Death is often hidden from view and only rarely discussed. Being open about death can calm your fears. It can help you value your life more and to think about the care you would like to receive when you are dying.
To us, it may seem that the Victorians were obsessed with death. The era saw the rise of suburban cemeteries, huge interest in funerals, mourning dress and mementoes of the dead. But in those days, death was part of every day life. People’s average lifespan was roughly half what it is today and most people died at home.
The situation could not be more different today. People live far longer thanks to advances in medicine. In the UK, men aged 65 can expect to live to 84 and women to 86.1
This may encourage you to think of death as something that will happen so far in the distant future that it isn’t worth contemplating. Older relatives may well die in homes and hospitals, and you may have never seen a dead body.
Another factor that may make death unmentionable is the tendency among some doctors to see it as failure when all their efforts are dedicated to prolonging life. This idea is also seen in some of the language used when people die. For example, newspapers which might report that people have lost a ‘brave fight’ or ‘battle’ with their illness.
A recent survey found that only around one in three people had discussed with their partner making a will, or their wishes concerning their funeral.2
Just under half of those interviewed thought that discussing death made it feel closer, and the same number said it frightened them. Yet the research shows that gradually people are becoming more willing to discuss and plan for their own deaths, and to help others do the same.
Katherine Sleeman, Palliative Medicine Registrar at the Cicely Saunders Institute, believes that ending the silence about death will diminish its terrors and lead to a new focus on improving the quality of life of dying patients.
She says: “We prepare about the arrival of a new baby, we plan for it, we think about what we are going to buy and what we are going to call the new baby. It is part of our daily life, our conversation. Why do we not prepare for our death in the same way? I would like everyone to have a good death but we can’t achieve that unless we as a society stop whispering and start talking about it.”3
The Little Sisters of the Poor, who run a number of homes for the elderly around Britain, encourage openness about death and dying among residents. Sister Kathleen, a nurse at St Anne’s Care Home in Stoke Newington, north London, says: “In a care setting such as St Anne’s, death isn’t a taboo subject, and I think that’s very healthy because death is a natural process of living. For many people, regardless of their age, death can be a fear. People can fear the act of dying and what’s going to happen after death.”
All this makes it difficult to discuss the most appropriate way to care for a person who is dying, and to come up with good guidelines. The Catholic Church says you should be made as comfortable as possible and offered painkillers to ease your suffering even this risks shortening your life.
The Church also affirms a dying person’s right to refuse “medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome.”4
Dr Julian Hughes, Professor of Old Age Psychiatry at the University of Bristol recalls an occasion when, as a newly qualified doctor, he was instructed to treat an elderly woman who was very ill. She had undergone invasive treatment including several operations. She was comatose and receiving oxygen and her body was covered in bruises.
He writes: “I put up various drips and started different antibiotics. But by the evening the woman had died. My conviction then and now was that everything I did that day was a waste of time – and the antithesis of good medicine.”5
Surviving a serious illness can give you a new perspective on life and death. Adrian Parker, now in his sixties, is a specialist drinks importer from Hertfordshire, who was diagnosed with a life-threatening brain tumour in 2008. After making a full recovery he says: “One of the things that it really changed was that up until then I would not have been accepting of death. The illness made me accept that destiny. You get an acceptance out of being that ill.” Watch a video interview with Adrian Parker.
Adrian says his experience has also led him to value life more. The same can be the case for someone who is confronted by death every day.
Another Adrian, Adrian Forsey, says of his work as a funeral director in Glastonbury, Somerset: “We get to see how short life is, that it can be taken away at any stage, and that you really have got to concentrate and enjoy what’s around you each and every day; saying to the ones you love that you do love them, saying what needs to be said while you’re still here, and smelling the roses as you go.”
A number of groups have been set up in recent years for people of all ages who want to talk about death.
Among the first of these was Death Café, a network of groups who come together to discuss all aspects of death in an unstructured, informal environment – usually over a cup of tea and slice of cake.
One of the movement’s organisers in the United States, Kate Brassington says: “Yes it’s morbid, yes it’s disturbing, it’s dark and twisted, yes it’s morose but it’s not death I am referring to nor dying, it’s life and the living we submit ourselves to when we don’t allow death into the room.”6
Our Lady of Guadalupe in Mexico urged the visionary St Juan Diego (1474-1548) not to be afraid when he thought his beloved uncle was dying. Juan, who had recently been widowed, rushed to fetch a priest to hear his uncle’s last confession.
On the road, Mary appeared to Juan and said: “Listen, put it into your heart, my youngest and dearest son, that the thing that frightens you, the thing that afflicts you, is nothing: do not let it disturb you.”