Opinion Articles

SOUL MATTERS: Why not start looking forward to a good death
By Jacqui Culver

‘Passion’ and ‘palliation’ are perhaps uneasy bedfellows, but for me, they sit well together. Two years ago Catholic Care successfully applied for a government grant to pioneer what is called the Palliative Approach within our aged care facilities. This approach “honours and protects those who are dying and conveys by word and action that dignity resides in people.” (Field and Cassel 1997)

The Palliative Approach arose from a vision for the last years, months and days of life of those who had entered our services with increased frailty, and/or progressive chronic or degenerative conditions.

This approach is not just Palliative Care, which is about symptom management at the end of life and only a small part of our approach.

The Palliative Approach is about choice and decision making, self determination and quality of life. It is about planning for an event that – like birth – is very much an integral part of life. It involves discussing what to expect and preparing for likely problems.

Death is inevitable for each of us but dying itself is actually about living until we take a final breath.

We take at least nine months to plan for a birth. We hope it will be a normal process but we prepare for possible complications. We try to make this ‘first’ as beautiful as possible. We spend a period after the event caring for those involved.

The Palliative Approach is about preparing for the last life event. We consider the environment, music, pleasurable aromas, tastes and touch that appeal. Who will be there?

We offer champagne or brandy mouth care, chocolate flakes on the tongue long after appetite ceases, open windows to let in a gentle breeze, music and scents that invite people in to share this passing of life. This may not be what everyone would want but it is choices that are important.

Sid had not seen his wife Alice in several months. His family felt that they could not bring her to visit because it was so upsetting for her. When Sid was approaching the last weeks of life, we suggested a ‘Celebration of Life’ party, an opportunity to share time and memories, to take photos and to eat cake. The family agreed and so we issued invitations (including the cat), we blew up balloons and bought cake…

Alice came along with many family members and friends and she spent a few happy hours with Sid.

Not long after, Sid passed away, amidst gentle music and the aroma of sandalwood. At his funeral, his family showed slides of the party, with photos of Sid and Alice holding hands, smiling and reminiscing. All had new memories to ease the heartache of the months to come.

Alice is with us now and able to talk openly about when she will reach those last few weeks and what she will want at that time. Staff feel comfortable with these conversations, because part of the Palliative Approach involves education around the ability to talk about death and dying and to express the sense of privilege felt in supporting people at during this special life event.

I hope that people will want to come to us to experience what can only be described as a ‘good death’.

Jacqui Culver
Jacqui is the Director of Social Services, Catholic Care, Diocese of Maitland-Newcastle.