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.



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.


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.


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:

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.

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

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