When someone close to you gets a terminal cancer diagnosis, the news is devastating for everyone concerned. Supporting each other through this difficult time is essential, and though it can be tough, it's important to be able to have honest conversations about dying. Knowing a person's wishes around their death - such as where they would like to die - can have a huge impact, not only for the person who's dying, but for those left behind.
A survey by Macmillan Cancer Support has found that around two in three people (64%) think that we do not talk about death enough in this country. Macmillan's GP Advisor for End of Life Care, Dr Peter Nightingale, offers his guidance on how to stop death from being a taboo subject for people impacted by a terminal cancer diagnosis.
• In the time leading up to the end of someone's life, the most important thing you can do is to offer to be there for the person. Be consistent in the time you make available to them and visit as often as you can. This familiarity will foster a comfortable relationship where you can both share your feelings, fears, wishes and hopes.
• Listen to the patient rather than talking yourself. People with a terminal diagnosis may value a sense of control so follow their agenda as much as possible in conversations, activities, and daily routines.
• Support the patient in talking about what they would like to happen and what a 'good death' means to them. For example, 64% of people with cancer would like to die at home but only 30% currently do. Macmillan offers Advance Care Planning support to find out what a person wants and what they don't want so their wishes are known by their loved ones when the time comes.
• Sense of touch and hearing are the last two senses to diminish when someone is dying - we believe even comatose or sedated people can hear sounds and feel touch. Keep talking and be tactile when appropriate, such as by touching their shoulder, patting their arm, or holding their hand.
• The dying person needs to be treated as though they are fully aware of their surroundings so keep explaining to them what is being done and why. This should cover everything from moving a pillow to letting them know who is in the room with them.
• Do not talk about the dying person in the past tense. This could be very disturbing for someone who can hear but not respond to a conversation.
• In the last minutes and hours, plan time for friends and family to have their own time alone with the patient so they can make their own final memories together.
• Lots of people will be grieving in the aftermath of the death - talk about what has happened and be available to listen if other people want to talk as well.
• Don't hold back on frequently mentioning the person who has died. Use their name, encourage reminiscing my family members and talk about their life.
• Maintain contact with other bereaved friends and family long after everyone has returned to their own lives. It helps.
Macmillan looks at how to discuss death with loved ones in its new report 'No Regrets', which is available here http://www.macmillan.org.uk/documents/aboutus/health_professionals/endoflife/no-regrets-talking-about-death-report.pdf or visit http://www.macmillan.org.uk for further information and advice on the end of life.