PARADIGM

PARADIGM: Enhancing Life near Death

Paradigm is a nonsectarian resource for terminally ill, chronically ill, irreversibly ill and dying people. We employ a non-traditional interactive process that helps people define and achieve a good death for themselves.

We call our organization Paradigm to signify the need for models of what it can mean to die well in the face of our society's estranged attitudes toward death. Our objective is to familiarize participants with the dying process and to engage them in actively improving the quality of their lives by helping to improve the quality of other dying people's lives.

Paradigm also strives to transform attitudes toward death and dying in the society at large. We believe that terminally ill people can, with their own dying, pioneer new standards of a good and wise death that the rest of us can strive towards and emulate.

THE PROBLEM

Americans are notorious for ignoring and denying death; we keep death out of sight and out of mind, postponing any serious considerations until death comes knocking at our door. This approach inevitably leaves us unprepared and frightened when we are faced with our own mortality. We seldom get around to asking ourselves seriously: Will my death be good? Will it be wise? Does it really matter?

In America, death is usually a solitary and passive affair. Death tends to be solitary because sick, aged, and dying people are often hidden away in hospitals and convalescent facilities where they are attended by anonymous personnel and deprived of purposeful human interaction. Death tends to be passive because few opportunities exist for the terminally ill to be active participants in their own dying process. Dying people are expected to be unobtrusive, receptive to the solicitude of others, and to wait patiently for the end. No wonder that we feel bitter when we discover that the marginal status we assigned to death in our healthy days is what we find for ourselves in our own dying days.

PHILOSOPHY AND MISSION

PARADIGM believes that dying people can achieve an awareness and acceptance of their death that can become a guiding presence to others. This is why we define PARADIGM as an outreach to dying people by dying people. We make role models available to help them liberate themselves from the emotional, physical and spiritual suffering that often accompanies death. Dying with the kind of support we offer does not eliminate the pain and poignancy of separation. It involves consciously facing these and living through them to the end.

PARADIGM does not suggest that there is one particular way of dying well. However, it is possible to identify some general developmental tasks that the dying person can accomplish if dying well is the goal. The following list of tasks is by no means exhaustive, and emphasis will vary in each person's dying.

Accepting death's necessity: Death is not only a universal biological fact of life, part of the round of nature, it is also a necessary structural component of what it means to be human. Everything that we value about life and living its novelties, challenges, opportunities for development would be impossible without death as the defining boundary of our lives.

Accepting one's own death: While it may be easy to accept death as an abstract, it is difficult to accept the specifics of one's own death. Why must I die like this, with this disfigurement, this pain? Why must I die so young? Why must I die before completing my work or before providing adequately for my loved ones? These are some of the most difficult questions dying people ask themselves. PARADIGM offers participants the environment and support to find their own answers.

Embracing death as part of one's personal identity: Living the good death can begin the moment a person accepts dying as one of the defining components of his or her identity. Dying people must consciously integrate their dying with all other aspects of their daily lives. PARADIGM supports participants in the process of familiarizing themselves with death and growing empowered in their new identity as dying people. Desensitizing death helps dying people regain control of their lives, enabling them to achieve a greater sense of balance and purpose.
Opening to death as transformation: Dying can be a time of extraordinary alertness, concentration, and emotional intensity. This heightened state of awareness affords an unparalleled opportunity for reflecting upon one's life as a whole and arriving at a higher level of self-presence and self-understanding. It is possible to use the natural intensity and emotion of dying to make this time a culminating stage of personal growth.
Assuming responsibility for the social dimension of dying: Dying people can pioneer new standards of a good and wise death that the rest of us can emulate. They are in a unique position to help the rest of society desensitize death and dying. They can support loved ones as they prepare for their loss, and join those who will remain in beginning a healthy grieving process.
Taking charge of the practical aspects of dying: Dying people can regain lost dignity by actively involving themselves in the practical preparations for their own death. These considerations include negotiating pain management, choosing the appropriate care for the final stage of dying, ordering final affairs, preparing rituals of transition, as well as learning how to say good-by and impart blessings.
Letting go: The dying person can learn to heed the promptings of mind and body, allowing movement from a struggle against dying to one of acceptance and acquiescence.

THE PROGRAM

The centerpiece of PARADIGM is the Mentor Program. This follows a peer-counseling model and operates as a succession of three generations of participants. New participants are paired with mentors who are specially trained to assist them through their involvement in the program. As participants become more familiar with all aspects of the dying process, achieve a more informed outlook on their own dying, and acquire experience and skills in assisting others, they will have the option of becoming mentors to newcomers. Ideally a participant's bond with his/her mentor is maintained until death separates them. As participants enter the final stages of dying, they strive to be present as models to other mentors, newcomers, friends, and family. They in turn are assisted and comforted in their actively dying stage by their fellow participants, particularly those to whom they have been mentors.

This approach allows for optional levels of participation. We keep the program flexible and respect the special needs of each participant without distinctions based on rank or judgments of success or failure.

Following are some of the general contours of this generational approach:

First Generation. PARADIGM's first contact with a prospective participant is in an intake interview. If the candidate is likely to benefit from the program, he or she will be invited to participate in our Pilot Program. This ten week seminar/support group examines PARADIGM's principles and programs; explores the shock, anxiety, and anger associated with dying; and takes an unflinching look at the personal and social dimensions of the dying process. After the Pilot Program those who wish to continue will become PARADIGM Associates. At this time they are paired with a mentor who will serve as confidante and personal link with the program. Group support and one-on-one counseling are available to all associates.
Second Generation. Associates are invited to continue their interaction with their mentors and are encouraged to participate in other PARADIGM programs. Some associates are invited to enter the Mentor Training Program. This consists of a series of specialized workshops and seminars covering the major issues and techniques of enhancing life near death.
Third Generation. As participants move toward actively dying, they learn to progress towards detachment, acquiescence, and closure. In the final days and hours, the participant's mentor and/or associates may be invited to assist and give comfort.

In presenting this idealized scenario we are not talking about adjusting the deathbed pillows so that the dying person can strike heroic poses for the edification of onlookers. Rather we are talking about achieving a good and wise death in the context of real dying with all its unpredictability, disfigurement, pain, and sorrow.

At every stage, participants are encouraged to evaluate the process to insure the quality and vitality of the program.

PARADIGM employs videotaping as the primary tool at each of these stages. Each participant is invited to make a video chronicle of his/her personal journey. These tapes provide an opportunity for participants to evaluate the progress they have made toward fulfilling their goals in dying. And, in turn, the tapes form a unique library of the developmental histories of people committed to dying wisely and well. Participants can also choose from an array of other resources include body work, exercise and nutrition programs, meditation, journal work, and art therapy.

PARADIGM is also a resource for the broader community. We make speakers available to interested groups, provide in-service training for healing and helping professionals, and offer Death and Dying Workshops for the general public.

PARADIGM
P.O. Box 14061, San Francisco, CA 94114
(415) 522-9192

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