good life, good death, good grief

Rationale

Various problems are caused in Scotland because:

  • People are unprepared for the experiences of death, dying and bereavement.
  • Communities are disempowered from providing support to people who are dying or bereaved.
  • Health and social care professionals, individuals and families are unprepared for death-related discussions.

For example:

  • People who are dying or bereaved can experience isolation because people don't know what to say or how to act towards them.
  • People may die without wills, leaving complicated situations for their families and friends.
  • Health care professionals often struggle to have conversations with people about what care or treatments they want as they approach death. This makes it hard to plan the care that a person really wants.
  • If the fact that someone is dying is not acknowledged then opportunities to resolve issues and say goodbye may be missed.

Facts and figures

  • 56,000 people die annually in Scotland. Of these it is estimated that as many as 46,000 people will have needs arising from living with deteriorating health for years, months or weeks before they die.
  • 29% of all acute hospital bed days are used by patients in their last year of life. Nearly 1 in 10 patients in hospital will die during their current admission and 54% of deaths take place in hospital.
  • Older people who haven’t made a power of attorney may end up stuck in hospital and unable to be discharged. This costs the NHS over £17 million a year and can cause huge distress for people and their families.
  • 60% of Scots die without making a will, leaving potential for family conflict and financial and legal complications.
  • Most people don’t plan for funeral costs. But the average cost of a funeral in Scotland is now over £4,000 and funeral debt is rocketing.

Importance of talking and planning

Planning ahead maximises the chances of having a good, dignified death and makes it easier for those who are left behind. It avoids some of the potential harms listed above.

Without talking and planning people nearing the end of life may undergo futile and aggressive medical interventions at the expense of quality of life. It is important for people to discuss and record what they would or would not want to happen if they were unable to speak for themselves so that those around them can make informed decisions in line with those wishes.

Family and friends left to make funeral arrangements are helped by knowing what the deceased would have wanted to happen.

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Before I die I want to ...
Bereavement Charter for Scotland
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