Several years ago Schoedinger held a series of focus groups with hospice staff and volunteers to learn more about the perceptions of the funeral industry, but also to learn about what special challenges hospice staff was facing with families out in the field. Two specific challenges kept coming up in each of the sessions:
- More and more families need help with low cost services
- Families are becoming more and more resistant to talking about end-of-life issues
The second challenge listed above seemed very interesting to me and I decided to look into why that was happening. At the same time, there seemed to be a big “movement” through the media about getting people to talk about end of life wishes. I watched several programs featured on the nightly news and on 60 Minutes about this very topic. There were even several websites developed dedicated to helping people get the conversation going.
It became obvious that hospice care was not the only segment seeing a trend and concerned about changing it. But why did it happen?
“It has become commonplace to say that contemporary western society is ‘death-denying.’ This characterization, which sociologists have termed the ‘denial of death’ thesis, first arose in the social science, psychological and clinical medical literature in the period between 1955 and 1985. During the same time period, the hospice and palliative care movements were developing and in part directed themselves against the perceived cultural denial of death in western society. While the ‘denial of death’ has been taken for granted by the lay public as well as by clinicians, in the sociological literature it has been increasingly questioned.” Source: http://pmj.sagepub.com/content/18/2/121.abstract?ct
After researching numerous articles on the subject, there appears to be several components to the thesis as reasons why our society is ‘death-denying’:
- Conversations about death are taboo – some cultures actually believe that talking about death will hasten the inevitable. Some people simply have an unjustifiable fear of talking about death. Regardless, it is a very real phenomenon and something witnessed by health professionals regularly.
- The “medicalization” of death – about 100 years ago people on average died in their fifties. Now, people live well into their 80’s, 90’s and even 100’s. This is due to the advances in medicine and medical practices. There are medications, therapies, surgeries and procedures, and even equipment that help prolong life. Death is no longer a natural end to life – it has become medicalized.
- Segregation of the dying from the rest of society – there are some wonderful buildings where families can go to be with their loved one as they are dying. These buildings and organizations try to provide a soothing a peaceful environment for families to help ease their grief and healing. However, it is segregating the dying from the rest of society. Nursing homes have also been stigmatized as a “place where people go to die.”
- Decline of mourning rites and rituals – about 100 years ago, people most often died in the home. They were embalmed in their beds and the funeral and associated mourning rituals also happened in the home. It was common for a wreath to be placed on the door to signify there has been a death in the home. And often, the church was very involved in whole process. Now, less people are attending church and many of those rites and rituals have gone away just due to the progress of our society.
- Increase of families selecting death-denying funeral services – when the economy took a turn for the worse, families were often unprepared for the costs of funerals. Many wished they could do more but lacked the resources to be able to honor their loved one in the way they would have liked. Also, some have taken on the idea that selecting minimal or no funeral services spares their families from the pain associated with the death. In reality, avoiding the pain and omitting any opportunity to encounter and experience grief does more harm than it does good.
Understanding why people are resistant to talk about death might make it easier when working with families in end-of-life issues. Schoedinger offers many continuing education programs, as well as general informational presentations, that can provide meaningful information to help you better serve your families.
Visit our Community Events page at http://www.schoedinger.com/about-us/community-events to download our Continuing Education Course Directory. You may also download the Directory from this issue of The Mourning Report.
Julie is the Director of Community Relations at Schoedinger Funeral Service.