The Minimalist Approach to the End of Life

Learn how a new lifestyle trend can revolutionize the way we approach our last days.

In recent years the minimalist lifestyle has been trending throughout the United States, particularly among the millennial generation. Unlike their parents who sought after material goods and wealth as part of “living the dream,” many younger people are choosing to live a simple lifestyle with fewer possessions, tiny homes, and less waste and consumption.

According to author Joshua Becker: “Minimalism slows down life and frees us from this modern hysteria to live faster. It finds freedom to disengage. It seeks to keep only the essentials. It seeks to remove the frivolous and keep the significant. And in doing so, it values the intentional endeavors that add value to life.”

While minimalism provides a more relaxed and meaningful way of life to its youthful followers, this movement could also be an answer to today’s current healthcare crisis surrounding the end of life. With an emphasis on simplicity and intentionality, the guiding principles of minimalism provide a framework for changing our approach to the later years of life and the process of dying and death. Here are some of those principles and how they might be applied to decision-making at the end of life:

Less is more

The current default mentality of our healthcare system seems to be “if some is good, then more is better.” A patient arriving in an emergency room anywhere in the country in the midst of a cardiac arrest will receive full-bore, defibrillated, intubated, catheterized, crash-cart care unless an advance directive and/or a healthcare proxy is available in the moment to refuse that care. And a cancer patient is likely to be offered treatment up until the last breath is taken, even when there has been no improvement from that treatment.

In this medical system more care will almost always be offered and carried out unless patients and their representatives are able to say “no” to that care. The patient’s best defense is to adopt the “less is more” mindset of minimalism and recognize that in many situations more care creates more side effects, more expense, more suffering, and more stress on patient and family.

Opting for less care can create space and time for enjoying moments with loved ones, contemplating what really matters in life and savoring the small pleasures that bring joy and meaning to existence. Less care can mean more quality of life if you approach it with intentionality and informed decision-making.

To be a “minimalist healthcare consumer” you must have an advance directive that spells out your wish for less rather than more care. You must communicate this desire to your medical providers, your healthcare proxy and your loved ones.

But you also have to address your fear of suffering, aging, illness and death, because those fears can drive you to choose more care when faced with a crisis. Complete your paperwork but also do your inner work to confront your deep-seated and normal anxieties about the end of life so that you will be ready to face the natural passage from life to death. You should also practice the “less is more” mindset during your later years by making careful decisions about the non-emergent healthcare you receive from your provider during routine office visits.

Eliminate the non-essential

Throughout your later years as you seek out medical care keep asking: “Is this essential?” Question every treatment or diagnostic test that is recommended to you and demand to know why it is necessary, how it might benefit you, and what could happen if you don’t do it. Don’t accept a procedure or test until you have had time to do your own research or get a second opinion. Some standard recommendations that have been accepted in the past such as the annual physical exam and routine screening procedures are now being questioned as they have been shown to result in over-diagnosis and excessive treatment.

If you take prescription medications ask if they are still necessary and if you can systematically discontinue some of them to see if they are helping or worsening your symptoms. Studies show that seniors who take multiple medications are more likely to experience negative side effects and even unnecessary death from the combination of potent drugs.

Find a primary care medical provider who agrees with your “less is more” philosophy and will help you create a sensible and simple plan for managing your healthcare needs. Don’t seek out specialty care unless your primary care provider says it is necessary. You have a right to say “no” to medical care and to find a practitioner who supports your right.

Individualism

While minimalism may be a trendy lifestyle with many people following the same guidelines, its principles encourage each person to find their own path to simplicity. As you begin to advocate for your individual philosophy of less medical care in later life it’s important to know yourself and seek out what is best for you.

Spend time thinking about the experiences of aging and dying that you may have witnessed with loved ones in the past. What would you like to be different in your end of life? How can you create a better path for yourself that reflects your unique wishes and desires?

For example, if you are a solitary person and prefer to live alone for as long possible then you will need family or community support to make sure you can safely stay in your own home as you age. If you enjoy social interactions with others you might choose to be in a senior living center in the future and you will need to provide for that option financially.

Get organized

One hallmark of minimalism is “keeping everything in its place.” This principle applies especially to your plans and paperwork for the end of life. Complete your estate plan, will, and advance directives and make sure those documents have been shared with the appropriate professionals and loved ones.

Decide what type of “less is more” funeral and burial or cremation you would like to have, perhaps a simple home funeral and green burial, and put those preferences in writing too. Keep your paperwork organized and accessible, including insurance forms, birth and marriage certificates, military discharge papers, titles, deeds, banking and investment information, online accounts and passwords, and medical records.

Live in the moment

A benefit of the minimalist approach is the ability to live lightly and with fewer burdens from the past and worries about the future. When you can live more fully in the present moment you are free to take in the small joys and pleasures that are available to you, like the beauty of a sunset, a bird singing outside your window, or the comforting aroma of dinner cooking on the stove.

However, living in the present moment takes work. You have to consciously let go of the past by giving away things you no longer need and making room for a new way of life. This applies to medical care at the end of life too—perhaps you will decide to discontinue treatments or procedures that have been part of your routine for a long time. Or you might part ways with a medical provider who doesn’t support your choice of a minimalist approach to the end of life.

As part of the medically minimalist lifestyle you will need to adjust to the normal changes of aging and learn to embrace them rather than seeking a medical solution to every ache and pain. Find modalities such as yoga, massage, relaxation, and imagery that can keep you comfortable without taking additional drugs. You may find that you receive positive “side benefits” from these practices rather than the negative side effects of many medications.

Prioritize what really matters to you

As Joshua Becker stated above, minimalism focuses on letting go of what is superficial and keeping those things in life that are significant. You have to determine what really matters to you in order to choose the components of your new less-is-more lifestyle.

This prioritization applies particularly to the non-tangible things like your relationships with loved ones and the time you spend with them. Would you prefer to stay in the community where you have lived for many years? Or would you consider moving to be closer to family as you age? These choices will play an important role as you let go of the complexities of the past and move toward a simpler way of life in the future.

No matter how old you are it’s never too early to start thinking about what is most important to you in life and making those things a priority. When you give your time and energy to the deeper and more significant aspects of life you will find it much easier to let go of all the things that don’t really matter to you.

Find Your Purpose

The key to successfully maintaining a minimalist lifestyle is recognizing that life has a greater purpose than just the accumulation of material possessions. When you know your own purpose you can make choices that support that purpose rather than interfere with it.

The healthcare decisions you make for yourself are important because your time, energy and finances can potentially be drained in later life if you pursue unlimited medical interventions in a quest to reverse aging and prevent death at all costs. The minimalist approach reminds us that the purpose of life is not to live as long as possible, regardless of the circumstances, but to live a life of meaning and quality for as many days as we can. Again, the emphasis is on the meaning and quality of life rather than on the quantity; another example of “less is more.”

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While minimalism as a lifestyle may not suit everyone, it is certainly worthwhile to apply some of these minimalist principles to the later years of life as we contemplate how to make the most of our last days. As a general rule if we focus on what is simple and has the greatest meaning for us we will be guided to make wise choices for the end of life that reduce stress, wastefulness and suffering from unwanted medical care.

You can start your minimalist approach right now no matter what situation exists for you right now. Think of one thing in your life that you no longer need and let go of it today; then repeat that process each day from now on. The more you practice living simply the easier it becomes as you free yourself from old burdens. Perhaps when you reach the end of your days you will arrive unencumbered, free to move on through the final passage with lightness and ease—that at least is the hope for all of us.

Karen Wyatt MD is a family physician who has spent much of her 25 year medical career working with patients in challenging settings, such as hospice, nursing homes and indigent clinics. She is interested in a spiritual approach to medicine, illness, death and dying and is the author of two books. Check out her website at www.karenwyattmd.com

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Author: kwyatt

Karen Wyatt MD is a family physician who has spent much of her 25 year medical career working with patients in challenging settings, such as hospice, nursing homes and indigent clinics. She is interested in a spiritual approach to medicine, illness, death and dying and is the author of two books. Check out her website at www.karenwyattmd.com