Help people to have a good death

Facing death is a lonely business. But with the help of compassionate services it need not be harrowing for families, writes Mark Drinkwater

For most of us death is something we try to avoid thinking about. A few years back, after much procrastination, I finally got round to making a will. I knew it was the responsible thing to do. But at the same time, I remember the odd feeling of initiating something that accepts one’s own demise.

It felt that the act of making the will was somehow bringing myself closer to death – illogical as that might seem now.

With people living longer it is perhaps unsurprising that we feel distanced from death. At work, the death of a client may be a relatively infrequent occurrence for most, but it is something that social workers will have to face from time to time. And yet, we rarely discuss this. It certainly wasn’t a subject I received any training on when I trained to be a social worker.

In my professional life, the deaths of clients have thankfully only been occasional. Well, except for one position I had when I first moved to London. That role was at an inner city care facility – a depressing place that was part of a huge homeless hostel.

Mostly, it was populated by men who had come to the capital in search of work, never to return to their home towns. These old boys would tell me about the unhealthy working culture that revolved around social drinking in the 1960s.

Road to ruin

In that era, much of the manual labour was allocated on a day-by-day basis, which meant that if you wanted to be employed next day, you needed to be buying drinks in the pub the night before – particularly for the foreman. At some point the work dried up for these men. Unfortunately, their thirst for alcohol continued.

Decades later, the residents in both the hostel and the care facility had become hardened drinkers incapacitated by a combination of old age, ill health and alcoholism. As a service attempting to intervene in their problem drinking, we were fighting a losing battle.

It wasn’t that we didn’t want to help. It was just that the resources weren’t there to deal with the scale of the problem associated with ingrained drinking habits.

The care facility was a service that the men entered reluctantly. It was where they would spend their final years and was referred to as “the place where people go to die”. But it was not a good place to go to die. Those who died there had what seemed to be an undignified death. It did not seem a fitting end to these lives.

Hospice movement

I didn’t stay long in that job, but if that soul-sapping experience had any purpose, it was to make me realise the importance of our latter days. This is something that is important to the hospice movement, as I witnessed on a recent visit to the summer open day at St Christopher’s Hospice.

The south London charity was founded in 1967 by the one time social worker Dame Cicely Saunders and is now a world leader in the field of palliative medicine and compassionate end of life care. The notion of a “good death” is something they have done much to promote particularly through their engagement with the local community.

I guess I had always associated hospices with death and unhappiness, but as I approached St Christopher’s on its open day I could hear the upbeat strains of a steel band playing Soul Limbo, the BBC cricket theme tune.

Its cheeriness set aside any sombre preconceptions I might have had. It served to remind me that however painful it is to think about death, it’s important to focus on quality of life and ensure that people make the most of their final years.

This article is published in the 16 July issue of Community Care magazine under the heading We’ve all got to die but only some of us get to do it with dignity