Is a Good Death only possible with End of Life Conversations?
Only 45% of Australians prepare for death by making Wills (1) and funeral plans. It is rare that a family has had an open and systematic End of Life Conversation or discussion. This discussion/ conversation should lead to the development of an End of Life Plan with the aim to achieve a Good Death for a loved one.
As society ages, there will be an increased demand for aged care services. This is due to:
- the increased life expectancy of the general population
- increased number of older Australians due to the aging Baby Boomer generation and
- people’s demand for choice on how what care they receive.
Approximately two-thirds of Australians die between the ages of 75 and 95. (2, 4) with various terminal illnesses such as:
- cardiovascular and respiratory disease
- together with the increase of people dying with dementia.
There will be a growing attitudinal change among the terminally ill and the aged to have more of a say in the planning of their End of Life experience. Another contributing factor for this change will be due to the End of Life experience and care that other family members or friends have endured.
DYING IS NOT DISCUSSED
In the United States, there has been a movement to get people to talk, about their wishes for the last days of their lives with their family and loved ones. Baby boomers appear to be embracing this and are beginning to make plans. Through these End of Life Conversations, ideas will be communicated about what they want for their the end of their life care options.
End of Life Conversations are often avoided due to people not wishing to talk about death due to fear or being in denial about it. Unfortunately, End of Life Conversations and End of Life Planning also become entwined with other highly emotive issues relating to voluntary euthanasia and assisted dying which is illegal in every State of Australia.
When in fact End of Life conversations and planning for the end involves much more? It is a process in which all of a person’s needs and wishes must be considered when preparing an End of Life Plan. It’s for the benefit of both an individual and their family to make sure that their loved one has an opportunity for a “Good Death”. It can only occur when there is a plan with a clear vision of a person’s wishes for their final stages of life and it is respected.
WHAT IS A “GOOD DEATH”?
We all wish for a “Good Death” in control, free from pain and surrounded by loved ones.
The term a Good Death(3) is an all-encompassing term which binds many qualities together.
They are deemed important in contributing to good End of Life Care.
The issues include:
- people being free of pain and other symptoms which they are suffering from
- able to decide what medical treatments they would want to receive
- listened to
- being with family and friends
- cared for at home
- not being a burden to others
- being treated with respect
- can include “having one’s affairs in order” and
- attention to a person’s religious or spiritual needs.
These factors offer the person dying with:
- choice, and
- support to address their specific physical, personal, psychological, social and spiritual needs.
During this time family members have strong opinions and preferences about their loved ones’ final days.
NEED FOR AWARENESS OF A LOVED ONE’S FINAL WISHES
An End of Life Conversation needs to find answers to questions to gain a better understanding of your loved one’s final wishes. These can include:
- where your loved one would prefer to spend their last days,
- type of funeral service they would want
- who will take care of them, and
- what they would like to do to achieve a Good Death
Awareness of their final wishes will assist them and family members to be better prepared to handle death, dying, grief and bereavement.
The next step is by communicating their wishes from the End of Life Conversation into a
more formal document such as an Advance Care Plan or Advance Health/Care Directive.
1 NSW Trustee & Guardian, Attorney General & Justice, What is a Will? viewed at http://www.tag.nsw.gov.au/what-is-a-will.html
2 Australian Bureau of Statistics (2013a) Deaths Australia, 2012, 33020DO019, Australian Bureau of Statistics
3 Seymour JE, Kennedy S, Arthur A, Pollock P, Cox K, Kumar A, et al. Public attitudes to death, dying and bereavement: a systematic synthesis. Executive summary. 2009. www.nottingham.ac.uk/
4 > Hal Swerissen and Stephen Duckett (Sept 2014) ‘Dying Well’ Grattan Institute
WHAT IS A GOOD DEATH?
Is an all-encompassing term which binds many qualities together. Which offers a dying person;
– the ability to maintain their dignity,
– have a choice, and
– support to address their specific physical, personal, psychological, social and spiritual needs
– in control, free of pain, and
– surrounded by loved ones.
These are deemed important in contributing to good End of Life Care.
How Do You Make Sure You Have A Good Death?
1. Think about what is important to you
2. What would you want (be pain free) or not want (be alone) at the end of your life
3. Document your end of life plans and wishes
4. Have end of life conversations with your family about your plans