We need to talk about death!
A new survey has shone the light on the nation’s reluctance to discuss dying and end of life plans.
By Yasmin Noone
An alarming majority of Australians have never discussed their end of life care wishes with their loved ones, let alone put pen to paper to record an end of life care plan, a new survey has found.
Recent research, conducted by Palliative Care Australia (PCA), has shown that 82 per cent of those surveyed had not prepared an end of life plan or recorded how they would prefer the end stage of their life to be handled.
CEO of PCA, Dr Yvonne Luxford, attributes the nation’s failure to plan for end of life circumstances to our reluctance to talk about death and dying.
Over 60 per cent of respondents believed that death and dying isn’t discussed enough, while 73 per cent of those surveyed, aged 65 and over also backed this claim.
“That is an incredible majority,” Dr Luxford.
“And, it’s been like that for quite a while. In our Australian westernised culture we don’t talk about the issues of death and dying enough. We do have a fascination with the death of celebrities and with dying in films and on television but we don’t discuss death with our loved ones.
“The ramification of this is that we don’t relate to death or dying. We are not letting our loved ones know what we want at the end of our lives…and we are not discussing it with our health professionals.
“If we are not discussing our needs with them, then they will not receive our message about what we need from our care.”
Dr Luxford believes that if health care staff, who deal with matters of life and death on a daily basis, are unable to talk about dying then the end of life care provided could be less than ideal.
“Aged care staff are certainly not receiving enough training in end of life care and in the palliative approach to care even though it’s something that’s really important for all levels of staff from an RN to an aged care [assistant].
“If you look at the statistics, one in three residents dies in an aged care facility each year. Aged care staff really need to be well trained in the palliative approach, but not only in terms of giving adequate care to residents but in approaching residents [and discussing] advanced care planning.
“I think residents would appreciate having an opportunity to fill out an advanced care plan. It advantages, not only the resident, but the staff as they will know what the resident wants and it will be recorded.”
The survey also asked people where they would prefer to die, with almost 45 per cent responding that they had just not thought about it. Of those who had considered it, 74 per cent said they wanted to die at home.
PCA’s vice president, Professor Patsy Yates, said that although this statistic was consistent with overseas findings, it stood in sharp contrast with reality.
“We know that the number of people who die at home in Australia has actually decreased over the past 50 years. Now only about 16 per cent of people die at home, 20 per cent die in hospices and 10 per cent in nursing homes. The rest die in hospitals.”
Prof Yates said that while many people carefully prepare financially for dying through wills and estate planning, and even plan and pay for their funerals, few take the time to plan for the process of dying and the type of care they wish for.
“We’d urge people to prepare a simple advance care plan, covering likely scenarios near the end of life and communicating their wishes about the type of care they wish for and where they’d like to be at the end of life.”
PCA commissioned the independent online survey of 1,000 people to gauge community views on dying and palliative care to mark National Palliative Care Week which runs until 28 May.
The organisation used the research to shape its new campaign, Let’s Chat About Dying, which aims to encourage people to talk about this topic.
“Our message is clear – don’t put it off. Chat to your loved ones about dying, understand what support is out there, and ensure your wishes are clear.
“No one lives forever and we are all entitled to support and comfort during our final days.”
A new range of information resources is now available on PCA’s website. Click here for more information.
We need to be educating everyone on death and dying after all non of us are capable of avoiding it. I was introduced to death at youngish age when my best friend died at 19, followed by my grandma, father, grandpa and mum died all in within a few years of each other. My Mum nursed her parents and my father at home. When my Dad died I was 21. It was up to me to make the funeral arrangements and tend to all the details, my elder brother was too unprepared and distraught. I made my own funeral arrangements then and a will.
Today death has almost been removed from life and yet it is such a huge part of living. If we cannot accept death or our impermance then; how can we live our lives to the fullest? Its definately a subject that needs to be bought out into the open and made “normal again” it is part of our everyday existence.
Making an advanced care plan can’t be left until the later stages of life. Everyone of every age needs to be educated and people need to be urged to do this while they are capable of making well informed and well thought out decisions. The more it is talked about the less scared people will be about doing it. It doesnt mean its the end of life as you know it, it just gives you the chance to have your say when you may not have a voice. Do you want your children to have to make those hard decisions for you in a time of stress or would you leave it upto a Dr. who your just another patient to? Take control of your own life.
Death is such a taboo subject in today’s society and education to overcome irrational fears is important. Ausmed is running a two day seminar in various locations around Australia on this topic later in the year, and the registrations have been utterly disappointing. Despite the fact that many nurses and allied health professionals confront death on a regular basis, there appears to be a reluctance to attend formal education on the topic.
Perhaps this will change as the topic is discussed more openly in media such as your journal.
Well done for posting this blog.
Providing the general public and nursing home staffs education
regarding the difference between old-age and old-age, in end-of-life
circumstances due to multiple end-stage-disease processes, is crucial if
we are going to economically survive the aging baby boomers over the
next two decades. In particular, the public desperately needs a clearer
understanding of the difference between quality life and physiological
life. The decision to pull the plug is seldom a relevant quality care
issue for patient or family today, but the doctor’s ability for plugging
in today’s expensive technology for maintaining meaningless,
physiological life is a daily quality of care issue throughout our
nation’s hospitals and nursing homes. Excerpted from The Medical
Profession Is Dead and the Doctor Is “Critically ill!â€