good life, good death, good grief

The evidence

Planning ahead for death can make life easier for loved ones and improve the care a person is likely to get as they the approach the end of their life, yet in Scotland:

  • 74% of people have not discussed what their wishes would be if they did not have long to live
  • For 61% of these people, this is because they feel ‘too young’ to discuss death, or because death ‘feels a long way off’
  • 79% of people don’t have any written plans for their end of life care, financial wishes or funeral plans
  • Only 35% of people have written a Will

People in Scotland are living longer than ever before, and there are overwhelmingly positive aspects to living in a society where medical care is so good and premature death so rare. However, where once death was seen as a natural and inevitable occurrence, it is now often seen as something avoidable or extraordinary.

Far fewer people live their lives as part of a network of face to face relationships which endures over their lifetime. At the same time as the decline of traditional frameworks of community support, traditional religious frameworks have also declined.

Changing expectations

A whole generation of people have grown up largely with the expectation that every aspect of dying will be taken care of by professionals and institutions and have never had to acquire the kind of emotional and practical skills for supporting the dying and bereaved that their grandparents took for granted.

In 2010 a group (known as SLWG7) was set up to look at these issues, focusing particularly on the potential of health promoting palliative care to address some of the avoidable harms that are associated with death, dying and bereavement in Scotland.

Within its final report, SLWG 7 set out what it saw as the rationale for undertaking this work. This rationale is based on evidence from attitudes surveys; social and historical observations; and the experiences of professionals working in relevant fields.

In England there is now general acceptance that the quality of people’s death, dying and bereavement experiences can only be improved if people have an opportunity to talk about and reflect on these issues. This was key to the establishment of the Dying Matters coalition in England in 2009 by the National Council for Palliative Care with funding from the Department of Health.

Further reading

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Before I die I want to ...