Hi Doctor, Thanks for being helpful and giving me the chance to ask advice. I am a female who has been positive for many years. During the illness I have always set goals and felt a need to reach them. This has changed in the last couple of years. I find that I no longer can plan anything for the future. I feel as if my time has run out. I am very unwell and the quality is not there. I can honestly say I feel that I am dying. It is more of a physical feeling than a thought. What I really want from you is some advice on how to deal with the final stages of life. What do you ask yourself at this time? How do you know what should be given priority? I am a solitary person who doesn't really enjoy the company of others. I have always been introspective but now accept that my soul searching didn't produce any real answers. I am not interested in seeing mental health people, I went to a trainee psychiatrist for about 6 months, he was harsh and rejecting of me. I would much rather just have some practical advice on how to make the most of each day or at least make it more tolerable!! I also want to ask you about this : I wanted to move into a better home, however by the time one was offered to me I felt too weak to be bothered with the shift, I also felt that because Iam so unwell it wasn't really worth it - nothing to be gained because it's too late. Is this the right attitude?

Sarah

Dear Sarah,

First of all let me say that I really respect the way you have accepted that you feel and know that you are in the final phase of your life. You do not sound angry, just resigned. That indicates that you have achieved a level of serenity that is very precious.

It sounds like there is not any indication that you are in need of mental health help. You ask some very difficult and complicated questions. The only way to answer them for yourself is to really evaluate what priorities you have that would give you a maximum quality of life?

For some people it is getting their spiritual house in order. For others it is spending quality time with people or pets who are important to them. For others it is reading things or listening to music that is meaningful.

You really have to do an emotional inventory about what would give you the most pleasure at this point in your life and then make sure that you do everything within your power to see that you accomplish whatever your personal goals are.

Regarding moving into a new home. This is generally something that is very bound up with having a future persepctive and orientation about one's life. There is so much energy and expense involved in moving and setting up a new place to live that to do so when you may not have alot of emotional, financial or physical resources to squander on what will be a very short term investment may not be a wise decision. But on the other hand if this is a dream home and would provide you with alot of pleasure, then to move might be one final big project for you to undertake.

Noone can tell you which choices are correct ones for you. Just spend what ever amount of time is necessary for you to do the work of self examination in order to be as certain as you can be that whatever you choose is an authentic reflection of your own wishes and desires.

I hope that this has been helpful.

Michael Shernoff, MSW