Dying & Death: A Canadian Perspective

Originally posted in allaboutestates.ca Nov 15, 2013:

The Vanier Institute of the Family published their latest Contemporary Family Trends, called Death, Dying and Canadian Families, written by Dr. Katherine Arnup, highlighting the Canadian death experience.

This is an excellent paper that discusses the change in the experience over the last years. I have summarized some of the key points.

Canadian Desires:

Desire 1: We want to live forever: We are living longer with more and more of us reaching our 100th birthday.

Desire 2: We want to be fully able and then to die suddenly in our sleep: Only 10% are lucky enough to experience ‘sudden death’. The rest of us will likely linger. For many seniors’ ‘old age’ is accompanied by a progressively increasing number of ailments and chronic conditions.

Desire 3: We want to die at home: Most Canadians die in hospital.

Desire 4: We want to die pain-free: In the past two decades, significant strides have been made in the management of pain and other symptoms at end of life. New drugs and willingness to prescribe opiods for pain relief has improved the dying process.

Desire 5: We want to die with dignity: Dignity resides in the quality and nature of the care provided and in the attitudes of both the caregiver and the recipient of care.

Assumption 1: Your family can take care of you: Unlikely- fear of being a burden to their family is one of the principal reasons that people consider ending their own life.

Assumption 2: Home care will be available when we need it: Unlikely: “home care is not an essential service guaranteed by the Canada Health Act; rather, it is provided on a regional and local level, with funding from provincial and territorial levels of government.”

Assumption 3: One big, happy family: Not so- families have their own challenges- long distance, young carers, family dynamics and differing perspectives and past experience influence greatly.

The article concludes asking us to think about this topic and to start the conversation with our family and with our health care providers.

In terms of Advance Care Planning, the following results were taken from a 2004 Ipsos-Reid poll on behalf of the Canadian Hospice and Palliative Care Association and GlaxoSmithKline. It states:

-8/10 agreed that we should start planning for end of life while healthy
-70% of Canadians do not have a living will or advance directive
-47% of Canadians have not designated a substitute decision maker for health care
-Fewer than 44% of Canadians have discussed end of life with a family member
-Although Canadians felt it was important to discuss end of life with a physician, only 9% had done so.

The document concludes with a glossary of terms, which include:
Advance Directives, Assisted Suicide, DNR, Euthanasia, Medicalization, Palliative care and Hospice Care. and I invite you to review these terms and the article in its entirety.

There have been many cases in the courts recently dealing with very important dying and death decisions. It is a conversation that Cdns don’t want to have- yet we know it is coming, we just don’t know when. Think about, talk about and write about it…..
-Audrey Miller

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