Good Intentions vs. Bad Adjectives

In the death doula and end-of-life advocate community, our language and goals often center around a "good death." Reflections are written on the "bad death" that brought us into the work. We use that binary language because we want to empower our communities to aspire to something more than what our modern, Western, racial capitalist society offers. We want to offer a framework people can visualize: peace, wholeness, and agency.

The case for a "good death" makes sense, but it also feels risky.

When we label a death as "good" or "bad," we are essentially suggesting that there is a way to "fail" at dying or that a sudden, traumatic, or messy end is a moral failing on the part of the deceased or their family. And if there is one thing I know as a death doula (and as a human!), it’s that we don’t need any more burdens to carry, especially when we are at the end of the road.

The Myth of the "Hospital or Bust" Plan

The risk of this grading system came into sharp focus for me during a conversation about death as my friend, Clara, gave me a ride to the doctor. It's important to note that I didn't know Clara very well when she offered me a ride that took her 30 minutes out of her way in both directions. That generosity was a big clue for me as I started to peel back the layers of her experience.

Another important note: Clara gave me permission to share her story. Also, for privacy, Clara is not Clara's actual name, but the rest of this story is true.

As often happens—on car rides, in the dog park, at cafés—our casual chatting turned to death because... well, that's what I do.

Clara discovered both of her parents several days after they had died suddenly in their sleep, three years apart. She used words like "nightmare," "horrific," and "the worst thing I’ve ever experienced." Because she had never spoken with them about their wishes, she was left to navigate a labyrinth of decisions , even while still sitting in a house with their already-decomposing bodies.

The trauma left her with one singular goal:

I never want my children to experience my bad death.

Her plan was simple and unrealistic:

"I will die in a hospital. I’ll go to the emergency room at any risk of death, so my girls will never have to find me."

I didn't call her bluff in that moment, but my heart broke as I spotted the leaking holes in her plan. Both of Clara's parents died of a heart disease, a condition with a significant genetic component. If she dies in her sleep, her "Hospital or Bust" plan won't save her children from the surprise. By grading her parents' deaths as "failures," she was inadvertently setting herself up for a final exam she might not be able to pass.

From "Good" to "Aligned"

As we sat in the car on the way to a doctor’s appointment, I looked at Clara as she navigated the traffic. My mind detoured for a moment as I realized we'd be heading back during rush hour. Surely, Clara had already calculated the timing. I winced and marveled at her generosity. This recognition started to add up. I saw a woman covered in tattoos, someone who wears tutus to protests and leads workshops on sex ed and consent in her spare time. Again, I didn't know Clara that well yet. But I could tell she is not a person who hides herself away.

I could tell that Clara is a person who shows up.

The reason Clara was the one who discovered her parents' bodies was that she was at their homes every week to bring them groceries, mow their lawn, review their finances, and set up doctors' appointments. Showing up is one of her core values.

I asked her:

"What if the goal isn't to avoid the surprise, but to align your death with how you’ve lived your life? How can you show up for your daughters now so that you are actually showing up for them when you die?"

She asked what that would look like. I reframed the question and asked how she currently shows up for them. It wasn't difficult to translate her concrete examples into values that she could apply to her end-of-life planning. As we pulled into the parking lot, she literally snorted as she laughed, "Do you think I could get a refund for the last seven years of therapy?"

Now, I don't think a few curious questions healed Clara. But I do think questions that were framed outside of judgment or a binary decision convinced her that she wouldn't ruin her daughters' lives by dying. That simple clarity offered her a liberating step forward. After my appointment, we avoided the rush hour crush by going to an early dinner. I hope the folks at nearby tables overheard our 2-hour death & dying conversation and that it sparked more than raised eyebrows.

If Clara dies in two years, her daughters will be heartbroken (and it would be a surprise because she seems fit as a fiddle). But imagine if they could all be aligned on her life and death! Then her daughters could say:

"We have had a conversation with Mom. We know what she wanted, and we know how she felt about us. We know that grief is going to be with us our entire life, but it will move alongside us. It is something we can hold, not something that will hold us back."

If Clara dies in 50 years, she'll be 103, and then they will be able to say:

“We've had hundreds of conversations about this. We've explored death and grief in so many ways. Those conversations have helped us navigate so many other forms of grief and so many other surprises, because we've become experts at planning and at aligning with each other and our values. We are no less sad than we would have been 50 years ago, but we have a lot to hold onto." 

We eventually had the talk over another dinner with her 17- and 19-year-old daughters. After we allayed the initial panic that this conversation had been prompted by a terminal diagnosis, we got into a freewheeling conversation that led to unexpected places, including the science of decay, writing letters by hand, and broad concepts of legacy.

It took several sessions and quite a few changed-my-mind moments, but Clara completed her End-of-Life & Legacy Binder... for now. She has reminders set up to revisit it yearly. Her girls have phone numbers in their mobile and in the binder of people to call so they never have to face a distressing scene or any stage of grief alone.

This summer, I'll be taking the girls out for smoothies and their own binder business.

If I approached our conversations with the "fix it" language of, “How can we make sure you have a 'good death' instead of the 'bad deaths' your parents had?” Clara would have seen right through me. Even if she hadn't named them, she is smart enough to know the heart disease odds, and she had already designated that a bad, horrific, nightmare death.

Clara hasn't fixed her death or removed the surprise of when, where, or how it will happen. Instead, she aligned it with her value of being someone who takes care of her people.

Reframing Language

I have to admit that I didn't immediately discard "good death" and "bad death" after my work with Clara. It took some Grim Reaper GIFs from her girls (GIFs are their love language), a gnarly pit in my stomach after casually referencing a "bad death" in conversation, and mulling it all over while walking my dog.

I came to realize that, at best, these adjectives create tension and unrealistic expectations; at worst, they define a "right" way to grieve and a "wrong" way to leave. I asked myself:

Who have I shut down with this language of convenience? 

Instead of setting goals for a "good death," I am centering my work around designing an Aligned Death that celebrates the courage and connection I built with Clara.

An Aligned Death allows for the messy multitude of faith traditions, cultural perspectives, and personal quirks. When you align your end-of-life plan with your values:

• It creates a clear path for medical teams to honor your wishes.
• It gives your loved ones the permission to make decisions on your behalf, remember you, and grieve you in your truth.
• It gives you the opportunity to align your life with the same values named in your end-of-life plan while offering the comfort of knowing you’ve shown up for your community one last time.

It turns out, Clara isn't looking for a "good" death. None of us are.

We want an honest death. We want a death that makes space for surprise while holding onto the values that will shape a grieving process and legacy that look and sound like us.

Post Script: A Note on "Loved Ones"

Most of the time in my writing, I use "loved ones" instead of "family." For some (many in the LGBTQIA+ community), biological family can be a source of complication, discomfort, or active harm, whether they show up out of obligation, public perception, or to impose their beliefs onto their dying family members. Your chosen family, friends, and community can be a beautiful and meaningful part of your Aligned Death.

End-of-life planning works across many themes and includes defining your boundaries, safety, and community. In my practice as a death & grief doula, I'll work with you to name who your "family" is, within and beyond DNA, and to define, document, and advocate for your limits.