Planning for Death... - Too Much To Declare

Ugh! I know. Me, too. But try not to go into denial.

Here's an article from the Guardian today (author's name at end of the post):

Talking about death is not easy. Most people avoid the topic. But ignoring the inevitable doesn't make it go away. All of us can benefit by talking openly about dying and discussing our wishes with those close to us and with our GPs.

We are less exposed to death and dying than previous generations: in Britain, many conditions that once killed are now treatable; life expectancy is increasing. These changes have transformed society for the better. But they have also contributed to a reduced familiarity with death. The most striking evidence of this is that the majority of people who die do so in hospital. Out of 500,000 deaths in England, 53% died in hospital instead of at home, which is where most people would wish to die.

Research this week by ComRes for the Dying Matters Coalition reveals that death remains a taboo subject in the UK. Fewer than a third of the public have asked a family member about their end-of-life wishes, or talked about their own. Just 37% of the public have written a will, 31% have registered to become an organ donor and only 8% have written down their end-of-life wishes. This risks people not getting the care they want, or leaving a mess for those close to them.

The Dying Matters Coalition, which includes charities, hospices and care homes, aims to change public and professional attitudes to dying, death and bereavement. Our ambition is to reduce the fear of dying, encourage people to discuss their end-of-life wishes and increase knowledge and awareness of palliative care.

According to our research, some 78% of the public and 88% of GPs agree that if people felt more comfortable discussing dying it would be easier to meet their end-of-life wishes. Education is key, so that people discuss their wishes and preferences. The baby boomers' generation particularly needs to consider this issue.

Too many people still die in distress with uncontrolled symptoms, are inappropriately resuscitated, or have futile interventions. Most people will die from frailty in old age, associated declining heart, lung and brain function, and will be well-known to health and social care services, which gives opportunities for advance care planning. Doctors need to do their bit by initiating earlier conversations with people with advancing disease, so that it is not left until the patient is too ill, or does not have the capacity to make decisions. The time to plan is when you are well. It puts you in control and gives you a chance to put your affairs in order; to manage your relationships, to say "sorry" or "I love you".

Dame Cicely Saunders, founder of the hospice movement, said: "How people die remains in the memory of those who live on." Preparing a good death is possible, but only if one's wishes are known. There is only one chance to get it right.

? Mayur Lakhani is a GP and chair of the Dying Matters Coalition and the National Council for Palliative Care

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