Celebrant turned zoo keeper

Posted by Wendy Coulton

I think my neighbours must have been impressed when they saw me clear out space in my garage this month. But the truth is I had no choice. You see, next week it will be the new home for the eye-catching and thought provoking centre piece for a free public event I have organised about end of life matters in my home city Plymouth.

My garage will be the temporary enclosure for an extra large paper mache elephant (as if sourcing one in the first place wasn’t difficult enough!) until it hopefully will stop people in their tracks at Plymouth Central Library at The Elephant in the Room event on Friday 27th and Saturday 28th March 2015.

The saying ‘elephant in the room’ refers to an obvious problem or difficult situation that people do not want to acknowledge or talk about. And that is exactly what I have witnessed too often with bereaved families in distress, conflict and hardship because no preparation was discussed or made for death.

My response to this was to get 15 respected speakers all under one roof across this two day event to cover a wide range of end of life topics including:

*  money and legal matters before and following death

*  health and social care issues like choosing where to die and the identity loss carers may experience when the person they have looked after dies

*  last wishes

*  organ donation

*  what to do when you suspect someone may be suicidal

*  what happens at the crematorium

*  business succession planning for the self-employed and small firms

*  the work of the coroner; and

*  bereavement care for children and young people

There will also be a Death Cafe discussion forum and information stands in the advice hub.

The aim of this free event is to encourage people to come in and find out more about their choices and key issues they may need to consider and plan for in the future.

Wouldn’t it fantastic if just as university open days, wedding fayres and recruitment events are commonplace, we could establish at least annually a similar approach to a focus on end of life issues and services?

 More event detail will be posted in February on www.dragonflyfunerals.co.uk

Die-alogue Cafe

First there was Death Café. Then Let’s Have Dinner and Talk About Death. Then Death Salon.

Now there’s Die-alogue Cafe

Die-alogue Café has been developed by an Australian academic, Stuart Carter. We’ve been talking to Stuart for some time. We like and respect him very much. His purpose is not to upstage other formats, but to offer an alternative.

His starting point is pretty much the same as the others:

Living in a death denying time in human history is not delivering the good deaths we say we would like to have … in the company of like-minded people: we don’t feel so alone, we can create a good death road-map.

Self-empowerment is the thing:

We choose to not sit around and wait for someone else to do what we can do, ourselves — when we have the know-how (knowledge), the where-with-all (tools) and the friends who are willing to lend a hand (help).

So the format is purposeful, the discussion focussed so as:

* to be of practical assistance to each other;
* to build a body of knowledge and expertise that will, by extension, strengthen our families and communities;
* to build bridges across cultural divides;
* to empower people to act wisely and face the future with a positive outlook;
* to raise awareness about injustices and
* to provide a gentle nudge of encouragement as we face our fears.

Die-alogue Café is not for children, people seeking grief therapy; or people who are not prepared to use the plain English words that describe our end-of-life realities. It is not everyone’s idea of a good way to spend a couple of hours.

Meetings are themed. They comprise ‘ordinary’ people and professionals – care home staff, nurses, doctors, undertakers, estate planners, etc. Outcomes may be various: Do research, take on projects, write letters, practice meditation, play games, create art, visit, invent; in other words practice the principles and report back.

The overriding purpose is to enable people to have better ends and better funerals:

While the location, the time, the group may be different the underlying sentiments remain… open, honest dialogue as a backdrop to creating a dance with death that when played out in daily life, will reveal treasures untold and enrich all who stumble across its stage.

You can find out more about Die-alogue Café here. You can find Stuart’s dedicated website and blog here.

Fight to the death

One of the things that’s changed is that ever so many people end up falling into the clutches of technology at the end of their lives. Something happens to them and the emergency response is to admit them to hospital – because the traditional view is that doctors are in a fight against death – that you have to ward off the evil death with everything you can.

But when death is coming, when it is inevitable, if you can actually help a person and a family to achieve a good death you’ve done a wonderful thing.

I think that there’s a lot of people who fear death. I don’t fear death at all, I just don’t. The idea for me of death is good, I can go to sleep. 

Dr Chris Abel, Islay

Watch it here.

Hat-tip: Mary Robson

Bad death, bad memory

Pain that is not relieved in a person’s life continues after they are gone, held as a sordid memory by loved ones.  Just as we retain treasured thoughts of joy, wisdom and warmth, we preserve images of pain.  Unrequited suffering contaminates memory, preventing healing, healthy grieving and closure. This pain in turn flows across our communities, touching many who may never have met the patient.

A poorly managed end-of-life experience can transform families for generations.

Source

Time’s up, take yourself out

A theme that we like to explore on this blog is the way in which longevity has reconfigured the landscape of dying. The blessing of long life has its downside: protracted decline. We are likely to linger longer, much longer, than our forebears. There’s a physical cost in chronic illness and possibly, also, mental enfeeblement. There’s the emotional cost to the elderly and their families. And then there’s the financial cost, which the government has wrestled with and now kicked deftly into the long grass.

In the Sunday Times Minette Marrin wrestled with it, too. I’ll have to quote a lot of it because the ST website is paywalled. She suggests some interesting solutions:

Last Thursday the Office for Budget Responsibility (OBR) announced in a chilling report that the escalating costs of an ageing population will mean yet more national austerity. Pointing out that the proportion of people over 65, who now make up 17% of the population, will rise to 26% by 2061, it estimates many increased costs, in care of the elderly, health and pensions, amounting to an added £80 billion a year in today’s money.

In the next 20 years, the number of people over 70 is set to rise by 50%, reaching nearly 10m, according to the Office for National Statistics.

The OBR states that Britain’s public spending will be “clearly unsustainable” over the next 50 years, despite the spending cuts. So, far from care for the elderly rising above today’s inadequate standards, it is almost certain to fall further below them. There’s no money now and in future there’s going to be even less. 

Universal bus passes (which cost £1 billion a year), winter fuel allowances (£2 billion) and free television licences must go. 

Everyone must accept that their savings, including their homes, may have to be spent on paying for care in old age. There’s no universal right to leave one’s property to one’s children.

Taxes of all kinds must rise hugely, or else there will have to be a large hypothecated tax upon people reaching old age. Services to old people must be reduced … Health service care must be rationed for the very old. Palliative care of every kind should be available, but not ambitious treatments.

There should be fewer old people. I’ve often felt the best thing one can do for one’s children is to die before real infirmity sets in. The taboo against deliberately shuffling off this mortal coil, as people did in other cultures in the interests of younger people, is wrong. Most people say they never want to be a burden to others in old age; it would be good if more of us felt able to prove we mean it, by taking a timely and pleasant walk up the snowy mountain. Especially since there’s no money left. [Our bold]

Source

How to Talk End-of-Life Care with a Dying Patient – Atul Gawande

Four questions a doctor needs to ask a person who is dying:

1.  Do you know your prognosis?

2.  What are your fears about what is to come?

3.  What are your goals? What would you like to do as time runs short? 

4. What tradeoffs are you willing to make? How much suffering are you prepared to go through for the sake of the possibility of added time?