Death and the dying process do not have to be scary things. Dame Lesley Fallowfield, an Academy of Medical Sciences member and professor at the University of Sussex, said, For many individuals, death is a gentle, peaceful and pain-free event. Although grieving the loss of loved ones can be a (complicated) process, some people do speak about their loved ones death as having been a positive experience. We need to demystify death and talk about it more.
I couldnt agree more. In a subsection called Terrified of Death, Dr. Rick Holm asks readers of Lifes Final Season, Why are we so afraid of dying? In summary he suggests that avoidance and death denial have led to a fear of death in our culture. He also wonders if we fear death because we see people suffering by the ill-advised search for a cure beyond any measure of possibility. I believe both are true. But I would like to add another possibility. People fear the unknown and the feeling of being out of control. While some fear what comes after death, I have found that most people who fear death are more afraid of the dying process. They wonder what their death will look like. Will they have pain? Will they suffer? They want to know. But the research shows that even then they dont want to talk about it. Fear can be stifling.
According to a recent survey of 1,000 people in the U.K., six in 10 respondents admitted they knew little or nothing about what happens in the final hours before death. And in those rare instances where information about death and dying is sought, 42 percent of respondents said they turn to friends or family for information about death and end-of-life care. Additionally, 22 percent said theyd be likely to ask medical professionals for information. The same percentage of people said they get their information on death from documentaries. And then 16 percent said they get their information from fictionalized TV shows and films!
Ignorance about death and the dying process may exacerbate peoples fears, the survey said. When asked about the dying process, 62 percent of the surveys respondents said they feared the person would be in pain and 52 percent worried the person would be frightened. These fears about death hinder what can be a positive experience for both the dying and their loved ones.
While the concept of a good death can be traced to the ancient Greeks (the word euthanasia is a compound word with eu meaning good and thanatos meaning death), it has been popularized most notably within the hospice movement started by Dame Cecily Saunders in the early 1950s. With an emphasis on palliative versus curative therapies, Saunders promoted quality of life over quantity of life using a multidisciplinary approach that addressed social, psychological, and spiritual aspects of care as well as the biomedical. The hospice and palliative movements stressed caring for the whole person and sought to empower patients to manage their dying process according to their personal preferences, beliefs, and value system. Of course, symptom and pain management would also remain integral to whole-person hospice care.
Nonetheless, with the advancement of hospice and palliative care and its focus on a good death, it must be stressed that there is no one right way to die. While being free of pain, surrounded by family, free of conflict, acceptance of death, stopping curative treatment, being at peace, and preferably dying at home are components that many or most would define as positive, the implication is that the individual can define a good death in their own terms and then be empowered to achieve it.
Demystifying death and dying, then, can be achieved through a threefold process. First, hospice agencies are skilled at providing death and dying education. Second, hospice staff including nurses, chaplains, and social workers assist patients and their families to define what a good death would look like for them. And third, the interdisciplinary team works together to ensure whole-person care because death and dying should not be scary things.
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