Can a death ever be declared a "good" thing? Researchers in Sweden found that people who knew their realities, accepted it and then prepared for it may have less pain and suffering during the last weeks of their life versus those who do not prepare themselves. Using just under four hundred people with advanced cancer diagnoses and their caregivers,the researchers discussed a number of factors that might enhance or detract from their quality of life during their remaining time. Researchers followed up with the caregivers shortly after the patient died.

The patients each defined their impending death as "good" when they were allowed to not only feel like they were prepared but that they were allowed to actively participate in their proceedings. Other factors included pain that was managed to the point of remaining bearable but without affecting lucidity. Interactions with their friends and family members were also deemed of utmost importance.

Most of the patients also agreed that they were happier when they were allowed to stay out of the hospitals, feeling more comfortable in their own home settings. Those who prayed and/or meditated, spoke openly about death with their family and felt that they were being respected were also less likely to be in severe pain as well. Some of the patients and their families felt that forming an allegiance with their oncology team, especially the nursing staff helped to keep them healthier and happier even during the final stages of their disease.

The research, published in the Archives of Internal Medicine concluded that it was stays in the intensive care unit that might have the most impact on quality of life. With some of the patients, a conversation that takes place in the ICU might be a case of too little, too late. According to Health Affairs, almost fifty percent of all adults age 65 or older will visit an emergency room for some reason in the last month of their life. Three quarters of those people will need to be admitted but only a small fraction will ever leave the hospital during that final month with the vast majority succumbing to their illness or injury while still in the hospital.

Experts suggest that final preparation conversations, as uncomfortable as they might be, be had even if there is no diagnosis of serious illness to warrant such a talk. It should be had again when there is such a diagnosis or when anything changes about the plans that were originally made.