Frank con­ver­sa­tions about dy­ing and death

Book aims to bring un­com­fort­able topic out into fore­front

The Daily Observer - - LIFE - SH­ERYL UBELACKER

TORONTO — It’s one of the last taboo top­ics: dy­ing and death, the “ele­phant in the room” that no­body wants to dis­cuss.

But in her new book Talk­ing About Death Won’t Kill You (ECW Press), re­leased ear­lier this week, Kathy Kortes-Miller says it’s essen­tial that fam­i­lies have con­ver­sa­tions about end-of-life is­sues — and it’s never too early to start.

“It’s go­ing to hap­pen to 100 per cent of us and it’s very much a life ex­pe­ri­ence,” said Kortes-Miller, pal­lia­tive care di­vi­sion lead at the Cen­tre for Ed­u­ca­tion and Re­search on Ag­ing and Health at Lake­head Univer­sity in Thun­der Bay, Ont. “It’s part of what hap­pens to us as a re­sult of liv­ing.

“And also be­cause when we die, our death will im­pact a min­i­mum of five other peo­ple. And it will im­pact them in ways of learn­ing about life, how they grieve, how they’re able to func­tion and then also how they deal with it the next time they en­counter dy­ing and death.”

Kortes-Miller, who spent decades work­ing in pal­lia­tive care, said she wanted to bring “death out of the closet” af­ter ex­pe­ri­enc­ing her own brush with mor­tal­ity when the mother of two was di­ag­nosed with colon cancer.

The book is in part an an­swer to the con­cerns that arose dur­ing treat­ment as she faced her own thoughts about po­ten­tially dy­ing and the role of health-care providers in help­ing pa­tients and their loved ones nav­i­gate a fi­nal jour­ney.

“I re­ally thought we were do­ing a good job un­til I rec­og­nized my own ex­pe­ri­ences as a pa­tient and saw that we re­ally weren’t,” the death ed­u­ca­tor said of med­i­cal pro­fes­sion­als. “I was a per­son who knew how to talk about these things and I had a tough time get­ting my health-care providers to talk about it.”

But it’s not only med­i­cal prac­ti­tion­ers who need to learn how to dis­cuss end-of-life is­sues with pa­tients and their loved ones, said


Dis­cus­sions about death — in­clud­ing fears, re­grets and one’s per­sonal wishes when dy­ing — should be part of ev­ery fam­ily’s con­ver­sa­tional tableau, she sug­gested.

“It’s not some­thing you need to dive deep into and do in one mas­sive, huge con­ver­sa­tion, but rather dif­fer­ent pieces of it as you think about what’s im­por­tant to you, whether your health-care providers need to know about you so they can pro­vide the best care pos­si­ble, and what you think is go­ing to mat­ter to you at the end of life.”

That in­cludes al­low­ing chil­dren to ask ques­tions and ex­press their feel­ings about death, whether that’s over see­ing a dead an­i­mal on the road, the loss of a pet or the death of a grand­par­ent, she said.

When a child ex­presses cu­rios­ity about what it means to die, for in­stance, it can be an op­por­tu­nity for adults to open a con­ver­sa­tion and make it a teach­able mo­ment.

“Kids are not born fear­ful of death ... They’re ac­tu­ally re­ally cu­ri­ous about dy­ing and death. And so if we sup­port their cu­rios­ity by talk­ing about it, by nor­mal­iz­ing it and hav­ing con­ver­sa­tions with them, they ’ll be­gin to de­velop that ed­u­ca­tion for them­selves.”

One of Kortes-Miller’s pet peeves is when peo­ple use euphemisms for death, such as a per­son hav­ing “passed away” or “gone to a bet­ter place.”

“We’ve re­ally moved away from us­ing the ‘D’ words — dy­ing, death and dead,” she said.

Many peo­ple fear the idea of dy­ing — and that in­cludes talk­ing about it, she said, not­ing that be­cause Cana­di­ans are liv­ing longer, many peo­ple are mid­dleaged when they first ex­pe­ri­ence the death of a loved one.

“And we’ve iso­lated our­selves from it be­cause we don’t see it. We’ve turned over the care of our loved ones who are dy­ing to the health-care pro­fes­sion ... so we find our­selves at a loss of know­ing what to do.”

Talk­ing as a fam­ily about death can lay the ground­work for an ad­vance care di­rec­tive, which spells out a per­son’s wishes dur­ing the process of dy­ing, such as the de­sired level of pain man­age­ment.

The le­gal­iza­tion of med­i­cally as­sisted death has also given peo­ple the op­tion, un­der cer­tain con­di­tions, to seek to has­ten end of life — and con­tro­versy over the law has caused Cana­di­ans to pay more at­ten­tion to the is­sue of dy­ing and death, said Kortes-Miller.

HO/The Cana­dian Press

It's one of the last taboo top­ics: dy­ing and death, the "ele­phant in the room" that no­body wants to dis­cuss. But in her new book Talk­ing About Death Won't Kill You (ECW Press) re­leased this week, Kathy Kortes-Miller says it's essen­tial that fam­i­lies have con­ver­sa­tions about end-of-life is­sues — and it's never too early to start.

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