As dinner table conversations go, we all know that sex, politics, and religion are considered no-go zones. Death and dying are probably next in line — while a whopping 82 per cent of Australians believe it’s important to talk to their family about how they’d like to be cared for at the end of their life, only 28 per cent of us have actually had that awkward conversation.
And as National Palliative Care Week falls on May 20-26, there’s probably no better time to broach the topic, given our ageing population. In 2016, there were 3.7 million Australians aged 65, and by 2056, that number is projected to hit 8.7 million — which makes talking about death even more essential, says intensive care specialist Professor Ken Hillman.
“We speak about Botox, and hair dyes, and liver cleanses, but we’re afraid to talk about ageing, death, and dying. The more we do, the more open and acceptable the conversations will be, and there will be less chance of ruining dinner parties when we bring the subject up!” he explains.
Commonwealth Games Lawn Bowls Gold Medallist and geriatric nurse Carla Krizanic is also on board, having seen both sides of the story in her work with elderly people.
“I used to be one of those people who didn't want to talk about death and dying, but through my job I've learnt how important it is to talk about. If you don’t, and you get to the stage when you can’t make decisions or communicate anymore, it becomes really hard on your loved ones and the nurses, because it becomes a guessing game.”
Don’t ignore family members who want to talk about death
Has your mum got a habit of asking you which paintings or furniture of hers you like, so she can gift it to you in her will? Chances are, you respond with, “Mum, I don’t want to talk about you dying! Let’s change the subject!” While that shows you love your mum, and her death is too painful to contemplate, you need to put yourself in her shoes a bit more, says Krizanic.
“My nan always walks me around her house and shows me things she wants to leave me in her will,” she says. “It’s important to her. Listening and having the conversation can put someone at ease, and make them feel secure that their family knows what’s important to them and will sort things out on their behalf if they’re not able to. If you try to avoid the conversation, it can give that person more anxiety.”
How to broach the conversation
If you’re the one bringing it up with family members, Krizanic suggests using a little humour. “Often a little laughter or a joke can lead into a much more important conversation. You can chat about it over dinner or while watching TV — it doesn’t have to be clinical. If you’re in a hospital, it’s nice to be outside with a cuppa. Try to make sure you’re relaxed and in a comfortable space.”
Things to cover include what would make you most happy in your final days, including who you’d like with you. “You should also talk about things like pain relief. Most people want to be comfortable, but some types of pain relief can make you sleepy and unable to communicate,” she explains. “So that’s important to talk about, too. If you’re not sure how to broach the conversation, there are discussion starter guides on the Palliative Care website.”
But I’m too young to talk about death!
You might think your death is a long way off, but no one knows when they’re going to kick the bucket. What happens if you are in an accident or get sick? If you can’t communicate? Wouldn’t you want your loved ones to know what would make you happy in those final days? Or the fact that you’d like Bohemian Rhapsody playing at your funeral and everyone wearing fascinators?
Professor Hillman says he’s already had the conversation with his wife about the three things he’d like for his end-of-life care. “I’d like the last few hours or days of my life to be symptom free, and that’s easy with palliative care. I’d also have people who I’m very close to with me, although I wouldn’t like that to go on for days and days, because they’d just get sick of it, so we’d need a roster. And thirdly, I’d like to hear Elizabeth Schwarzkopf singing Four Last Songs.”
For Krizanic, it is even simpler. “I’d like to be sitting in the sun if I can, holding my husband’s hand, and having a cup of tea,” she says. “It’s really funny when you think about. Everyone stresses about all these things but when you sit down and think about it, it’s always the really simple things you’d like.”
Have you had a conversation with your family about your end of life plans? How did you broach it?