RITE AND REASON:NUALA O'FAOLAIN's brave words about dying on RTÉ's Marian Finucane Showrecently touched a nation and started a dialogue on death and dying that is rarely heard in a world so focused on staying young and healthy.
What we know about death and dying in Ireland can be gauged from the first national survey on the subject, which was commissioned by the Irish Hospice Foundation and released in 2004. It found that the three most important things for Irish people when they are dying were to be surrounded by people they love; to be free from pain; and to be conscious and able to communicate. Two-thirds wanted to die at home and only 10 per cent wished to die in a hospital.
However, the vast majority of the 30,000 Irish people who die each year die in a hospital of one kind or another, and 40 per cent die in an acute hospital.
In O'Faolain's interview, we were given a snapshot of how she was coping at that time. People's response to receiving a life-limiting diagnosis for themselves or a family member will differ and will probably change over time as circumstances change.
Typically people cope with this news in a similar way to the way in which they have coped with other difficulties in their lives. Some of us are talkers and reach out for support. Some of us keep our thoughts and feelings private.
At times we may be scared, anxious and despairing. At other times we may be able to focus on how to use the time we have left and still experience happiness.
We all have a certain amount of death denial, so talking about death can cause anxiety and may be seen as morbid or unnecessarily upsetting for others. But given that death is inevitable and, as a tribute to O'Faolain's courage in opening up the subject, can I suggest that we take 10 minutes to review where we are in our lives and what we might do differently if we knew our time was limited?
Being alone is a common fear and the support of friends and family can be a source of great comfort as death draws near. Today is a good day to start doing things differently - to reach out to your family and people who mean a lot to you. Let go of old hurts and falling-outs.
On a more practical note, take a moment to think about your views and wishes regarding death practices. Let someone know what you would like to happen. Do you know your loved one's views on burial or cremation? Do they have a strong opinion on organ donation? Would they like a priest to be called for the last rites? Would they want to know if their time was limited?
A short conversation, when people are in the full of their health, can clarify issues that can cause distress at the time of death. We all assume there will be time at the end to have those difficult conversations. On television, we see characters who are conscious and holding lucid conversation as they draw their last breath, but that is not a reality for many dying people.
One thing I have learned from working with bereaved clients is that many people have deep regrets about time running out, things left unsaid or not knowing the wishes of a family member.
A gift that each one of us can give to those we care about is clear instructions about our last wishes. Have a conversation today, write down the details, and then get on with enjoying the life you have.
The recent media discussions on death can nudge us towards a more conscious way of living. Ironically, the more we accept our mortality, the more we can open up to living more fully.
O'Faolain's gift to us is giving us the opportunity to reflect on our lives and make some changes now.
Dr Susan Delaney is a psychologist and bereavement services manager of the Irish Hospice Foundation. Bereavement leaflets are available at 01-6793188 or www.hospice-foundation.ie