The ‘D word’

Dying Matters Awareness Week is 6th to 12th May. The theme, ‘The way we talk about Dying Matters’, focuses on the language we use, and conversations we have around death and dying.

We asked one of our Consultants in Palliative Medicine, Dr David Matthews, to share his thoughts, then Community Nurse Specialist, Jody Dewar, reflects on a recent community visit that involved a difficult conversation.

Lost, passed away, moved on, no longer with us, left us, checked out, gone to heaven, breathed their last, resting in peace, promoted to glory, out of their misery, popped their clogs, pushing up daisies, sleeping with the fishes, met their maker, six feet under, wearing a wooden onesie, croaked.

Euphemism has its place. It can help us communicate and connect with the difficult, painful, unthinkable, unbearable.

But sometimes there is a need to be clear and transparent about what we mean.

Euphemism isn’t accessible to all. To some people, if a person’s lost, why can’t we find them? If they’ve moved on or left us, then why don’t they just come back?

Sometimes the word needs to be said, the elephant in the room needs to be addressed.

So many times, I’ve witnessed that using the word we so often try to avoid is the very thing that helps people to realise, start to process and experience the relief of acknowledging the unspoken reality – ‘they’re sick enough to die’, ‘they are dying’, ‘they have died.’

Language matters. Sometimes in our well-meaning attempts to avoid hurting people we can inadvertently deny them the truth, opportunities to put things right, the chance to prepare or to begin to heal.

So don’t be frightened by the ‘D word.’ The truth sets people free.

Dr David Matthews, Consultant in Palliative Medicine

 

Case study

I recently met an elderly couple who had been married for many years. When I arrived at the house, the husband immediately said I wasn’t to mention the word dying as it was too upsetting for his wife, and the family wanted to protect her.

It’s always quite difficult but I think being able to adapt yourself to situations, being gentle, and giving open questions, helps. The breakthrough with this couple was by talking about advanced care planning.

Using very gentle terminology and getting a view of what was important for her and also her family allowed the patient to quite openly express what she wanted and how she wanted to be involved in her decision making.

Her husband was quite taken back. It was like acting as a mediator between the two of them in a gentle way, and thankfully, the outcome was really good.

It was the right time to talk about advance care planning as the wife was able to talk about what was important for her. And it was good for the husband because, although he was obviously trying (as he thought) to protect her, it was actually a way for them to both know what she did and didn’t want.

Jody Dewar, Community Nurse Specialist

 

Pictured: Dr David Matthews and Jody Dewar

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