Dying Matters: So Let’s Start Talking About It

Queen’s Nurse Catherine Best shares her views on the importance of talking about this often taboo subject.

Introduction

We are all going to die.

Within the literature there is a plethora of modus operandi that tells the stories of lives lived. Poems such as They shall not grow old, tell the story of those who failed to return from the First World War, ‘the war to end all wars’. Little did we know what was to come.

Authors such as Cory Taylor, who tells of her life with terminal cancer, and Oliver Sachs, the ‘neurologist and writer’ whose autobiography, On the Move reveals his life’s work, emphasise the importance of living and dying well.

Furthermore, the media captures the stories of those caught up in disasters, acts of terrorism, environmental catastrophes such as the recent Australian bushfires and war. Now, we are in the throes of a pandemic and although it appears that the situation is improving, we still have a very long way to go before we return to a sense of normality, if ever.

The narratives that have emerged and will continue to emerge for years to come will tell of the sorrow and grief that has permeated throughout, but it will also tell of the heroism, of pulling together as a society and as a nation that refused to lie down and accept its fate.

A Taboo Subject

So, in the week when we openly declared that dying matters, how many of you reading this blog have ever thought about your own death? Are you just too young to die; have too much yet to achieve? Do you know what you want to happen when you die? Or do you simply see it as too morbid a subject to consider?

There is however, one sure thing, whether we talk about it, or not, we will all die. Despite this, death discourse remains a taboo subject in many societies, or is it, that we are ‘just not encouraged to talk about it’.

And yet death is all around us. How do you feel when seeing a cortege go by, attend a funeral, visit or simply walk past a cemetery? Perhaps, it’s during this time that we should all take a moment, to contemplate life as well as death?

Funeral Rituals

For centuries, funeral rituals have been passed down from generation to generation. It was the Victorian era that signified the beginning of the art of dying and the modern-day funeral practice. This grew over the 20^th Century to include, the hospice movement, an undertaking that gained strength, through the work of Dame Cecily Saunders, a name that doesn’t necessarily spring to mind when considering nursing pioneers, for ultimately she needed to become a Doctor to realise her aspirations.

For those of us happy to talk about death, a whole industry has emerged for us to explore. From employing end of life doulas, and , to planning our own funerals, and deciding how we want our disposed of; even bizarrely, attending our own funeral, we have much to consider.

Sharing these very important aspects of our lives means that hopefully, our wishes will be met and our family unburdened of the endless decisions required to be made when someone dies.

 So where do nurses fit in?

When writing this blog, I am reminded of the behaviours that come naturally to a caring nurse. Nurses are in a unique position to discuss the finer points of dying. Issues such as Advanced Directives, commonly known as living wills, DNACPR and Assisted Dying are all part of a repertoire of questions, that the dying and their families may want answers to.

Assisted dying in the UK is illegal, but it doesn’t stop the questions being asked. Nurses should be in a position to answer these questions openly and honestly. Perhaps those that are dying are simply afraid; not of death itself, but of dying in pain, of not knowing what will happen and when; or how they will be cared for. Nurses can help allay these fears.

Resilience

But until then, how we plan for our death is as important as how we live our lives.

In these times, when many are unable to kiss their loved ones goodbye, hold their hand as they take their last breath and are prevented from expressing their grief through funeral rituals, more and more people are concerned about the long-term effects this will have in a post-pandemic world.

As we continue to live under these new constraints, it is clear that our resilience is being tested beyond our perceived capabilities. It is therefore, essential that we ensure our physical and mental wellbeing remain intact. What we do, at least for now within the confines of lockdown may just enable us to emerge the other side, perhaps not fully in one piece, but with enough ability to bounce back.

As I end this blog, I’d like to bring your attention to a curious phenomenon. Since the onset of the pandemic, on-line Death cafes have reported a ‘surge of interest’. It appears that our fascination during the crisis, with dying and death is beginning to take on new dimensions not just nationally but internationally.

So, it seems, at least for now, we are talking about death, after all.

Catherine Best, Queen’s Nurse