How to have a good death

Maggie Fergusson in More Intelligent Life:

DeathLate last summer my parents called in their local undertaker. It was not that they felt they were nearing the end: at 86 and 82 they were both still fairly fit and leading independent lives. But they were about to downsize from the rambling Victorian house where they’d brought up five children, and were in the business of sorting things out so as to save us bother further down the line. Planning their funerals was a part of their tidying up. Neither Mum nor Dad is especially frightened of dying. Both have a faith; both share Pope John XXIII’s belief – often cited at funeral services – that “death, like birth, is only a transformation”, that it is “as easy and natural as going to sleep here and waking up there”. So it was disconcerting to find that the lady from the undertakers pointedly sidestepped the words “death” and “dying”. Instead, she guided them through a lengthy menu of coffins: the “Balmoral”, the “Priory”, the “Autumn Oak” – names seeming to imply that the transition out of this life is just another move up the suburban property ladder. And she talked of the impeccable service she could guarantee them in their “hour of need”. What precisely, my sister pressed, might this “service” consist of, given that by the time it was required Mum and Dad would no longer be alive? “Well, for one thing,” she replied, “we would be sure to keep them at the optimum temperature.” Oh, how we laughed! But perhaps we should not have been surprised by this dodging of the D word. Roughly every half a second, someone, somewhere in the world, dies – and nearly a person a minute in the United Kingdom. Yet ours is an age in which death has become taboo. “For all but our most recent history death was an ever present possibility,” writes Atul Gawande, an American surgeon and author of the bestseller “Being Mortal”, which has established him as a leading authority on the end of life. “It didn’t matter if you were 5 or 50. Every day was a roll of the dice.” But things have changed. Fifty years ago, most of us would have died at home. Now, though 70% of us would like to, only 12% do, leaving the vast majority to die in hospitals, hospices or care homes. So many – perhaps most – of us no longer know what death looks like. “A hundred years ago, everyone knew how people died,” says Min Stacpoole, a clinical nurse specialising in palliative care and based at St Christopher’s Hospice in south London. “Now many people are frightened of having a dead body in their house.”

As medicine advances, so life spans stretch. In the past 50 years, the number of people living to 100 has increased dramatically. Take this as an illustration: in 1955, the third year of her reign, Queen Elizabeth sent greetings to 199 people on their 100th birthdays. Last year, as Her Majesty herself nudged 90, this figure had risen to 6,946. Meanwhile, in the course of 2014, 780 people in Britain turned 105. With the horizon steadily receding, it’s easy to be lulled into a feeling that death is not something with which we need to be concerned, and a sense that mortality is just another illness to be tackled and treated. And yet possibly the only way to reduce the fear of death, and to be ready for it when it comes, is to look at it head on. “I’d like to introduce conversations about death to kids in school,” says Mary Flatley, a nurse at a large London hospice who has accompanied around 500 people in their final hours, and for whom dying holds little terror. “I’d like to have death right there at the forefront of life.”

More here.