Fear of dying is reduced if we know the facts, plan for the inevitable, involve our loved ones and try to have a ‘good death’. This piece acknowledges the importance of knowing how cancer kills us, the vital role of palliative care and why we should have our unique personal death plan.
I recently read an excellent piece in the Guardian, How do people die from cancer? and its importance struck me for a number of reasons.
The author, oncologist Ranjana Srivastava, explains how cancer affects the body and while she points out the increasing survival rate, she also goes into comprehensive details of how the disease causes death. It is essential reading just to gain an understanding of what is still a major killer, and one that is peculiarly taboo, in part because many people shut down when the conversation turns to terminal illness or death.
Fear of the unknown, whether that be the prognosis of a health condition or the unknown of what you feel at the time of your death, can have a huge impact on your psychological state in your final months. Talking with healthcare professionals can help ease this stress and shed light on what your body is going through and how the process of dying is managed. This is also a good opportunity to express what you need from palliative care to ensure you are comfortable when you pass, as Dr Srivastava explains: “In places where good palliative care is embedded, its value cannot be overestimated. Palliative care teams provide expert assistance with the management of physical symptoms and psychological distress. They can counsel anxious family members, and help patients record a legacy, in written or digital form. They normalise grief and help bring perspective at a challenging time.”
Palliative care is a relatively recent, but highly specialised, development in health treatment and the process of managing end of life. Srivastava goes on to highlight this as an important stage in the acceptance of death and a 'healing' opportunity for people to identify and talk through their own personal death plan. “There is evidence that truthful, sensitive discussion about mortality, enables patients to take charge of their healthcare decisions, plan their affairs and steer away from unnecessarily aggressive therapies.
“It’s your life and your death: you are entitled to an honest opinion, ongoing conversation and compassionate care which can come from any number of people including nurses, social workers, family doctors, chaplains and, of course, those who are close to you.”
The Final Choices Death Plan template offers you a starting point to begin realistic conversations with your loved ones about death, how you want to die and your funeral wishes. It is part of the movement to make death less of a taboo and to address the subject honestly and positively. This means being open, knowing the necessary facts, finalising your affairs and engaging with your medical professionals, carers and loved ones so that you have as good a death as possible. After all, over 2000 years ago the Greek philosopher Epicurus observed that the art of living well and the art of dying well were one.
That of course, is too glib, and for those who are dying, fear and anxiety as a result of lack of understanding are huge burdens to shoulder. Among the greatest fears of those diagnosed with a terminal illness is how to tell loved ones, and the effect it will have on them. There is a solution - and you have it - it just requires you to take the first step and start that conversation.
Writing a death plan
A death plan allows you to relieve the burden of decision making from the shoulders of those you love and creates the opportunity for a peaceful end of life.