The way we talk about dying matters
This Dying Matters Week, we join hospices across the UK to break down taboos around death, dying and bereavement.
By talking honestly about these topics, we can help more people receive good end-of-life care tailored to their needs.
Read an article by Tia Mountain
Read an article by Dr Jon Earle
Tia Mountain, a Nurse in our Living Well Team, explains why it’s important to speak openly and clearly about death and dying, and the benefits of creating an Advance Care Plan:
“Living well and dying well are fundamental to good palliative care. As a hospice we strive to facilitate both.
“Dying is inevitable, and one of the challenges we face is that people often do not want to talk about death or dying.
“Many people are not aware that dying well is possible.
“This is why it is vital for us, as healthcare professionals, to have open and honest conversations about death and dying, and also about how people can live well while receiving palliative care.
“Having these transparent conversations is important because it enables people to express their wishes, including what’s important to them, ensuring their future care is consistent with their values and preferences.
“This is part of Advance Care Planning.
“By discussing and documenting these conversations, healthcare professionals are then able to provide more individualised, person-centred palliative and end-of-life care.
“For those important to the patient, having advance care planning documentation in place for their loved one can bring peace of mind.
“When talking about death and dying with patients, families, and healthcare professionals, it’s beneficial to use clear communication.
“For example, we avoid using euphemisms such as “gone to sleep”.
“The Advance Care Planning process usually occurs over a period of time and can involve several conversations.
“Some people will have strong preferences they have already thought about, whereas others may need more time to think about what is right for them.
“Ultimately, we are guided by the individual so they are fully involved in the process. Significant others can also be involved if that is the person’s wish.
“Within all of this, it is important to remember that we are all human and being human is a crucial part of the way we talk about death and dying.”
Dr Jon Earle, who is part of our In-patient Unit Medical Team, shares his thoughts on common questions around death, dying and end-of-life care.
What do you say when a patient asks: am I dying?
No matter how many times I’m asked this question, I still have to take a breath.
It takes immense courage it takes to ask, and I know the words I use in response will have significant importance.
Many times, the question allows discussion to naturally follow, often addressing the worries that caused the question.
For any of us considering our own mortality, the wishes to be comfortable and pain-free are most common.
As a palliative care team, we have a role in reassurance.
Based on our experience, we can talk through these worries, sharing what usually happens in the final moments of someone’s life.
Prognostication is another aspect of this question.
Although we hold no crystal ball, we can roughly estimate how long someone may have left to live.
We will only share this information if it is wanted, and in as much or as little detail as needed.
I have witnessed on many occasions how even a little detail shared can provide some reassurance in an uncertain time.
Do all the patients that come to the In-patient Unit die there?
Palliative care is very much evolving.
Even within the space of a few years, I’ve seen the specialty grow and adapt to try to provide care to patients earlier on in their journeys.
This means that we do admit patients to the In-patient Unit for symptom control before they are discharged back home or into a care facility.
As we also continue to provide good-quality end-of-life care, there will naturally continue to be associations with hospices and dying.
However even despite this link, I’ve found hospices to be some of the lightest and most uplifting of places I’ve encountered.
How important is using clear language in palliative care?
For me, to communicate effectively relies on being clear.
I find clarity is achieved by a combination of understandable language coupled with honesty.
The key to any communication within palliative care is to focus on the patient and their needs.
You could have the clearest communication skills, but if a patient doesn’t want to discuss an issue, that’s probably not the right time or space to discuss it.
For me, a key part of communication is meeting patients where they are at, not where we are at. By letting go of our agendas, it removes the pressure from patients, making things even slightly easier at a difficult time.
- To find out more about Dying Matters Week, and to access resources on starting conversations about death, dying and bereavement, visit www.hospiceuk.org/our-campaigns/dying-matters/dying-matters-awareness-week