Death is a fact of life. So much about
dying is beyond our control. Planning
for it can make a big difference when it
comes to taking our final bow.
By planning, most of us can meet
death at least partly on our own terms.
“Between 90 and 95 per cent of
deaths in Canada are not sudden or
unexpected,” says Donna Wilson, a
professor in the Faculty of Nursing at the
University of Alberta.
She researches aging and end-of-
life care. Since she started working in
healthcare in the 1970s, she has seen
plenty of positive changes, she says.
“A whole bunch of things have come
together to shift death into being more
natural, more family-oriented and less
Better medications and improved
palliative and end-of-life care have
helped ease much of the pain associated
with death. New technologies and
approaches to healthcare also allow
more people to choose where they die,
whether at home, a hospice or a hospital.
The number of Canadians dying in
hospitals peaked in 1994 at 80 per cent
and has since fallen to 43 per cent.
Wilson says this trend has given family,
friends and communities a bigger role in
helping people who are dying.
“A good death from my perspective is
a death that is without suffering,” says
Dr. James Silvius, provincial medical
director for Seniors Health and the senior
medical director for the Seniors Health
Strategic Clinical Network at Alberta
Health Services. He adds that a good
death takes place where people feel
comfortable and can share the experience
with family and friends.
We can plan for our own personal
version of a good death by thinking
about what we want and communicating
those wishes to friends and family.
Humour can kick-start the conversation,
Wilson says. When her aunt recently
turned 100, Wilson suggested it might be
time to stop buying green bananas. “It
got a laugh out of people, but it also puts
the message out there,” she says.
Alberta Health Services provides
several resources for advance care
planning. The Green Sleeve program (see
sidebar, page 27) is a step-by-step guide
on how to think about, communicate
and document your healthcare wishes.
“It really is the key preparation for death
that people need to take,” Silvius says.
When people don’t prepare in advance,
he says, they may get treatments they
don’t want or expect.
Palliative and end-of-life care includes
special services to manage symptoms
and improve quality of life for people
who are dying and their families. Silvius
says palliative care is available for people
with life-limiting illnesses from the
time of their diagnosis. Many people
in palliative care are not immediately
dying, but their health isn’t improving
Psychological and social supports are
part of palliative care. “I’ve had some
people in my practice that I’ve followed
until they died at home,” Silvius says.
“Much of what we did with them was
around family support and making sure
the family knew what was available to
them in terms of assistance and support.”
“Dying is different for everyone,”
Silvius says. “It can be made easier
by sharing the experience with those
A good death
Many of us, when we plan for it, can
meet death on our own terms in Alberta
WRITTEN BY DOUG HORNER
PHOTOGRAPHED BY GEORGE WEBBER AND JORDAN CONARROE