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Talking about death a lot makes me less afraid of dying. I have been leading Death Cafes online for the Elisabeth Kubler Ross Foundation and Mission Hospice for more than 4.5 years. They are open, supportive conversations about all things death and dying. We may sip on tea and have a bite of cake. Around 6 people have been with me from the beginning, almost every Tuesday morning for 90 minutes. The one thing we all nod our head in unison about is that we each feel less afraid of death because we have normalized talking about death in our lives. We didn't necessarily aim to be less afraid. It simply was an outcome of showing up. We talk about the death of loved ones - by accidental overdose, suicide, cancer, old age - and hold the space for that pain. We talk about the hard and soft places within ourselves as we navigate finding our way without them. We listen deeply to and witness the rawness, the tender healing, the unplanned sense of renewal. We are fully present and we hold the space. And if we are really lucky, someone cracks a joke that is just the perfect release. Come join us. Bring your cup of tea. Registration is free. To register go to the Eventbrite website and search for online events for the Elisabeth Kubler Ross Foundation and Death Cafes, or you can email me at rhyhalpern@gmail.com for more information. 2nd & 4th Tuesdays, 10am-11:30am PT, with the Elisabeth Kubler Ross Foundation. 3rd Tuesdays, 10am-11:30am PT, with Mission Hospice.

Annika would not believe it but her TikTok videos have exceeded 40 million unique views! She doesn't know because she died.  Annika was 27 years old when she sought medical assistance for what she thought was an infection in her eye, only to find out she had Stage 4 of a rare form of cancer. Her type of cancer had only 200 cases documented worldwide.  She started making and then posting videos on social media under the title "And Also Annika" with the subtitle, "Just a girl living with cancer and documenting that journey here."  As an end of life doula, I sat with Annika's very sweet and gentle dad just three weeks after her death and listened deeply. It was a gift.  He isn't ready to watch the videos yet, but he gave me permission to write about them and his beloved daughter. He was fully aware and proud that her videos garnered a huge social media following, leaving an amazing legacy.  I planned to watch a handful of them but that was not possible. I was glued to my screen for 3 hours, watching 54 videos. She chose titles for each video such as How I Lost My Eye, How I Get Through My MRI's, My Prognosis, Wigs, This is Serious, My Fortnight Cover, New Lumps, Eating Popcorn, About the Flap on My Face, Give Cancer the Middle Finger, Day by Day, and Let's Do Some Cardio.  My favorite one did not garner a huge amount of views, only 241k. It is titled What Caused My Cancer . Annika showed up with humor, smarts, sorrow, and acceptance. She had an amazing ability to reason things out and apply her intelligence and heart to all she was going through in equal measure.  After two rounds of chemo and radiation, when the tumors just kept ferociously spreading she applied her mental steadiness to planning for her death.  She knew what she wanted to say and what she wanted to leave left unsaid. The millions of views are evidence that her life and death touched so many of us.  I am forever inspired by her light and inimitable grace. She gave us a window into how it is done. All respect and love, Annika! Thank you and bless you!

What do solo agers say they need most? Help at home!  I feel like I need this too! I spend so much time on home maintenance, calling utility and credit card companies, and being my own IT person.  I can imagine that needing home modifications like handrails installed or repairing a broken door might become quite overwhelming.  With ride sharing services, I feel relieved that I will have reliable, albeit expensive and sometimes inconvenient, transportation to help me keep up with medical appointments and social engagements with friends.  I work hard on keeping healthy but I can see a future need for patient advocate and perhaps legal help. Downsizing is a constant effort and one day it may be too much for me. Here is a list I found of the top needs of solo agers. What one do you think is most important? Home Maintenance & Chore Services Home Modifications Technology Home Security Downsizing/Organizing Items Social Connections with other Solo Agers How to Use Transportation Apps Power of Attorney/Patient Advocate Services

Solo Agers don't talk much about their wishes with friends and family. I include quasi-solo agers like myself in that group because we may have partners or kids or best friends who don't necessarily live nearby.  Sickness and advanced age present certain challenges for many of us solo agers.  The most important thing we can do is to open up conversations with our loved ones, whether they are our biological or chosen family, or friends! We simply must determine and communicate our wishes. And then we need to plan and communicate those plans to our doula, our health care proxy, our doctors, lawyers, landlords, our handy people who can help with at home modifications, our care managers and our other community people who can help make sure our wishes are known, respected and followed. Wouldn't that be a relief? Wouldn't you sit back and enjoy the sunset even more if you knew your end of life plan was settled?  Avoiding planning, not talking, not deciding is not the way forward to peace.

22 million older (ages 65+) Americans live alone. 30% of them have no children or family support. The older 'solo agers' get, the more they tend to be women. The number is actually higher because some people define themselves as solo agers even though they have children or family support. They might be estranged from them or they might be very private and/or independent. I know quite a few solo elders, the term I prefer, and am always interested to hear how they are planning for their end of life. It appears that they are a perfect fit with End of Life Doulas!  They can customize their needs and wishes and know they will be deeply respected. They can have emotional support and companioning. They are not alone. They are empowered solo elders! Are you a solo elder?

There are 6 million people in the United States over the age of 85. 40% of them live alone in their homes or in facilities. They are part of the 22 million people 65 or older who live alone.  About half of these 'solo agers' as they are known, are content, satisfied or happy living alone. They state that the most important thing to them is their freedom and independence.  Another 25% are increasingly pessimistic. The other 25% do not have strong feelings. The biggest complaint of all solo agers is loneliness.  We need each other. From the first day of life until the last.

As of 2017, an estimated 1.5 million people are 65+ years old and identify as lesbian, gay or bisexual. This number is expected to double by 2030.  Unfortunately this data does not include transgender and nonbinary people, so the number is actually higher. Many of us, including myself, have experienced our sexual orientation as fluid at different times in our lives, and we deeply want to show our support to break down the walls of 'othering'. In addition to ensuring that LGBT older adults feel safe when receiving medical care, we must break down the walls of social isolation and victimization.  LGBT family structures are not necessarily based on blood ties. Families of choice and extended family systems are equally important.  As end of life doulas and caregivers,we need to support diverse familial systems and create a warm and loving environment for all of our clients, no matter their gender or sexual orientation.  Many LGBT people are solo agers. End of life doulas can provide loving, emotional support to ALL solo agers. No one should feel they must go this final journey alone. We care.

Something is happening in this world that has never happened before, and I am a part of it!   Within a decade, more than 1 billion people- or 1 in 6 people -all over the globe will be over 60 years of age. I am already one of them as I hit 60 a few years back. I get very tired of reading the condescending articles about aging: get used to loss, declining health, facing past regrets, physical limitations, less energy and the fear of loss of quality of life and ultimately death.  I get it. I am an end of life doula. I teach classes for the Elisabeth Kubler Ross Foundation on death and dying. I lead Death Cafes. I write on the topic. I contemplate it daily. Yes, we are of the nature to get sick and to die. I am not denying that. Nevertheless, my experience of aging is one of letting go and releasing old pains, patterns and hurt. I have a quieter mind, more self-acceptance, and a deeper sense of my own identity. As I get further along in my 'third act', I am meeting myself at a more soulful place. I know gratitude, pleasure, connection in an easy, open way. My spirituality and overall energy have been revitalized.  For me the key has been a significant reduction in stress as I retired from the workforce and work part time, my children are raised, and I left a very long and not too happy relationship. I know happiness and joy at a new level. I love the new people in my life and finally live in the right place. For me being older is all about arriving to a place I wasn't sure existed. My inner elder is blossoming and will help me along my way to the end of my days, whatever ups and downs they bring.  What are the gifts of aging that you have received?

I got so mad when Hospice called me a few months after my mom died for a 'grief check-in' call. My mom died 7 years ago and the call came 3 months later. The woman's voice on the phone was concerned; she asked how I was doing with my grief, her voice full of clawing inflections of sugary sympathy. I immediately was on the defensive. I said something like, "My 94 year old mom was ready to die. In fact she wanted to die. She gave me a gift with her readiness. So I am not in grief. I just feel love. I don't appreciate that you are assuming I am grieving and suffering and this is such a hard time. I have lost a lot of people and know grief. This is not that. Don't put that on me." I am not proud of what I am certain was a terse response, but I am proud of what my mom gave me. I never assume someone feels a certain way after the loss of a loved one. I am curious and inquire. I don't want to put any expectations on them about how to feel, nor do I assume they are 'grieving'. I want to open the space and find out what their journey after loss is like. What is your preference? How do you want people to ask you how you are doing after a deep loss? What words make you feel open? What makes you feel closed? What does grief mean to you?

The term "compressed morbidity" doesn't sound nearly as wonderful as it is. In Eastern philosophy, it refers to someone being in tune with the Tao or with nature, so they will live a long life and die fast.  Doesn't that sound wonderful? By extension, the philosophy also says that the last ten years of one's life should be the best ten years. Often in Western society, the last 10 years of someone’s life are the worst 10 years, marked by decline and loss. By another extension, if the last 10 years can be our best years, and if we are living well into our 70's, 80's, and 90's, then our 'third act,' after work and childrearing is done, when we settle into a quieter time, promises all sorts of wonderful riches, leading up to that last decade.  For me, my 60's have thus far been my best years, where I finally embrace, in my way, how to relish life and love with joy, curiosity, play and openness. Gratitude! Here's to your compressed morbidity!

Be a loud listener! A friend once remarked, "Wow. You really pay attention. I am not used to that. I don't usually listen to everything a person says. "We typically speak at the rate of about 120-150 words a minute, which is not enough data to fully occupy the brain of the person being spoken to, especially if said person is socially or otherwise anxious. Research shows that often we don't know what is going on in another person's mind. So, asking the sorts of questions that will allow a person to reveal their true selves is the key. The worst kind of questions evaluate, with the implication that you will be judged: Where did you go to college? What do you do? Were you close with X person who just died? Did you win? But were you there when Y happened? The best questions give the responder the freedom to go as deep or as shallow as they want: How is your mother? What is the best way to grow old? What was that like for you? Can you be yourself where you are and still fit in? What do you think? How did you adapt to that big change? What are you learning about in your life? So take a moment and consider: are you asking questions out of a need to evaluate and judge? do you want the other person to open up? Are your questions closed or open ended? Are you listening with your eyes, 100% engaged? Do you 'fake listen' waiting for the other person to take a breath so you can jump in with your own experience, hijacking the conversation? If you have a hard time listening, try SLANT: Sit up Lean forward Ask questions Nod your head Track the speaker. Listen loudly.

That is the eloquent sentence my dear friend and poet said to me the other night when talking about the death of his 65-year-old twin sister. He feels her absence. He feels her memory. He feels the part of him that is absent without her. He is incorporating into his being both the memory and absence of her, as well as allowing absence itself to be a space he holds. I find this terribly tender and honest, raw and true. We have holes in ourselves made by the loss of those we loved. In the holes, there is a wholeness that is the memory of them. In the memory of them, we feel the absence of them. Ultimately, we integrate the loss into our beings. There is no duality left. There is absence and memory. There is wholeness. There is love.