Talking about death and dying
The importance of having a conversation with someone about Death and Dying
Death and dying are difficult topics for most people to discuss. In contrast, in the absence of talking about death and dying or discussion about wishes and preferences around death and dying, people may die as a result of circumstances or in ways they would not have preferred.
The topic of death and dying may be discussed in such conversations
An area where someone wants to end their life
Arrangements for funerals or after-death plans
Arrangements for dependent care
Donating organs and blood is another way to do this.
You may be asked challenging questions about death and dying as a health or social care professional caring for someone near the end of their life. There are some questions that are difficult to answer, such as:
“Am I about to die?”
“How long do I have left?”
During this section of the module, guidance and communication skills will be discussed that may be helpful when faced with such scenarios. Learn more about the communication skills that are involved in discussions about death and dying by browsing the links below.
Beginning a conversation
You are more likely to talk when you have the time and space to do so in the right place and at the right time
Feel free to ask someone how they are doing
Consider turning the conversation about death and dying to the future and any concerns people may have if you want to start a conversation about death and dying
Using open questions like “Can you tell me more about that?” or “How does that make you feel?” will encourage people to open up and share their thoughts.
Keeping an open mind and being honest
It is most common for people to prefer to have open, honest communication with the people who provide them with care. As part of the end-of-life care planning process, it is imperative to be honest with patients so they can gain a sense of control, plan for their futures, and take into account their wishes and preferences. Although it is worthwhile to convey certain facts about a person’s condition or prognosis, it can be quite challenging to portray the reality of communication situations involving “breaking bad news.”
The ability to respond to challenging questions
A number of difficult questions arise when discussing mortality, such as: “Am I dying?” and “How long do I have left?” There may not be a clear answer to these questions, and discussing them can be emotionally distressing.
It can be helpful to leave a moment of silence after someone asks a challenging question to see if they elaborate. Rather than giving a blunt and immediate answer, stay calm and say ‘yes you are dying’ and do not change the subject or ignore their question.
The person has elected to trust you with their question, even if it may seem tempting to suggest they ask someone more senior. You should sensitively explore their feelings and concerns no matter how qualified you feel to answer their question. While some like to receive information right away, others need time to process what they hear. Your most appropriate course of action should be to reassure them that you will make arrangements for them to speak to someone who can respond to their question as soon as possible, and then you can actually get on with organizing it.
Some people may have concerns beyond the questions they have posed when posing challenging questions. Utilizing effective communication skills is an important way to explore the possibility of added concerns or fears. Understanding why someone has asked such a question can be helpful. Because you are facing a potentially challenging question at this point, they have asked it now.
Responding to and exploring challenging questions can also be enhanced with the following communication skills:
The act of active listening requires you to show that you are listening to what they are saying, and it involves body language, such as nodding in response to what they are saying, and short affirmative verbal phrases such as “I see” and “Right”.
It is imperative to provide individuals with the time and space to open up in such conversations, and allowing short periods of silence can aid in this. In addition to allowing people to take a breath, short pauses enable them to think.
Information given must be appropriate and within the bounds of your practice – it is imperative to gauge the amount of information people want. Others need time to process what they’ve heard. It is preferable for some people to receive full information right away, while others need a few minutes to process the information.
You show that you have listened and understood when you analyze information. As well as allowing people to add to what they have told you, it gives them a chance to clarify anything they think you have misconstrued.
Awareness of cultural differences
There is a difference in how different cultures perceive death and dying. When working in a diverse society, it is imperative to be able to talk about death and dying culturally sensitively.
There are some cultures that consider discussing death inappropriate. It is important to learn as much as possible about the beliefs and values of an individual and their family in order to build a professional relationship. It is important to explore death and dying beliefs sensitively. An individual who identifies as a member of a particular religious group may find it helpful to consult a local chaplain regarding possible beliefs regarding death. You should do this before approaching your service user with the issue. In addition to offering spiritual support, you can show that you are sensitive to their needs by providing chaplain support.
People deserve adequate symptom control and care regardless of whether they prefer not to discuss death.
Following are some general views about the topic of death and dying that may be found in various cultures and religions:
Across cultures, some families may not want to disclose a terminal diagnosis, such as African-Americans, Chinese, East Indians, Hispanics, Indonesians, Japanese, Native Americans, and Vietnamese. In order to avoid emotional suffering and preserve hope, this is necessary.
Christians, Hindus, Jehovah’s Witnesses, Mormons, Muslims, and Seventh-day Adventists believe that using drugs that may hasten death is contrary to their religion’s teachings.
In the final moments before death, Buddhists may prefer not to receive drugs that impair cognition.
It is common for Taiwanese people to fear bad luck if they talk about death out loud, so they avoid discussing it out loud to avoid it.
The above are generalizations, so we must keep this in mind. Discussing death and dying with a person and their loved ones should always take into consideration their specific beliefs and preferences. This is so that you can practice in a way that respects their culture and religion.