Bringing death into the open can lead to more positive outcomes
Benjamin Franklin, one of the founding fathers of the United States of America said that nothing can be said to be certain except death and taxes.
Sadly, we are hearing a lot about death in the news from parts of the world in conflict now.
We also hear a lot about taxation and whether we should pay more tax or less.
Yet there is little discussion of death in our local news or our conversations. There has been the issue of assisted dying raised in parliament, but for the most part death is a bit of a taboo subject.
To some extent the lack of prominence of discussion about death is a good thing as it reflects our higher life expectancy, better living conditions, improved health and social care and the limited direct effects from armed conflicts.
In past years, death was more present in people’s lives, especially as more people died at home rather than in hospital.
Now death is often hidden, taking place more often in clinical environments.
This can be made more apparent too when families become more distant and fewer families live together across several generations.
We may indeed see death as a grim subject that we don’t feel comfortable discussing, but it is important to talk about it.
Talking about issues does generally help to reduce anxiety and misunderstanding and we would all want our loved ones and ourselves to die in the environment that they and we would wish for.
We are seeing a rise in people with dementia and it may not be possible for many people close to death to be able to express their wishes adequately.
I am not suggesting that we sit down with an elderly relative and say that we need to talk about death in case they develop dementia. But having the topic of death as a more natural part of conversations in general would be helpful.
There are many health and social care services that help people who need palliative and end of life care.
We tend to think about hospices or perhaps Macmillan or Marie Curie. They do indeed provide greatly valued care and support and local collaborative work spearheaded by the Highland Hospice offers the opportunity for significant advances.
However, other services also spend a large proportion of their time and efforts supporting people in the weeks and months before death.
These include hospital and community NHS services, primary care including general practice and pharmacy, social care, spiritual care, and there is also the huge contribution from caring friends and family.
There are many people devoting their time and energy to helping people at the end of life and this is of immense value to us all.
Starting to talk more about death and end of life will mean that this work can be even better focused on how people want to be supported and make the work even more valuable.
Dr Tim Allison is NHS Highland’s director of public health and policy.
