How to talk about death and dying
Tuesday 8 August 2017
We all have different relationships with death, shaped by our personal experiences, religious or spiritual beliefs, culture, family history and current life circumstances. The one thing we all have in common is that dying and death will be a significant part of our lives. The simple fact is that we’re all going to die, and most of us will experience losing people we love and care for during our lifetime.
While talking about death and dying might be uncomfortable or upsetting, research shows that having conversations about these subjects within families and communities and with our health care providers can help us prepare emotionally for our deaths and others’, and make it more likely that we receive the medical care we would prefer at the end of our lives.
Why talk about death and dying
Research by Dying to Know Day shows that while 75% of Australians have not had end of life discussions, 60% of us think we don’t talk about death enough. Having open conversations about death and dying allows us to consider how we feel about different options for end of life care, how we would prefer to live our final days, and how we want our lives to be celebrated and remembered.
When people who haven’t had conversations about death and dying become seriously ill or injured, often their family have to make decisions on their behalf about the medical care they receive. This can cause distress if they aren’t sure they are making the right choices for their loved ones, and might mean the person receives treatments that they wouldn’t have chosen for themselves.
Making decisions about death and dying before we’re in a crisis situation allows us to think about our options deeply, consult with people like family, friends and doctors, and live life knowing that our wishes have been made clear. While you can formalise these decisions as part of advance care planning, having a conversation about it with those close to you is a great start. You can always change your mind on any of the subjects later, if at another stage of life you feel differently.
For more about the importance of talking about dying and death, watch Isabel Merrin's TEDx talk about her experiences working with dying people.
How to talk about dying and death
Starting the conversation
Starting conversations about dying and death might not feel easy, but there are tools to help you make the process simpler.
Dying to Talk Discussion Starter is an Australian tool that can guide you in thinking about what to talk about. There is also a dedicated Aboriginal and Torres Strait Islander version, and a card game which you can download and print.
Playing a game like Hello can guide you to think and talk about different facets of death and dying, from medical care to spiritual wishes, while Dying to Know Day events held in August each year aim to improve regular Australians’ ‘death literacy’ and provide safe, comfortable spaces for people to talk about their wishes.
Sitting down with your GP to speak about creating an advance health directive will allow you to go over the practical aspects of end of life medical care, and understand what options will be available to you in specific circumstances.
Not all conversations will be about you: talking to your parents, partner, family members and other loved ones about their wishes is just as important. Some people who feel closer to death because of age, illness or having experienced bereavement, might feel relieved if you bring up the topic. Others might find it very difficult, but just letting them know you’re available to talk if they want to is a good first step.
Keep in mind that talking about death and dying isn’t about having all the answers, in fact, it may open up more questions for you. You may not know how you feel about things like whether you want to receive CPR or where you would like to die, until you talk about it.
What to talk about
Below is a list of topics to consider when thinking and talking about that relate to dying and death. It’s alright if these are things that you think about and discuss over time, rather than tackling them all in one conversation.
End of life medical care
An advance health directive is an outline of the medical treatment and health care you want, to be used if you can no longer make decisions for yourself due to illness or injury. It can contain specific instructions about medical treatments you do or do not want to receive in certain circumstances, or it can be more general, for example saying that you would like to receive all available medical treatment.
To create an advance health directive, you need to have some sections signed off by a doctor, so it’s a good opportunity to talk with them about what the different treatment options and likely scenarios are, so that you have a good understanding of your choices. You will also need to have your signature witnessed by a Justice of the Peace/Commissioner for Declarations.
Who is in your “team”
You can choose who will make decisions on your behalf if you become ill or injured in a way that means you can’t make decisions for yourself. If you legally appointed someone to have enduring power of attorney, this person can make health and financial decisions on your behalf.
You can also think more broadly about the people you would like to be in touch with or have around you while you are dying. Are there people you want to see or talk to before you pass away? There might be old friends or relatives that you would like to make time to see, and close loved ones you would like at your bedside during your final days. It might be important to you that a loved pet is with you if possible. You might desire certain professionals be involved, like a death doula, or a spiritual or religious leader.
Spiritual or cultural beliefs
You might have beliefs you want honoured, rites or ceremonies performed while you are dying or after you have passed away, or services you want held after your passing. It might be important to you to return home, be on country with family and have access to culturally sensitive services and activities in your area. These might stem from religious or cultural beliefs, or might simply be things you think would be nice or special. Whatever your wishes, if it’s important to you; it’s a good idea to make it known.
Let those close to you know how you feel about different burial practices, whether you would prefer a traditional casket or cremation, or an alternative practice or eco-friendly burial. You can pre-arrange some of these aspects yourself, or write down your wishes.
Is there anything you really want to do before you pass away? Clarifying these goals can help you achieve them before you’re not in a position to. If you’re already in care, this information can also help your care team to prepare you to meet these goals if possible. These could be ideas of things you would like to do, or events you would like to attend, like a family celebration.
If you would like to be an organ or tissue donor, or you wish to donate your remains to science, it’s a good idea to register these wishes now. Discuss your choices with your loved ones, so that they are prepared to honour your wishes when you pass away.
Death is a significant and inevitable part of life. Thinking and talking about it, understanding how you feel and what you believe, and sharing your wishes with your loved ones and medical team can give you peace of mind and allow others to take care of you in accordance to your wishes. Want to know more about talking about death and dying? Visit the sites below: