When was the last time you sat down to have a conversation about death with loved ones? If you cannot remember the last time you had a conversation about death or any of the issues tied to death and dying, you are not alone. Part of the reason for this is that there are social norms and cultural beliefs that discourage us from talking about death, including beliefs that talking about death can bring bad luck, illness and or actual death. This is ironic considering that if there is one sure thing in life, it is that we all will die. Birth and death are the two biggest rites of passage we all will experience in our lives. Both often are associated with pain and discomfort and the cycle of life – the start of it and the end of it. However, while we talk about, plan for, and celebrate birth, dying and death are not similarly honoured. The question is why? As with participating in all life-oriented celebrations, being present and participating in end-of-life (EOL) care can be an act of honouring the life of a loved one and an opportunity for real human connection (McGroarty, 2019).
Click the link to learn more about the importance of talking about EOL wishes with parents when they are still healthy:
Often when people learn that someone they know is dying or has a terminal illness, they avoid talking about it with them. They neglect to initiate, be receptive to, or engage in a dialogue about important EOL issues. Such topics of conversation can pertain to the dying person’s:
- Feeling about their diagnosis.
- Hopes and fears.
- Treatment preferences – type of treatment they want/don’t want (including nutrition and hydration).
- Definition of quality of life.
- Wishes for specific circumstances around death – who will be with them, where will they be, will it involve medical aid in dying (MAiD – See Chapter on End of Life), etc.
- Advanced care planning (ACP) and estate planning (i.e., advanced directives for personal care, will and estate plans, powers of attorney for personal care and for financial matters and property).
- Wishes for what they want to happen to their body after death (e.g., organ donation, body donation to science, traditional burial, green burial, embalming or not, cremation, aquamation, a mushroom shroud, etc.).
- Preference for how they and their life will be remembered (e.g., a cemetery marker, a park bench, a tree planting, etc.).
- Preferred type of memorial (e.g., traditional funeral, celebration of life, memorial), how it will look and who will be there.
(Kassalainen et al., 2021; Life File, n.d.; Monuments & Memorialization, n.d.).
The Importance of Talking About Death & Dying
Although these may seem like scary topics of conversation, they are important ones. And why not have them? When it comes to conversations about dying and death, we often provide rationalizations such as a desire to not upset the person who is dying. But people who are dying often want to talk, yet remain silent due to similar concerns for their loved ones (Facing End Life, n.d.). People who provide care for the dying indicate that engaging in discussions of death and dying with loved ones is the biggest act of love you can give each other, helping both the person being cared for and the care giver (The Conversation Project, 2014a). In fact, research shows that when dying people and their families discuss wishes for EOL care, the outcomes for all discussion participants are improved (The Conversation Project, 2014a; Sorrell, 2018).
Having these conversations provides us the opportunity to really connect with the people in our lives and to realize some of the richness of life that is only made possible by acknowledging the inevitability of death (O’Brien, n.d; Booth, 2019). Ideally, these important conversations should happen long before we get old or sick or start the dying process (IHI, n.d.; Sorrell, 2018), but we often wait until we have no choice. When these discussions must occur in the midst of a crisis, they are much more difficult and heart wrenching. It also often means that we end up having to guess a loved ones wishes (Kaasalainen, et al., 2021).
VIDEO: Learning How to Think About Death Changed How I live
In the following video, John Lehland, journalist and author, explains how talking to an elderly friend changed his perspective on aging and death and the importance of acknowledging his own mortality.
"ACP is defined as a process that supports adults of any age to understand and share their personal values, life goals, and preferences regarding their future health care" (Kassalainen et al., 2021, p. 2).