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Coping With Impending Death

How to prepare yourself and your loved ones for the inevitable.

WebMD Feature

As the recent series finale of HBO's Emmy award winning series, Six Feet Under, implied, no matter how accepting we think we are of death, coming to terms with the loss of a loved one as well our own mortality can be shocking, divisive, and devastating.

This drama focused on the life and times of the Fisher family, an eclectic clan who ran a funeral home and as such, experienced death on a daily basis. The series wrapped up by focusing on the aftermath of the death of the family's older son -- a death that ripped the family apart, leaving each member with regret, anger, guilt, fear, and sadness.

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And while nothing can ever fully prepare us for our own death or that of a loved one, there are things to do now to help prevent such spiraling particularity after a long illness, experts tell WebMD.

Set Things Straight

"There is only so much you can do in anticipation of a loss, but you can prepare yourself by trying to review your relationships and tie up loose ends," says Gerald Shiener, MD, a psychiatrist at William Beaumont Hospital in Royal Oak, Mich. "Go over mixed and negative feelings and regrets in a given relationship and take the opportunity to put things into words that you have never had a chance to say."

If you are the ill party, "try to take an inventory of how you lived your life and how you want to be remembered," he says. Trying to make amends for anything you may regret and to make apologies to anyone who may have misunderstood your intentions can also be helpful, he says. "This is your final opportunity to clear up misunderstandings," he says.

"If you know its end-stage cancer and death is inevitable, you have the time to prepare -- unlike an accidental death," says David Baron, DO, chairman of psychiatry and behavioral health sciences at Temple University School of Medicine and Temple University Hospital in Philadelphia.

"If you can plan for a death, you do have the opportunity to say things, and oftentimes individuals who aren't given that opportunity with a sudden death are left with agonizing feelings. It gives us an opportunity to say goodbyes in a meaningful way," says Baron, who began his career as a psycho-oncologist who counseled advanced cancer patients at the University of Southern California's Norris Cancer Center in Los Angeles.

"If you know death is coming, value the time you have left," he tells WebMD. "It's about not being afraid to say goodbye and saying the things you want to say."

Not doing so can be devastating. "If the individual passes away and the family member says 'I never really told him or her how much I cared for or appreciated X, Y, or Z,' it can make it worse," he says.

"Yes, its a sad time, but it also can be a time to underscore all the good times you have had together and provide an opportunity to say, 'I never told you how much it meant that took on a second job, so that I could go to college,'" for example, Baron says.

"If you are dying, it is your opportunity to say your goodbyes and don't be afraid to share your fear, frustration, and anger," he says.

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