Everyone deserves to have open conversations about death, even during a pandemic

Working as a cancer nurse and in bereavement services for the NHS, I’ve seen first-hand how much more challenging coronavirus has made it to talk about dying, death and bereavement, for both patients and professionals

Bereavement can be one of the most difficult experiences we have to go through in life. Now, coronavirus is making it even harder.

Families and friends who long to hold dying loved ones close in their final days are separated. Funerals cannot be conducted as planned, meaning people can no longer grieve together. And daily news reports of global death tolls are a constant, harrowing reminder that thousands of others across the world are facing similar distressing circumstances.

While working as a cancer nurse and in bereavement services for the NHS, I’ve seen first-hand how much more challenging coronavirus has made it to talk about dying, death and bereavement, for both patients and professionals.

The opportunities for a discreet conversation and a quiet word have all but disappeared behind personal protective equipment and the lack of clarity on visitation guidelines. Having meaningful discussions with families that are frank and honest, whilst also sensitive to questions and concerns, is a large part of my everyday role. Open body language often helps to strike that balance in these discussions, but is being made near impossible by plastic visors and social distancing.

We are having to adapt everything we do to manage this painful process and make it as sensitive as we can while keeping everyone safe.

The hardest thing is families not being allowed to visit when you are looking after their sick relatives. Telling the family that their loved one is deteriorating is a very different conversation face to face, and it feels very different to do this on the phone.

Despite the extra challenges we currently face when it comes to talking about dying, it has never felt more necessary to talk openly and honestly about death. High-quality advance care planning discussions, with a focus on personalised care and support, should be the foundation for good end of life care for everyone. This ensures that final wishes are respected and that people are treated with the compassion and dignity they deserve at the end of their life.

While many of us don’t like talking about death, bereavement will impact everyone’s lives at some point. Not having conversations about people’s final wishes are lost opportunities which can cause complex psychological and emotional distress for those left behind, sometimes even years after. We may be left wondering if we’ve failed to abide by someone’s wishes or missed out on the chance to say something important.

Conversations can sometimes be rushed because they are so uncomfortable to have – but that is surely a better option than never broaching the subject with your loved one and foregoing the chance to fulfil their final wishes. The only way to get more comfortable with the topic of death is to ensure we give one another permission to talk about it, and the space to express our different views and thoughts on the matter.

For many people living with cancer, discussing end of life can be frightening and unsettling, but open conversations can really help to navigate concerns.

Alison Robinson is Macmillan lead for bereavement services at Worcestershire Acute Hospitals NHS Trust. Specialists on the Macmillan Support Line can provide guidance on all aspects of living with cancer at this difficult time. The charity is urging people to donate what they can to Macmillan’s Emergency Appeal.