The fear of talking about dying

It’s a sad fact these days that most people in the West learn about death secondhand – usually from reading novels or watching films. But, no matter how evocatively death is portrayed on film or in fiction,  it is completely different to experience the real thing.

Until the mid 20th Century, most people died at home, with their family and community around them.  Death was an accepted part of everyday life, and old age was relatively rare.

Since then, our Western relationship with death has changed greatly. We live much longer, and most of us will die in a hospital or in a hospice or residential care rather than at home with our family.  This means that remarkably few of us have been present at the moment of someone’s death.  As a result, there is fear and sometimes even horror just at the thought of seeing a dead body.

Many of us therefore, not only view death and dying with dread, but are unprepared to deal with the issues that confront us when someone we love starts to die.  We don’t know what to expect or how to react, or how to provide the support our dying relative or friend really needs.

This is especially true when people die in institutions. It’s easy to become enmeshed in medical and clinical processes and practices, where emphasis is placed on life-extending treatment and on our own desire for our relative or friend to recover, rather than on what the dying person really needs.

Death as a medical failure

In our Western science-based culture, a doctor’s task is seen above all as saving and preserving life. Death, as a consequence, is often regarded as a medical failure. Therefore, the dying process can become something of a game of pretence, instead of a meaningful spiritual progression where everyone concerned can face the truth and grow together.

Even hospices can find it awkward to draw attention to death and dying.  References to death are usually tucked away on the back of brochures or not mentioned at all.  The language surrounding end-of-life care is more often about pain control, medication and prolonging life than about the fact that the patient is going to die.

So, rather than having the time to prepare for death, it is not uncommon, for instance, for a terminally-ill person to be receiving life-preserving medical treatment such as chemotherapy until their  final moments.

Failure to name the ‘D’ word can be distressing for everyone. Relatives may know the person is dying, but are fearful of making things worse by talking about it.  The dying person may be afraid of discussing it for fear of upsetting relatives.

Therefore, death becomes the ‘elephant’ in the room.  Everyone knows it is there, but pretends it is not. confusing for both relatives and friends, and for the dying person. He or she may know that death is imminent, but may be afraid to say it, or to question treatment for fear of upsetting others.

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