Talking about what happens next

It may seem like a taboo subject but discussing end-of-life is something we should all do – and older Australians play a key role in leading these conversations.

Key Points

  • Researchers study how we talk about end-of-life 
  • A new course results in more positive expressions and attitudes around death 

  • Participants felt others thought more negatively about death than they do themselves, which could lead to important discussions being avoided  

It’s the topic that nobody wants to think about it, let alone talk about – but seniors have a special role to play when teaching others to talk about death and dying. We tend to frame our attitudes and emotions about end-of-life in a sad and negative way, and while this is understandable, is it always the most suitable approach? 

Researchers are looking into the benefits of reframing the conversation around death and dying to focus on better planning for the inevitable, managing future needs and expectations of care at end-of-life, improving patient and family care, and helping develop future health services. 

“In an ageing population, when our elders and terminally ill are often cared for by health professionals in residential care rather than in the home, we can go through life without really discussing or witnessing the end of life,” Dr Lauren Miller-Lewis, Flinders University research associate and CQUniversity positive psychology lecturer said. 

Researchers from the Flinders University’s Research Centre for Palliative Care, Death and Dying (RePaDD)and Palliative and Supportive Services, CQUniversity Australia, Palliative Care NT and the University of Technology Sydney, surveyed nearly 1,500 people about expressing their feelings and insights into death and dying. Those surveyed were enrolled in a federal government-funded six-week online course that encouraged talking about death. 

An analysis of the emotional content of the words used by participants showed that by the end of the course, they were able to employ “more pleasant, calmer and dominating (in-control) words to express their feelings about death.”

“Words aren’t neutral, so understanding the emotional connotations tied to words we use could help guide palliative care conversations,” Dr Miller-Lewis said.

Me and them

The study also found differences between how course participants described the feelings towards death and dying of other people in the community compared to their own. Emotionally negative words such as ‘sad’, ‘fear’, ‘scary’ and ‘loss’ were observed to be more commonly used than their own preference for more emotionally positive words such as ‘inevitable’, ‘peace’ and ‘natural’. 

The results indicate we assume others feel more negatively about death than we do ourselves and this could impact on our willingness to start conversations about death with others. Do we avoid it because we think others will get upset if we bring it up, and does this then leave important things unsaid? 

Analysis of the words used showed a greater benefit for younger participants, who showed a bigger increase in pleasantness (valence) and dominance (power or control) by the end of the course, showing the benefit of gaining insights into becoming more emotionally accepting of death. 

Insights, feedback and suggestions from the Dying2Learn program have been used to develop new interactive online resources on the CareSearch website to help people with starting and responding to conversations about death and dying with family, neighbours, and work colleagues.  

Source: Flinders University