Death is a fact of life. So much aboutdying is beyond our control. Planningfor it can make a big difference when itcomes 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 ofdeaths in Canada are not sudden orunexpected,” says Donna Wilson, aprofessor in the Faculty of Nursing at theUniversity 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 isa death that is without suffering,” saysDr. James Silvius, provincial medicaldirector for Seniors Health and the seniormedical director for the Seniors HealthStrategic Clinical Network at AlbertaHealth Services. He adds that a gooddeath takes place where people feelcomfortable and can share the experiencewith family and friends.
We can plan for our own personalversion of a good death by thinkingabout what we want and communicatingthose wishes to friends and family.Humour can kick-start the conversation,Wilson says. When her aunt recentlyturned 100, Wilson suggested it might betime to stop buying green bananas. “Itgot a laugh out of people, but it also putsthe message out there,” she says.
Alberta Health Services providesseveral resources for advance careplanning. The Green Sleeve program (seesidebar, page 27) is a step-by-step guideon how to think about, communicateand document your healthcare wishes.“It really is the key preparation for deaththat 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 includesspecial services to manage symptomsand improve quality of life for peoplewho are dying and their families. Silviussays palliative care is available for peoplewith life-limiting illnesses from thetime of their diagnosis. Many peoplein palliative care are not immediatelydying, but their health isn’t improvingeither.
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 HORNERPHOTOGRAPHED BY GEORGE WEBBER AND JORDAN CONARROE