 30% of us have them filled out.  You can find an abundance of forms online or through your healthcare provider. Who do you want to speak for you? Who do you trust to respect your wishes? Who do you trust to handle decisions for your care that you may not have anticipated? Try giving yourself a reasonable time period to do it, perhaps a month to decide on a form and another month to fill it in, and a third month to review with the person you want to speak for you if you cannot speak for yourself (health care proxy). If you find yourself having a difficult time facing it, talk to someone about it. But don't stop. Keep going. The ACD is a living document. You can change it any time.  You should review and update it every five years or so.  The important thing is to get it done.

I want to have a sense of completion before I die, assuming I die slowly like 90% of us do. Dr. Ira Byock wrote about this. As we approach the end of our days on earth, we withdraw from the world, then the country, then the region or community. We say goodbye to family and friends as our perspective narrows. We are spending our precious time on a smaller slice of the proverbial pie. Just the people who matter the very most. As we move towards a sense of completion, everything that is not absolutely essential falls away. We are with ourselves, with our own reckoning of self, our own acceptance of death, making our way to the transcendental and letting go.