Conversations about death are often falling on deaf ears

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Conversations about death are often falling on deaf ears

Conversations about death are often falling on deaf ears

In Western culture, a malaise exists in our attitude to death. Although we are all a heartbeat away from our own funeral, conversations about our end of life plans are often seen as taboo. Three quarters of people in the West know when they’re going to die, yet in the UK, more than half of people in a relationship don’t know their partners' end of life plan according to a survey by the Dying Matters Coalition.

Advancements in life-prolonging technology and an increasing awareness of a healthy lifestyle means that our population is ageing, with at least 25% of the population predicted to be over 65 by 2033. Likewise, the demographic in the UK is becoming more diverse, with the white ethnicity decreasing from 94% to 87% of the population, so it is critical that our plan for palliative care adapts to the evolution of our society.

The ‘Fit for Future’ review was set up by St. Margaret’s Hospice to look at the ways that end of life care models need to adapt to be able to cope with this changing dynamic, combined with increasing pressure on public funds. One of the areas we need to consider is cultural differences in dealing with death and what we can constructively learn from them.

In developing countries, from Asia to Latin America, attitudes towards death are limited by a scarcity of resources. Ironically, despite limited palliative care options, individuals have much more freedom to think about how they want to live the last of their days. Whether it’s within the extended family, or the immediate family, the subject of death is broached and together they decide how loved ones should approach their final days; a view that celebrates life, rather than mourns death.

In contrast, a study on palliative care and culture found that, in America, responsibility for discussing end of life plans falls on doctors, which creates a one-size-fits-all care model. Whether it’s growing numbers in A&E waiting rooms or our inability to think about our end of life plan, it would appear that in the West we’ve created a system of dependency; a transference of responsibility for wellbeing onto the NHS, or charities like St. Margaret’s Hospice.

We need to change this dependency culture and take charge of our own care. This ambition has been very much at the core of our review, which has challenged communities, from the medical to the academic, to the patients and their carers themselves, to explore alternative ways in which we can deliver end of life care. By engaging with the community we hope that our report will have established findings that can help shape a care strategy that works for the individual, demystifies palliative care and creates a sustainable plan for the future.

Spike Milligan’s epitaph reads: “I told you I was ill.” Even a comedic icon was serious enough to discuss his end of life plan. It’s important that, like Spike, we understand our own limitations as well as limits on resources. Let’s take life back into our own hands, by getting to grips with our plans for death.


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