good life, good death, good grief

Professionals are unprepared

Health and social care professionals are unprepared for death-related discussions.

As a society we have generally come to expect every aspect of our health to be looked after by professionals, including support through dying, death and loss. However, many health and social care professionals are not as prepared as they need to be in order to meet this expectation.

Living within a society that is uncomfortable talking about death and dying, most health and social care professionals find it difficult to engage in open and sensitive conversations with patients and carers on this subject.

Many people do not get the opportunity they may wish for to discuss and plan for their death and dying. This can mean that patients and their families are unprepared for death, leading to all the practical and emotional problems outlined earlier.

This is even more likely to be the case for younger patients and those affected by non-cancer conditions that have not traditionally been associated with death, dying or palliative and end of life care.

Meeting the needs of health and social care professionals

Individual health and social care professionals need to have thought about these issues themselves before they can constructively discuss them with others.

However, though many health and social care professionals come across death frequently in their professional lives, few have the time and space to reflect on how this makes them feel.

Lack of time and space to come to terms with the deaths of patients means that professionals may have to become gradually de-sensitised to death. It has been argued that there has been a gradual erosion of the “compassion” of staff.

This is at least partly attributable to a healthcare culture where expression of grief is seen as “failure” and there is an unspoken expectation that staff do not need to take time to deal with the deaths they may witness on a daily basis.

Services are task-driven and it is generally perceived that staff do not have the time to provide more “soft” elements of care such as “being with” the dying and the bereaved, even though these elements are central to delivering dignified, compassionate and person-centred care.

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Bereavement Charter for Scotland