The National Bereavement Survey, commissioned by the Department of Health, makes interesting reading.
Around 22,000 people responded to the first survey to measure care leading up to death – published by the Office for National Statistics.
The most striking, though not surprising, finding is that for those who expressed a preference, the majority (71 per cent) preferred to die at home, although most people died in hospital (53 per cent).
People’s reluctance to die in hospital, is reflected in the findings that hospitals, where most died, had the lowest ratings for caring for the dying with dignity and respect.
Only 30 per cent of people who died in hospital were given a choice about where they died, said relatives, compared to two-thirds of those who died in a hospice.
Sarah Wootton, Chief Executive of Dignity in Dying, made a key observation on the findings: “The end of life care which needs more work and investment is the involvement of patients in the decisions made about their care, and the recording of those decisions.”
She is absolutely right. Too often the end of life – dying and death – is ignored because it’s awkward, distressing or embarrassing to address. So the key decisions such as level of medical intervention, where the patient wants to die, who they want present and the type of funeral are left to medics, grieving loved ones and, in the case of the funeral, the chosen funeral director.
It’s going to take time to change this attitude of denying the inevitable, although the Dying Matters coalition is doing a great job, but change it will especially when baby boomers increasingly address their mortality. This is the ‘me, me, me’ generation, and they have been well informed and self centred about most decisions they’ve made and the same will be true for their end of life choices.
My Last Song has anticipated this by providing a death plan template which encourages the patient to be the centre of decision making, but involving their doctors, carers, close family members and, if appropriate, a minister of religion.
The issues covered are medical treatment, where to die, who you want present, and more holistic items such as any music you may want to hear, pictures you want to see, fragrances you wish to smell, how you may want to be dressed or made up. It also covers the pragmatic such as planning what happens to the pet and suggesting that the funeral wishes and will are up to date.
A death plan won’t guarantee a good death, but its adoption will ensure that a far greater number of deaths are comfortable and comforting. That’s the least we deserve, surely.