| Home | Questionnaire | Guests | Stats | BookReviews | Memorials | & Links & |
| EgyptianBkOfTheDead | Write Us | What's New? | Handwriting Analysis |
Reflections on Death: A Guest Book / Questionnaire
© 1994-2007 by Jerral Sapienza , Curator: The Bardo of Death Studies
The Reflections on Death questionnaire is a questionnaire on Death & Dying, and your reflections on the process, relationships, lessons and events associated with the death of a friend or loved one. Compiling folks' answers since 1995 here, we've had thousands of visitors a month coming by to look at these resources, and several hundred a month who offer their own reflections and fill out the questionnaire to further contribute to the archival resources available here.

The questionnaire is quite long. Feel free to complete as much or as little of it as you feel meets your particular situation. You will need at least twenty to thirty minutes in order to complete it, and some people will even spend a couple of hours detailing their contributions here.

      The idea of the questionnaire is to help you see Death as Teacher instead of merely as something to dread or suffer through. The more you are able to glean from your experiences with someone's death process, the more likely you will be able to feel more comfortable with the Big Picture view of Death & Dying; Life & Living and how it all weaves together.     Sharing of ourselves and our experiences can be of great comfort to others who also may be going through some of these same difficult moments on a solitary, and at times very dark, path.     Thousands of people have taken this survey, and their results (if they've' specified it's okay to share) are posted here, too, for people such as yourself to browse though and learn from.

      There is a unique gift for each of us in learning to approach Death in a more wholistic and accepting manner, as we Learn, Grow, and Share of Ourselves along what otherwise can for many seem a Very Lonely Journey...

Urgent Whispers: Care of the Dying
Get your copy today!

Urgent Whispers: Care of the Dying is a Personal Reference Manual for Friends & Family Assisting a Loved One at the End of Life.   Useful not only for those sitting vigil with a dying loved one, but as a reference manual and journal opportunity after the fact to help you process some of the thoughts, feelings and reflections about death along the way, regardless of whether or not you were able to attend.

    Click on the cover to see more information on the book, read reviews of it, or find a bookstore or library in your area with a copy of the book.

  Since you've arrived here at the Bardo of Death Studies' questionnaire on Death & Dying, we thought perhaps you might also be interested in the book's presentation of some of these similar materials.

--- End of Commercial... and   back now to the Questionnaire :-)

Please feel free to answer only the questions you feel comfortable answering. And do realize that due to the inquring nature of some of the questions, you may find yourself feeling a need to further process some of your feelings about your experiences and how the questionnaire re-stirs them. You may wish to contact a friend, family member, or professional counselor to continue some of the thoughts and feelings this quetionnaire brings up.
We appreciate any reflections you have.
When you finish, click on the SUBMIT button to close the book and return.

One technical aside here... This is quite a long questionnaire. If you connect to the Net via a modem, it is possible that in the course of your answering the questionnaire, your connection could reset, if your provider has a 15 - 20 minute (or shorter) timeout on your connection. It will almost certainly take you longer than 30 minutes to complete. (You can actually complete the questionnaire over several hours or days, and just send it whenever you complete it... as long as you don't RESET or completely RELOAD, your browser will save your answers.

Just take whatever time you need and send it when you can. In some cases, that may mean re-dialing your modem in order to reconnect to the Net first.)

To start with, some questions which have nothing to do with Death at all, but which have more to do with what kind of hardware you're using to look at us and share with us, and what we need to keep up with in order to keep up with you...
Can you tell us which you're using?
And with which type of do you usually use?
do you typically log in to do your browsing?
Jump now to the END , midpoints: * * * * * * * or the TOP of the questionnaire...
about this web site?
:More Details about how you found us: (No length limit on this or any answer blanks below... )

Jump now to the END , midpoints: * * * * * * * or the TOP of the questionnaire...
To your best recollection, what age were you did your first significant experience with Death occur?
did you deal with it, overall?
What was the nature of that first death, as in, was it someone you knew well, or a relative, a neighbor, an accident... how did you come to be involved in it all?

which has best helped you deal with the Death?
Other comments on Helping You Deal with Death?

which most hindered or got in the way of your dealing with Death?
Other Comments on What Most Hindered Dealing with Death?

Jump now to the END , midpoints: * * * * * * * or the TOP of the questionnaire...
Perhaps you know of some Books or Works dealing with Death & Dying which have been particularly helpful to you, which you think others should know about...
You may want to fill out a BookReview form for us, or read our existing BookReviews before you go... [But be sure to come back to finish the questionnaire before you go!]
Can you name any particular works or writers which have been particularly useful or inspirational to you regarding the Death & Dying or Grief process?



In general, this questionnaire is worded to refer to a single death experience. But if you prefer to answer different questions about various different deaths, then you may do so. You may use as much space in a box as you need, (except for the pick-lists, the boxes will grow as large as necessary, as you enter more data) and answer the question multiple times in each box for different deaths if you wish.

In order that we understand a bit better the specific death which is most significant to you at this point in your life, can you tell us your relation to the person, when they died, of what cause, and at what age?:
My died ago, caused by .
At death, his/her age was
Any more details you'd care to write about how this death happened:

And now, some Sentence Completion exercises to help you to focus on some of the common topics associated with Death & Dying studies. Just complete the sentence, and if you feel like it, go on for as long as you wish on the same topic. The little boxes will scroll with you if you choose... allowing as long an entry as you like. (Or cut & paste if you prefer.) Feel free to skip over any questions here, and / or jump around in the questionnaire as you see fit. Answer whichever questions you wish to answer or the ones which speak most loudly to you. If you don't like the way one of the sentence completions is phrased, but it triggers a response from you, then feel free to just write what you feel.

Most of us certainly have an idea what Death is, but if I had to describe Death to someone from some Strange Alien Culture which knew nothing about it at all, I would explain like this: For us humans, Death is

The first time I ever experienced someone's death, I

Thinking now of the most significant death, when I remember how this death affected me and those around me, the thing I remember most vividly is

I sometimes think about the culture I was born into and how it deals with Death. One thing I'm certain this culture better needs to learn about Death is:

Dealing with Death can be tough, difficult, a challenge. But even though Death may seem mostly darker and perhaps as if it has no gifts... still one thing I recall which happened and for which I shall always be grateful is

Jump now to the END , midpoints: * * * * * * * or the TOP of the questionnaire...
It's not unusal to need help dealing with Death. Some folks receive support from family, some from co-workers, some from books and movies and some from just walks out in nature. What was of most support to me in dealing with death was:

And the hardest part of dealing with this Death was:

[ If you could be present for someone at a friend or loved one's death, and have feedback as to what is important to a dying person: ]

When I think about what is important and how my actions mattered, I am reminded that even small things are important. One piece of advice I might offer regarding just "Being There" for a dying person, would be:

There are sometimes some surprising learning experiences at times like this. Even though I may not have known it was possible, I realize now that I have learned so much from the death of my that I want others most to know about how I:

But things in death are not clean, clear, understandable... For me, the part which was most confusing was when:

Sometimes it's hard to accept the fact that someone has died. I remember when I first learned about the death of my <Friend/Loved One> my initial reaction when it first "hit me" was I...

Jump now to the END , midpoints: * * * * * * * or the TOP of the questionnaire...
There are, of course, some things I would have changed if I could, but there just wasn't time. Not that I can really call it a regret, but I do wish, however, that I might have had an opportunity to:

And some things went so much better than I ever had imagined possible. Although I still don't always understand how it all happened, I am just SO thankful that I was able to:

Something that some people report which seems so very strange to others... Maybe it was the stress. Maybe it was some of the strangeness of the moment. Maybe it was just my emotions getting mixed up. But I recall that even during the time when I was so intensely involved with the Death around me, there was a time when I just felt such a strong urge to LAUGH, that I couldn't contain myself, and I did laugh outloud. I've thought about it since then, and I would just say now that:

One thing that happened which for many people might seem almost so small that they wouldn't think about it, (yet which strongly impressed me as an important part of the whole death process,) was when:

And on the other hand, one thing which it seems everyone always seems to think is so important, (yet which to us just didn't seem to matter at all,) was:

Jump now to the END , midpoints: * * * * * * * or the TOP of the questionnaire...
Sometimes I think I'm over it all, and have dealt with things well enough. And yet, when I get to thinking so strongly like this about Death, about Life, about my loved one, I rediscover once again that I can still get all teary-eyed (feel like crying) just thinking about it, or when:

There are often confusing thoughts and feelings which come up around issues of death. I recall having had the thought, "It's just not fair: . . ."

I don't know... Sometimes I dream... What if it all hadn't yet happened? What if we were still together? If I think about that, and dream myself into another dimension, or another life where we're still together, how might that look? How might I be living today in that alternate reality, and how might it differ from this life?

Sometimes it gets so difficult. I just wish that I could

When I look back on the experience, and what the Medical Community in general was able to do, my basic view of the Medical Community is one of:

[If cancer, AIDS, or degenerative death was involved: ]
What I felt about my contact with hospice during this experience was:

One thing which many people say would have helped them more was some kind of a knowledge of what to expect in the final days, as health deteriorated, signs of impending Death. From my experience, the most important signs and mileposts I could suggest were present would be:

And on the other side of the coin, people who attend a dying friend or loved one, or are closely affected by the death process, have their own process. Regarding the stages of the grieving process, I would offer the reflection that for me,

Jump now to the END , midpoints: * * * * * * * or the TOP of the questionnaire...
Religion plays an important part in the lives of many people at times like this. For me and us, Organized Religion (church) meant:

My current / past Religious Affiliation is:

Many people feel that there is something about death which transcends religion and culture, that regardless of where we're born, what language we speak, what religious faith we may or may not practice, still there is common link of Spirit in all Deaths. To me and my experience, this broader view of Spirit feels:

Jump now to the END , midpoints: * * * * * * * or the TOP of the questionnaire...
Sometimes we can't exactly escape the reality of money, even in things like Death and Dying. For me, in the case of our loved one's death, the way money seemed to play its issues out with us was that:

Looking back on what we went through with the funeral and all of the people in attendance there, both professionally and 'mourners' and how we felt about those in attendance, the thing that stands out most about the funeral situation in general was:

Some of the experiences associated with the death of a friend or loved one can best be described as "odd" or "weird" or even "other worldly" compared to how our lives were before. Perhaps the "strangest" part of this process for me was:

One of the most interesting and prevalent phenomena associated with the process of Death & Dying is what is often called the stage of Visitations from the Other Side. At this time, many dying persons (and often those in attendance with them) experience visions and/or visitations from long dead relatives, Spiritual & Religious Masters, Angels, and other 'paranormal visitors'. Often in the course of the visitations, the new 'traveler' seems to be welcomed aboard to their new realm, and moved into a later stage of the dying process in a state of blissful peace. As for my awareness of my friend / loved one's experiences of this kind,

(And similar to the visitations from the Other Side', yet still associated with 'this side', people sometimes write us and tell us about 'Near-Death Experiences' they have when they themselves were critically near death, which may have significantly changed their view of death & dying. If anything like this has ever happened to you or someone you know of, feel free to discuss that here:)

Some people report that their loved one(s) have returned to visit them after the death. Some come back in a dream, others in broad daylight. Visitations like this are reported with various manifestations and offering various messages of clarity, prediction, assurance, etc. If anything like this has ever happened to you or others you know, please tell us something about it here in whatever words you can find to describe it:

In order to better cope with the difficulties or processing of a death experience, sometimes people have found particularly creative ways of coping... some private ritual or invented event that they did alone or with others in order to cope. Can you tell us something of your own personal coping ritual or event which helped you?

Perhaps you've found, as you got back to your own life and continued on about your own path, that you have been changed significantly, but that you've continued to include some of these practices, habits, rituals, or observations in your ongoing daily life. Any you'd care to talk about?

Now that it's done and over, and you don't have an opportunity any more to resolve issues with your loved one, you will need to go on from here. How do you feel just now about your state of affairs with this person?
If you have unresolved issues now, what kinds of issues do you feel are still out, and what ways might you devise to begin to resolve them? Who might help you with that?

Often during the process of grief and grieving, in dealing with the death of a friend or loved one, there are some strong new intimacies and friendships which form and are forged in the pressures of the times. These friendships often endure, and in many cases become lifelong friendships which, though, can never replace the friend or loved one, still seem somehow almost reflective of, or perhaps "set up" by our lost friend or loved one. Perhaps you've noticed some new emerging friendships from your own process?

Even realizing that reality of someone's death, sometimes we find ourselves floating in a kind of dream-like state which often can be helpful and healing. In that dream state, if you were to be able to have one last conversation with your friend or loved one, what you might you hope / expect to say to (or hear from) them? How might this help you to deal with your feelings now?

When we think of Death, or hear about someone who is dying, it can cause some pretty strong stirrings inside of us. One of the immediate questions which occurs to some people is, "What about me?"
And so, what about you? Have you given much thought to your own mortality, your own death? What if you knew you were to know you would die very soon? How might you feel about knowing that? Anything you'd like to say about your own death?

If you had to write your own obituary, what might it say? What kinds of things would you want to be sure people remembered about you? Pretend you are a newspaper reporter assigned the task of collecting the pieces. How might your obit read?

Perhaps if you have witnessed the family and social interactions at the time of, and following, a friend or loved one's death, you have seen the necessity of giving thought to the "Rights & Wishes of the Dying", and how they might sometimes be very different from what others present may desire or believe. What kinds of things does this bring up for you, or what kinds of things might you want people thinking about when you die, regarding necessities of Rights and Wishes of a dying party? What important factors or issues does this remind you should always be carefully taken care of?

Sometimes one of the most helpful ways to work through some of the process of grief and resolution in the process is to reach out to help others. If you were able to do so in the process, how did you reach out? Or if you wish that someone else had reached out to you better, what would have been of most help to you at the time?

(We know that not all questions will apply to all people, but for what was useful, how was this experience for you?) Feel free to tell us something now about your feelings about this questionnaire. Has it been useful in helping you think, re-think or express some of your feelings about death and dying?

Perhaps you think we should re-word one of our questions, or you know of another question you feel we might include here. Feel free to let us know any of those kinds of comments:

Thank you for taking the time to give us your thoughts and feelings about Death & Dying and sharing this part of your life with us. We'll be posting many of your responses on the Bardo here, and you're most welcome to return often and review what you and others have said.
Best Wishes to you.

Would you like a personal response from someone here or someone out in the ReaderShip of our pages? If so, please don't forget to leave your Email address, and indicate that you'd like to be identified with your Email address.
      Please note: We don't post Email addresses unless you say it's okay to post. And if you provide your email but ask it not posted, then be assured that it will never be sold, rented, or used for anything other than contacting you specifically regarding this questionnaire. But do bear in mind that if you do choose to post your address, then it's able to be browsed by folks anywhere who take a look at the Responses Page for your specific entry month.

Now that you've had a chance to see this and perhaps some others of our pages, please take a moment here to rate our site's informational content and availability:

As general 'generic comment' information, Please tell us:
Your Gender: <== Your Age
<== City/Reserve/Borough you're from
<== State/Province/Locality
<== Nation/Country
And, lastly, for optional info about you, to help personify your comments comments...
<== Your Name
<== Your Job, Course of Studies, or Profession
<== EMail Address
Other comments you'd like to share: (Let us know if you wish it posted)

anonymous excerpts or the entirety of your writing on our Respondents Page?

Any other requests regarding posting/not posting your responses?

Shall we with Name or Email Address so that people browsing here might be able to contact you about your comments? The default choice is that we list you merely as something like:

F55 Minneapolis, MN =USA=
M22 Fairport, IL =USA=
etc... showing only age and sex, city, state, country.

[It's normal for it to take a minute or two to send if you've filled everything in!]
Every submission is read individually, and should be posted within a few days. Thank you.

If you'd prefer to E-Mail a more complete word by itself, feel free to do so.

Thank You for your Input

Come back and visit us soon, and see what you and others are saying!
This page © 1994-2003 by Lifelong Learning Excellence, Inc.,
The Bardo of Death Studies, and Jerral Sapienza,
its curator and principal writer.
All rights reserved. Individual & Site Licenses available for use as or in conjunction with coursework. Contact us for further information.