Talking About Death

When talking to children about death, it’s best to be up front and honest. This can be a confusing and distressing time, but it’s important to present an accurate picture of the situation for kids to try to understand and process their feelings. 

Find a safe, calm place to have the conversation, and allow time for you to share and for them to absorb the information. Be honest and use simple, age-appropriate language they can understand. For kids of all ages, avoid using euphemisms like “passed away” or “gone to a better place,” as these can be confusing. Psychologist Dr. Lisa Damour suggests gently saying something along these lines: “I have some very sad news to share. Your grandparent has died. That means his body stopped working, and we won’t get to see him again.”

Children may have a lot of questions about death, and it’s important to be patient and create a judgment-free space for them to ask and express their feelings. Be prepared for these questions to come up over time and at unexpected moments; they may also ask questions that seem surprising or direct, as they may not yet understand social norms. Children of any age may be concerned that the death is somehow their fault or feel guilty. It can be helpful to check in with them about this, and reassure them that isn’t the case. Reading stories about loss or grief together can also help explain the situation and open up discussions to help them process their emotions.

It’s normal to express grief and sadness when talking with a child about a loved one’s death, though it’s helpful to settle yourself a bit before the conversation to avoid alarming them. Letting them see that it’s natural to have and express feelings about the loss can help them better experience their own feelings.

Sources

“How to talk to your children about the death of a loved one”. UNICEF. https://www.unicef.org/parenting/child-care/how-talk-your-children-about-death-loved-one 

The most effective way to have a conversation about the end of life with someone who has dementia is to initiate the discussion shortly after they have been diagnosed. The symptoms of dementia can accelerate quickly and unexpectedly, leaving a loved one unable to readily express themselves and understand what is being communicated. For this reason, it’s important to discuss end-of-life decisions and arrangements as soon as possible so they can communicate their preferences and concerns.

When considering these conversations, it can be helpful to identify which topics are most pressing. If someone already has a dementia diagnosis, the legal and medical documents that require their direct input become the immediate priority. For conversations focused on end-of-life medical treatment and legal decision-making, the essential topics include:

• The importance of an advance directive to outline their wishes for medical care.
• Their interest and preferences in life-extending interventions or life-sustaining treatments.
• Creating a will, trust, or power of attorney to ensure their financial and legal affairs are managed according to their wishes.

Focusing first on the medical and legal documents ensures their voice is central in these critical decisions while they are still able to participate fully. Other important conversations about post-death preferences that can be addressed include:

• Funeral arrangements and preferences
• Whether they want to be an organ or tissue donor

People with dementia can become easily confused, so explain potential end-of-life options with simplified language and take your time with these explanations. People who have dementia can also become overwhelmed when too much information or too many questions are presented to them during an interaction, so it is crucial to keep discussions brief. You may need to have multiple conversations about end-of-life decisions in order to gather the information you need or to fully understand what your loved one’s preferences are. It can be helpful to ask questions such as: 

• Do you want all available treatments to be used? 
• Are there treatments that you don’t want to receive?
• Do you want to donate your organs or tissues? 
• What are your religious/spiritual/cultural beliefs about dying? 
• How do you want your beliefs to be respected and honored?
• Do you want to die at home?
• Do you want to be buried or cremated? 
• Do you have a will/trust/power of attorney? Do you want to create one? 
• How do you want to be remembered? 
• What type of memorial do you want? 

Every individual’s experience with dementia is unique and their responses or ability to respond can vary. Their cognitive abilities can fluctuate daily or within a matter of hours, so it’s important to be patient and determine which times of day they tend to be more capable of communication, such as in the morning instead of the evening. You may have to repeat your questions or statements in order to facilitate an ongoing conversation. Additionally, some individuals with dementia realize that they can’t communicate or explain themselves as effectively as they’d like to and this can be frustrating, so remember to be as supportive and encouraging as possible. 

Sources

“How to Talk about End-of-Life Care When a Loved One Has Alzheimer’s Disease”. The Conversation Project. https://theconversationproject.org/tcp-blog/how-to-talk-about-end-of-life-care-when-a-loved-one-has-alzheimers-disease/ 

“End-of-Life Planning”. Alzheimer’s Association. https://www.alz.org/help-support/i-have-alz/plan-for-your-future/end_of_life_planning 

“Talking about death and dying to someone with dementia”. Hospice UK. https://www.hospiceuk.org/information-and-support/your-guide-to-hospice-end-of-life-care/talking-about-death-and-dying-someone-dementia#:~:text=The%20Alzheimer%27s%20Society%20advises%20that,be%20appropriate%20to%20tell%20them. 

The most important consideration when interacting with someone who is dying is to treat them with compassion, dignity, and respect, being mindful of interacting with them as you usually would, rather than focusing only on their condition. Remember that this person is not defined by their condition or the outcome, but by their unique presence and individuality. Be attentive to them and listen carefully when they want to share their thoughts and feelings, allowing them to lead the conversation. 

While it is not inappropriate to talk with a person who has a terminal illness about their condition, it should only be approached if they feel comfortable addressing it with you. Many individuals welcome open and honest conversations about their perspective as they near the end of life. However, it is important to be respectful of their wishes if they aren’t ready to talk about it yet, particularly if the diagnosis is recent. Talking about their condition, prognosis, or the dying process can be a sensitive and emotionally charged topic. Paying close attention to body language can provide important cues about their comfort level with the conversation. It is also helpful to recognize that these conversations typically occur during the period of living with a terminal illness, as direct access to someone in the final days of actively dying may be limited.

If they are comfortable discussing their condition, it is essential to be considerate in your responses. Since this individual is dying, it isn’t appropriate to provide reassurance about their condition, offer advice, or make suggestions for additional treatment. Avoiding language that minimizes their experience or potentially disenfranchises them is also crucial. Instead, focus on simply listening to them and validating their emotions about their situation. This is likely an intense emotional experience for them, so sometimes it may also be helpful to reflect on experiences you’ve shared or other memories that may bring them a greater sense of happiness during your time spent together. 

Overall, interacting with someone who is dying requires sensitivity, respect, and showing up authentically for that person. Remember to demonstrate empathy and listen without judgment to what they are willing to share. Your willingness to be supportive and maintain connection can be a vital source of comfort as they navigate their end-of-life experience. 

Sources 

“Providing care and comfort at the end of life.” National Institute on Aging. https://www.nia.nih.gov/health/end-life/providing-care-and-comfort-end-life 

“What to say to someone who is dying.” VeryWell Health.  https://www.verywellhealth.com/talking-to-a-dying-loved-one-1132505 

“What to say to someone who’s very sick.” AARP. https://www.aarp.org/home-family/friends-family/info-2018/terminal-illness-friend-advice.html 

When discussing death, it is essential to remember that different cultures and religions have unique beliefs and practices. While these may be unfamiliar to you, it is important to respect them and understand that they are deeply meaningful within their own context. As you may speak with individuals from a wide variety of backgrounds, understanding these influences can help you approach the topic with greater sensitivity.

You may encounter broad generalizations, such as the idea that in many Eastern cultures, death is viewed as a natural part of the life cycle, with a significant focus on spiritual liberation or reincarnation. Conversely, Western cultures often tend to view death as a sorrowful milestone, emphasizing the grief of loss and the memory of the loved one, frequently with a focus on an afterlife. It is important to remember these are broad themes, and within any culture, expressions of grief and beliefs can vary significantly based on specific traditions, religions, and individual families.

Religion can also profoundly influence practices associated with death. Some faiths may focus on the resurrection of the body or an afterlife, while others may mandate specific burial and mourning practices to honor the deceased and care for their soul.

When discussing death in this context, it is vital to approach the situation with humility and respect. Remember that cultural and religious practices are diverse, and no single person can represent an entire tradition. Even within the same community, beliefs and customs can vary.

When you encounter unfamiliar practices, let humility guide your response. View it as an opportunity to listen and learn, recognizing that a grieving individual or family may not wish to act as a cultural representative. The primary goal is to foster empathy, support, and understanding by acknowledging the personal meaning these customs hold for them.

Sources

“How well are you coping?” American Cancer Society. https://www.cancer.org/cancer/survivorship/coping/coping-checklist-for-patients.html 

When discussing death and dying in the workplace, it’s crucial to approach conversations with respect, empathy, and cultural sensitivity. These discussions typically arise in one of two contexts: when a colleague is grieving a personal loss or when the workplace experiences the loss of a colleague. The ability to appropriately express thoughts and feelings about these topics can contribute to a supportive and compassionate work culture, while recognizing that everyone has different attitudes and perspectives surrounding death, dying, and bereavement.

Since death is often associated with stigma in our society, people often don’t know what to say to a coworker who is grieving a personal loss, such as the death of a family member. Likewise, words don’t always effectively communicate how we feel when witnessing someone else’s grief. However, it can be helpful to let your colleague know you’re willing to listen and support them. This can be as simple as sharing an empathetic statement, offering your time to listen, or following their cues regarding how comfortable they are talking about their loss. At the same time, it’s equally important to avoid euphemisms or statements that can minimize someone’s grief experience, such as telling them that time heals everything or that everything happens for a reason.

When a death occurs within the workplace itself, you may notice that even employees who didn’t personally know the deceased may express sadness or grief. Although it may seem unusual, this is a normal and valid grief response. Another way to navigate these conversations is to validate your co-worker’s grief and their perspectives regarding the loss. Taking the time to listen to co-workers and ensuring they feel heard and supported is important, especially since statements of invalidation can result in disenfranchised grief and further complicate an already emotional situation.

Due to the professional nature of the workplace, some people may struggle to determine an appropriate way to approach a grieving co-worker. However, it is always best to be your authentic self and communicate your genuine concern. Your co-workers will value your compassion and empathy during a painful and challenging time. If you notice that a co-worker is significantly struggling with a loss, take a moment to reach out to them. Alternatively, you can also contact your human resources department or supervisor to let them know that your co-worker might benefit from being connected to an employee assistance program for resources and mental health support.

Sources

“How to Support Employees through Grief and Loss”. SHRM. https://www.shrm.org/topics-tools/news/hr-magazine/how-to-support-employees-grief-loss 

“How to Cope in the Workplace When an Employee Dies”. Center for Grief Recovery and Therapeutic Services. https://www.griefcounselor.org/2017/11/28/cope-workplace-employee-dies/ 

“Working Through the Death of a Colleague”. Harvard Business Review. https://hbr.org/2020/11/working-through-the-death-of-a-colleague 

Before sharing information about the death of a loved one on social media, it is generally advisable to think about how sharing this information will impact the family and friends of the person who died. Another key consideration is whether sharing this news online is authentic to the preferences and values of the person who died. If they were generally a private individual, it is helpful to consider whether they would have wanted information about their death shared online. 

First and foremost, you should also consider whether family and friends have already been notified about the death and if sharing information about the death will violate their privacy preferences. A common best practice is to wait for a close family member to announce on social media first. Aiming to approach the situation with empathy and respect generally ensures that sharing news regarding the death of a loved one is navigated with a tone of grace and compassion rather than impulsivity.

Rather than posting condolences online, it is also advisable to send condolences privately shortly after the death has occurred. Allow the family to process their grief and inform other people of their loss within their own time, rather than posting this information independently without their approval. Ideally, asking for consent to share a post about the person who died is the most appropriate course of action; if you do not receive a reply or explicit consent, you should not share the news. In an effort to protect the privacy of those who knew the person who died, posts regarding the death should not include any explicit, personal, or sensitive information.

It is important to be mindful that the Internet and social media contain plenty of misinformation, even in regard to the death of a loved one. Before posting, first consider if and why the information needs to be shared publicly. When you do share, aim to only post details that have been confirmed, especially anything regarding the circumstances of the death. For example, sharing information that a loved one died due to suicide without validating that information first is not appropriate, as rumors often result in incorrect information being spread.

A helpful approach can be to simply share a link to an official obituary rather than rewriting the details yourself. This ensures accuracy and protects privacy. Similarly, it is equally important to consider who has access to the information being posted. It is generally advisable to double-check social media settings to confirm that sensitive or private information is not being shared publicly. Once information is shared, it can be difficult to control who views it and how rapidly it spreads to other individuals online.

Sources

“Death & Social Media: 10 Dos and Don’ts for Social Platforms”. Funeral Basics. https://www.funeralbasics.org/death-social-media-10-dos-and-donts-for-social-platforms/ 

“The Unwritten Rules About Dealing With Death On Social Media”. EverPlans. https://www.everplans.com/articles/the-unwritten-rules-about-dealing-with-death-on-social-media 

Creating end-of-life discussions that are inclusive and respectful of everyone requires a conscious effort. We must address barriers related to culture, language, and financial means. For this to happen, healthcare providers, educators, and advocates must work together to build genuine cultural competence and sensitivity.

To serve people effectively, professionals must first understand the diverse perspectives within a community. This process begins by acknowledging the earned distrust many groups hold towards the medical system due to a history of being denied equitable care. With this foundation, a commitment to continuous learning about different cultural beliefs and death practices is essential. Crucially, this work involves building trust with community leaders and members long before it’s needed, fostering partnerships rather than transactional relationships.

Making essential information and resources accessible is another cornerstone of inclusivity. Materials must be available in multiple languages, formats, and literacy levels. Outreach should extend beyond traditional clinical settings like hospices and into community hubs like places of worship, community centers, and other trusted local spaces.

Representation is also vital. People often feel more comfortable and understood when they see themselves reflected in those providing care. Diversifying the workforce in end-of-life care helps ensure services resonate with the communities they serve. It is equally important to prepare all staff, including translators, for these sensitive conversations, ensuring they are equipped and comfortable with the subject matter. Ultimately, an inclusive approach to end-of-life care honors the unique needs and values of every person. By focusing on greater collaboration, improved access, and deeper cultural understanding, we can build a more equitable and compassionate system for all.

Sources

“Cultural relevance in end-of-life care.” EthnoMed. https://ethnomed.org/resource/cultural-relevance-in-end-of-life-care/

“Diversity in representations and voices of terminally ill people in end-of-life documentaries.” National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109586/ 

“How do cultural factors influence the provision of end-of-life care? A narrative review.” Science Direct. https://www.sciencedirect.com/science/article/pii/S089718972300054X 

It is crucial to recognize that individuals with disabilities have the same rights as anyone else to make decisions regarding their end-of-life care. To support this right, caregivers and others should ensure that communication and support are tailored to the person’s specific needs. This means providing information in accessible formats and using communication methods that work for the individual, thereby empowering them to make fully informed decisions about their care.

Whether one is a healthcare provider, death educator, representative, or advocate, it is essential to avoid making assumptions about the preferences or capabilities of individuals with disabilities. Professionals should ensure that the individual is included in proactive discussions about their values and goals and is supported to actively participate in their care. Involving the individual with the disability in discussions and decision-making is a central component of establishing an environment where they feel heard, respected, and empowered to share their preferences regarding end-of-life care.

It is also important to consider the role and influence of caregivers or trusted loved ones in end-of-life discussions. These individuals often serve as a support system in the lives of those with disabilities. They can help ensure that needs, preferences, and wishes are recognized and understood appropriately. 

Ultimately, a multifaceted approach is necessary to make end-of-life discussions and decisions inclusive for individuals with disabilities. This requires a conscious effort to identify and challenge ableist assumptions—recognizing that many conditions non-disabled people may perceive as “worse than death” constitute a valued daily life for those with disabilities. Central to this approach is partnering with patients to make crucial decisions, which must be supported by ensuring accessibility, recognizing diverse support systems, and promoting disability awareness. Implementing these strategies helps ensure that individuals with disabilities have equal opportunities in end-of-life care planning and receive care that aligns with their own values and goals, not the biases of others.

Sources

“End-of-life decisions for people with intellectual disabilities, an interview study with patient representatives.” National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/23295812/ 

“Placing the preferences of people with profound intellectual and multiple disabilities at the center of end-of-life decision making through storytelling.” Sage Journals. https://journals.sagepub.com/doi/full/10.1177/1540796919879701

Open and honest conversations about death and dying must be facilitated and encouraged among the general public to reduce stigma. This involves acknowledging death as a natural part of life, rather than solely a medical event or something to be conquered. Ways to accomplish this include discussing advance care planning, end-of-life wishes, and the practical and emotional aspects of the end-of-life experience. Allowing people to express their curiosity about death and to ask questions in a non-judgmental space is also helpful. By normalizing these conversations, we can reduce the discomfort and fear associated with death and foster a more compassionate and realistic understanding within our society.

Education and promoting awareness are crucial in reducing stigma regarding death and dying. Some of the stigma is associated with myths and misinformation, while for other communities, it is rooted in legitimate historical trauma and negative experiences surrounding death. Providing accurate, detailed, and culturally competent information about end-of-life care, death, grief, and the concerns that surround these experiences is essential to dispelling misconceptions, acknowledging past harms, and building trust. Introducing more educational programs, death cafes, community workshops, webinars, and other campaigns are some ways to accomplish this. By increasing awareness and understanding, there can be a more significant focus on empathy and compassion towards those who are grieving or navigating their end-of-life journey, while also working to prevent past negative experiences from recurring.

Developing and fostering supportive environments is another crucial aspect of reducing the stigma surrounding death. This centers around our ability to create safe spaces for individuals to express their grief, share their experiences, express their curiosity, or ask questions. It also means ensuring that support networks and resources are more easily accessible. This includes practical support from employers through compassionate bereavement leave policies, legal aid for navigating end-of-life paperwork, pastoral care, and community-based bereavement groups for those caring for a loved one, grieving, or seeking information after a terminal prognosis. Providing this kind of comprehensive, practical, and emotional assistance helps normalize the grieving process and models the compassionate responses necessary within our society.

Ultimately, a collective effort and understanding are necessary to reduce the stigma around death and dying. It involves influencing cultural and societal attitudes towards death to take a noticeable shift, acknowledging the universal and shared experience of grief, and understanding that open and compassionate conversations are crucial for creating a supportive society. By proactively addressing the topic of death with empathy and consideration, we can foster a culture that embraces and supports individuals in their experience of grief and the end of life. 

We can overcome the fear of talking about death by promoting education and awareness, creating a safe and open environment for conversations about death, and learning to embrace mortality. Overcoming this fear is often a gradual process that occurs over an extended period of time, especially since most people have to learn to look beyond the stigma attributed to the topic of death and dying. Additionally, sometimes people have a fear of talking about death because they have an underlying fear of death itself, also known as thanatophobia. If the fear of talking about death is connected with this deeper fear of death, treatment may be needed to conquer the phobia before addressing the fear surrounding conversations.

In general, death education and promoting awareness surrounding death can be very helpful in reducing fears associated with talking about death. As people gain a better understanding of death and dying, they tend to become more comfortable about facing their own mortality and discussing death-related topics. Death education helps people understand the wide variety of perspectives, attitudes, theories, and components pertaining to death, dying, and bereavement. The provision of death education interventions has also been shown to reduce fear surrounding death while promoting more positive attitudes toward death as a natural transition at the end of life.

Establishing a safe and open environment for conversations about death is another crucial component in overcoming the fear of these discussions. Everyone holds different perspectives and attitudes towards death, which are shaped by their own experiences, culture, societal norms, belief systems, and more. Some individuals are uncomfortable discussing death due to a belief that speaking about it will make it more likely for a loved one to die. Others may be uncomfortable discussing death since it is associated with stigma or taboo within their culture. 

Creating an environment that allows open communication without the risk of criticism or judgment can help people feel more comfortable in expressing their thoughts, emotions, and curiosities about death. Attending death cafe events and seminars, visiting support groups, participating in therapy, or even having informal conversations about death and dying with loved ones can help to diminish stigma and promote honest discussions. Hearing about these experiences from public figures like celebrities and online influencers, as well as from close friends and family, can further help normalize these conversations.

Finally, learning to embrace mortality is instrumental in overcoming the fear of talking about death. Death is the natural end to life and is ultimately inevitable. Accepting this inevitability and conceptualizing how we will navigate our own experience of death and dying is a step toward achieving a healthier and more positive relationship with our mortality. Activities that encourage further reflection on facing mortality include journaling, meditation, or even exploring personal preferences regarding final arrangements. By taking proactive steps to accept mortality, individuals can gain a greater sense of peace and understanding that will enable them to engage confidently in meaningful conversations about death and dying. 

Sources

“5 Strategies for Accepting Your Mortality”. Psychology Today. https://www.psychologytoday.com/us/blog/mindful-anger/201707/5-strategies-accepting-your-mortality 

Death Cafe. https://deathcafe.com/ 

“Death Education for Palliative Psychology: The Impact of a Death Education Course for Italian University Students”. Behavioral Sciences. https://www.mdpi.com/2076-328X/13/2/182 

“Thanatophobia (Fear of Death)”. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22830-thanatophobia-fear-of-death 

“Videos”. The Conversation Project. https://theconversationproject.org/videos 

The death positive movement, also sometimes known as the death positivity movement, is aimed at dismantling barriers and fostering an ideological shift of beliefs surrounding death. The movement has roots in earlier initiatives like the hospice movement of the 1970s and has been advanced by a wide range of modern projects such as Death Cafés, Death Over Dinner, and The Conversation Project. While often associated with mortician Caitlin Doughty, who helped popularize it through her “Ask a Mortician” series and the founding of The Order of the Good Death in 2011, the movement is a collective effort. It was this broader wave of public engagement that positioned the death positive movement to become more widespread.

At its core, the death positive movement promotes open and honest conversation surrounding death, dying, grief, and loss. It emphasizes the importance of providing support after a death has occurred, and encourages individuals to engage directly in countering the conditions and circumstances that contribute to unacceptable, harmful, or otherwise preventable deaths. It embraces the role of advocacy surrounding death while also upholding the importance and value of death education. Tenets of the death positive movement were also established to ensure clarity regarding the intent, purpose, and beliefs of its supporters. 

The death positive movement is often associated with helping individuals to become more conscious of their daily living and the negative impact that traditional funeral and cremation practices can have on the environment. Since the movement emphasizes that dead bodies are not dangerous and typically aren’t a health threat, it also encourages people to reclaim the right to personally care for and handle the bodies of deceased loved ones. Many supporters of the death positive movement participate in eco-friendly death practices such as natural or green burial, human composting, aquamation, and other methods that are less harmful to the environment.

Ultimately, the death positive movement helps to foster death acceptance and empowers advocates to compassionately help other people understand and navigate concerns surrounding their mortality or the loss of a loved one. It highlights that accessible, affordable, and environmentally friendly death practices can be embraced across all cultures and backgrounds within the community. Finally, it continues to be an increasingly popular social phenomenon as many individuals continue seeking answers and an organized effort to make meaning of the ever-evolving landscape surrounding death, dying, and bereavement.  

Sources

“History of the Death Positive Movement”. Order of the Good Death. https://www.orderofthegooddeath.com/history-of-death-positive-movement/ 

“These women are leading Los Angeles in the death positivity movement”. Spectrum News 1. https://spectrumnews1.com/ca/southern-california/business/2023/08/31/the-death-positivity-movement#:~:text=People%20are%20interested%20in%20saying,in%20popularity%20during%20the%20pandemic. 

Coimetrophobia refers to the fear of cemeteries. It is characterized by intense emotional and physical distress, which may present as the following symptoms when an individual is near or at a cemetery: 

• Shaking
• Shortness of breath
• Sweating
• Dizziness
• Nausea
• Anxiety or panic attacks
• Heart palpitations
• Difficulty speaking 
• Difficulty thinking or focusing 

There are many reasons why individuals with coimetrophobia are afraid of cemeteries. Some individuals may express that they are sensitive to the presence of spirits, and being at a cemetery can be an uncomfortable or overwhelming experience for them. Other individuals may be uncomfortable being present near dead bodies and the volume of deceased individuals at a cemetery can be upsetting. It is not uncommon for individuals with coimetrophobia to also experience thanatophobia. Due to the fear of cemeteries, individuals with coimetrophobia may have difficulty completing certain activities such as: 

• Watching films or shows that depict cemeteries 
• Driving on a street or crossing a street near a cemetery
• Attending Halloween-themed events, such as haunted houses that depict cemeteries
• Attending funerals 
• Making funeral arrangements 

Individuals who have coimetrophobia but want to overcome it to attend the funeral of a loved one may pursue a few strategies to help them cope with their fear. In most instances, these individuals will experience the most benefit from working with a mental health professional who can introduce evidence-based interventions into their daily routine, such as cognitive-behavioral therapy or mindfulness. In addition to interventions and receiving treatment, having a close friend or family member attend the funeral can be an excellent source of support for someone with coimetrophobia. 

Sources

“Coimetrophobia: The Fear Of Cemeteries”. Everplans. https://www.everplans.com/articles/coimetrophobia-the-fear-of-cemeteries 

“​​Everything You Should Know About Thanatophobia”. Healthline. https://www.healthline.com/health/thanatophobia 

Discussing death and dying helps us to acknowledge the inevitability of death, which often fosters greater awareness regarding the brevity of life and the importance of making the most of our experiences while we’re alive. Many individuals realize that they want to live more authentically and to the fullest extent possible when they begin to confront their mortality. This awareness further contributes to the notion of living more intentionally and focusing on being fully present in our daily activities. 

When we talk about death, we recognize the fragility of life and the ever-present component of uncertainty in the human experience. No one is aware of the exact moment when they will die. Although we know the average life expectancy for men and women, there isn’t a guarantee that everyone will meet the projected average. When we truly begin to understand the limited amount of time that we have, it prompts us to be more mindful of what we prioritize in our lives and what truly matters to us. Instead of becoming distracted or distressed over trivial matters, a new focus emerges in relation to aligning our pursuits and actions with our values and purpose. 

In understanding our relationship with our own mortality, the presence of mortality in our relationships with other people also becomes more evident. This can present as a deeper sense of compassion and empathy for people as they face personal challenges, experience loss, or navigate the process of actively dying. Through another lens, we also begin to become more appreciative of the time that other people spend with us, realizing that these moments are not always guaranteed and sometimes we have overlooked the joy and fulfillment that exists in the most simple of moments spent with a loved one. In recognizing the fragility of life, a greater need to treat others with compassion, respect, and dignity begins to emerge. 

Although death can be an uncomfortable topic for people to discuss and approach in an exploratory manner, it is a topic that prompts us to know ourselves and other people on a deeper level. There are many valuable insights and lessons that we can learn from discussing death and dying. These conversations illuminate the vast complexities and multifaceted nature of the human experience by reminding us to live with intention, cherish our relationships with others, and pursue the purpose and beauty that life can offer us daily. 

Sources

“Talking About Death”. The Art of Dying Well. https://www.artofdyingwell.org/talking-about-death/ 

“Death literacy: why it’s important to talk about dying”. The Conversation. https://theconversation.com/death-literacy-why-its-important-to-talk-about-dying-184087 

Death is a topic that many people find difficult to discuss, yet it’s an inevitable part of life. Having open and honest conversations about death and end-of-life wishes with loved ones can provide comfort when the death experience happens, and tools such as conversation starters, books, games and discussing an advance directive can help. When talking about dying with your loved ones, planning ahead and choosing a comfortable and private place is ideal rather than “springing” the topic on someone without warning. It’s also helpful to think about what specifics you’d like to discuss, along with end-of-life preferences of your own you’d like to share.

Conversation starters about death and dying

Sometimes, all it takes is a simple prompt to get the conversation going. According to Hospice of Red River Valley (HRRV), some jumping-off points include:

• Reflecting on a recent diagnosis, hospitalization or death of a loved one — a helpful opening phrase from HRRV is: “I was thinking about what happened, and it made me realize ______.”
• If you’ve come to some conclusions about your own end-of-life preferences, you can share those and ask what their own would be. 
• You can mention that you’re thinking about the future and would like some help planning. 
• There’s also a helpful step-by-step guide from The Conversation Project you can refer to.

Bethesda Senior Living encourages being open about your end-of-life wishes — putting them down in writing and even preplanning your funeral. Sharing this information with more than one person is a helpful practice. Also:

• Try to set emotions aside in favor of practicality when it comes to discussing things like where one might want to spend their last days and funeral arrangements.
• Be willing to venture into difficult territory about forgiveness, if necessary, to avoid regrets after you or a loved one has died.

Books about the subject of death and grief

There are many widely varying books that can help you think about death and dying. If you resonate particularly strongly with one or more, you can discuss some of your favorite ideas from the book with loved ones or even share a copy. Hospice UK suggests some popular choices such as:

• Kathryn Mannix, With the End in Mind
• Atul Gawande, Being Mortal
• Sherwin B. Nuland, How We Die
• Max Porter, Grief is the Thing With Feathers
• Paul Kalanithi, When Breath Becomes Air 

And for children:

• Alec Aspinwall, I’ll be the Water

Games that open discussions about death

There are many games on the market that aim to open up conversations about death and end-of-life, which we discuss in detail in this article in our magazine.

Advance directive conversations

Consider creating an advance directive, which details exactly what you’d like to happen in the case you become seriously ill or incapacitated. You can share this document with loved ones to begin a conversation about death and dying and your preferences around end-of-life care.  

Sources

“5 Tips for Talking About Dying With Your Loved Ones”. Bethesda Senior Living Community. https://www.bethesdaseniorliving.com/senior-resources/5-tips-for-talking-about-dying-with-your-loved-ones

“Get Started”. The Conversation Project. https://theconversationproject.org/get-started

“Books to help us think about death, dying and grief”. Hospice UK. https://www.hospiceuk.org/latest-from-hospice-uk/books-help-us-think-about-death-dying-and-grief 

“10 Fun Games to Help You Talk About End-of-Life Care.” The Conversation Project. https://theconversationproject.org/tcp-blog/death-is-not-a-game-well-sometimes-it-is/

“12 Additional Must Read Books About Death and End-of-Life Care”. The Conversation Project. https://theconversationproject.org/tcp-blog/12-must-read-books-about-death-and-end-of-life-care/ 

“10 Must Reads About Death and End-Of-Life Care”. The Conversation Project. https://theconversationproject.org/tcp-blog/10-must-reads-about-death-and-end-of-life-care/ 

Some of the most effective methods for communicating values and treatment goals at the end of life include engaging in honest discussions regarding preferences, maintaining appropriate legal documentation, and collaborating with a multidisciplinary team of healthcare professionals to facilitate informed decisions. Decisions regarding values and treatment goals may shift during different phases of life or following major life events, so it is equally important to take time to reflect on your preferences, beliefs and views about death and dying prior to initiating these interactions.

Starting the conversation with friends, family, and healthcare professionals is often the first step towards effectively communicating values and treatment goals. Although this can be a difficult conversation to have with loved ones, it is an important conversation that should not be postponed or avoided. To move beyond abstract ideas, you can use guided conversations, such as card games that prompt discussions about what matters most, or scale questions (e.g., “On a scale of 1 to 10, how important is it to you to be at home?”). As you share your preferences with them, focus on explaining why you have these preferences and why they are important or meaningful to you. Taking the additional time to walk your loved ones through your thought process and the rationale behind your requests can help them understand why these wishes need to be honored both during your dying process and after your death.

Another important aspect of communicating your values and treatment goals is to ensure they are effectively and accurately documented through advance directives. Documents such as living wills or power of attorney can establish clear expectations regarding your preferences for end-of-life care, medical interventions, and life-sustaining treatments. For immediate medical decisions, a Physician Orders for Life-Sustaining Treatment (POLST) form translates your goals into actionable medical orders. In regions where it is legal, you may also explore conversations with your care team about Medical Aid in Dying (MAID). Do Not Resuscitate (DNR) orders are also important to have readily available if they align with your goals. It is important to update these documents as needed if any changes to your values or treatment goals occur over time. You will find that having these documents available will not only provide you with peace of mind regarding your preferences, it will also reassure your loved ones that they can make informed decisions during a difficult time.

Collaborating directly with the multidisciplinary team of healthcare professionals who will be responsible for your care is another recommended option for effective communication. Your care team might be physicians, specialists, social workers, spiritual care providers, and many other individuals who will use their expertise to ensure you have a dignified end-of-life experience. Working together can help them to personalize your care as death becomes more imminent and help them understand how to best support you during your final weeks, days, and hours.

There are several barriers to having effective conversations with healthcare professionals regarding the end of life. Some of the common barriers to these conversations include:

• Lack of training and education 
• Fear of impact on patients and caretakers 
• Challenges in navigating patient readiness to discuss the end of life
• Prognostic uncertainty 
• Lack of familiarity in having EOL conversations 

Healthcare professionals may struggle with having end-of-life conversations due to feeling unequipped to facilitate the discussion. The overall discomfort and stigma associated with the topic of death can make it difficult to initiate the conversation. It can be equally challenging to navigate this sensitive topic due to the intense emotions that it can provoke among patients and their loved ones. Additionally, death is typically perceived as a negative outcome in medical settings, and many physicians do not receive enough training in how to discuss the topic with patients and their loved ones. 

Another barrier that is frequently overlooked is the lack of time and resources in most healthcare settings. Healthcare professionals often have significantly limited time during and between appointments with patients, so they aren’t able to dedicate as much time to an in-depth conversation about end-of-life concerns. As the volume of patients needing care and observation increases throughout the day, the amount of time that can be dedicated to each patient gradually decreases to ensure that other patients can be seen promptly. 

Sometimes cultural and religious beliefs can be a barrier to end-of-life conversations as well. Different cultures and religions have unique perspectives regarding death and dying, which can influence the decisions that patients make regarding end-of-life care. These decisions and preferences may not entirely align with the recommendations that a healthcare professional might make when developing end-of-life care plans with the patient. However, it is important for healthcare professionals to be sensitive to the needs and preferences of their patients and to create an environment that is supportive of their wishes and goals.

Although there are numerous barriers to having effective end-of-life conversations with healthcare professionals, many of these barriers can be overcome with the provision of additional education and training. This applies not only to the healthcare professionals who need to navigate these conversations, but also to the patients and their loved ones who often need to advocate for their preferences in relation to end-of-life care. By fostering more open dialogue regarding death and dying, healthcare professionals can ensure that patients receive appropriate care and support that aligns with their values and goals. 

Sources 

“Facilitators and Barriers for Initiating Conversations About End of Life”. Palliative Medicine Reports. https://pmc.ncbi.nlm.nih.gov/articles/PMC9805848/ 

“Exploring Barriers and Solutions to End-of-Life Conversations, Advance Care Planning”. ASCO Daily News. https://dailynews.ascopubs.org/do/exploring-barriers-and-solutions-end-of-life-conversations-advance-care-planning 

“Your Guide for Talking with a Healthcare Team”. The Conversation Project. https://theconversationproject.org/get-started#Your-Guide-for-Talking-with-a-Health-Care-Team 

Open and honest communication is a personal choice when considering how to inform loved ones of a terminal diagnosis. Receiving the initial diagnosis is an intense and overwhelming experience, and deciding when and how to share this information is a deeply personal decision. The focus should be on what feels right for you—whether that means sharing immediately, waiting until you’ve processed the news, or deciding who you want to tell. Your well-being is the priority, and you are not responsible for managing others’ emotional reactions. It can be helpful to seek support for yourself in navigating these conversations.

There are a few different ways that you can share the news about your terminal illness with your loved ones. One of the most essential components is to allow enough time for the conversation to unfold. Allowing enough time for your loved ones to ask questions, express their concerns, or process what you have shared is crucial. Some methods that you can use to discuss your terminal illness with your loved ones include: 

• Requesting to have a family meeting
• Meeting individually with loved ones to share the news more privately 
• Asking if your healthcare provider can be present to help explain the information, if you feel it would be helpful and the setting allows
• Asking a friend or family member to communicate on your behalf 
• Writing an open letter to your loved ones 

Before sharing your diagnosis, it can be helpful to first reflect on a few key points. Consider with whom you want to share this news, how much information you feel comfortable disclosing, and what kind of support you are hoping to receive. This does not need to be a single, overwhelming conversation; it can be a series of smaller discussions that unfold over time.

When you are ready to talk, it is essential to be direct and use clear, easy-to-follow language so your loved ones understand your condition. If there are children present, you may consider using age-appropriate language to help them understand. You can also share details, such as a physician’s timeframe, if you feel it would help your loved ones prioritize time with you.

Throughout these conversations, you may wish to express how meaningful your loved ones have been in your life. Sharing feelings of love, gratitude, and support can be beneficial for everyone involved. Please remember that everyone processes this news differently. Your loved ones may have many questions, while others may need time to process. Some may become visibly emotional, while others may not react immediately. It is helpful to have patience with these different reactions, as they often come from a place of shock or grief and are not a reflection of their love for you.

Sources

“Life-Threatening Illness: What to Tell Family, Friends”. WebMD. https://www.webmd.com/palliative-care/life_threatening_illness_what_to_tell_family_friends 

When engaging in conversations with someone who is terminally ill, it is essential to navigate the topic with sensitivity, empathy, and respect. It is ideal to wait for the person to introduce the subject, allowing them to discuss it when they are ready and with whom they feel comfortable. They need time to process their prognosis, and it’s important to give them that space. When they do choose to talk, it is often with a trusted few, rather than feeling obligated to discuss it with everyone.

While you may have many questions, concerns, and emotions during this conversation, it is crucial to remember that the focus should be on the person who is dying. Use this time to acknowledge their feelings and the unique fears they are navigating as the dying process progresses. It may be difficult for them to express their feelings about what they’re experiencing. Hence, creating a safe space for them and holding it with compassion and support is crucial. You may use this time to gain greater insight and understanding regarding how to be supportive and sensitive to their needs. 

Active listening is essential in any conversation, especially when engaging with someone who is terminally ill or dying. Some individuals may be more reserved or hesitant to express how they feel about their death or the dying process, so it can be helpful to be mindful of verbal and non-verbal cues. Asking open-ended questions can help them elaborate more on what they are experiencing and how they feel. It can also be helpful to rephrase or repeat what they say to confirm that you understand their meaning. 

Additionally, avoiding offering advice or making statements with cliches or euphemisms is essential. It is not possible to fully understand what the other person is experiencing since they are navigating their death, and every experience is unique. Making a cliche statement or providing advice can come across as minimizing what the dying individual is experiencing, so allowing them to lead the conversation is a best practice. Ultimately, the goal in discussing death with someone who is terminally ill or dying should be to provide them with additional support and compassion during a time when they feel incredibly vulnerable. 

Sources

“What to say to someone who is dying”. Optum Perks. https://perks.optum.com/blog/how-to-talk-to-someone-who-is-seriously-ill-or-dying 

“Talking to someone about dying.” Marie Curie. https://www.mariecurie.org.uk/professionals/palliative-care-knowledge-zone/talking-about-dying#listening 

“Thoughtful Ice Breakers That Lead to Meaningful Conversations”. The Conversation Project. https://theconversationproject.org/tcp-blog/thoughtful-ice-breakers-that-lead-to-meaningful-conversations/ 

“11 ideas for when someone is having a hard time talking about their wishes for health care”. The Conversation Project. https://theconversationproject.org/tcp-blog/11-ideas-for-when-someone-is-having-a-hard-time-talking-about-their-wishes-for-health-care/ 

“What Matters to Me: A Workbook for Better Healthcare”. The Conversation Project. https://theconversationproject.org/wp-content/uploads/2025/05/TCP_WhatMatterstoMe-Workbook_English-v2-5.25-Updated.pdf 

Talking about death and dying can be challenging and uncomfortable for many people. In Western society, discussions about mortality are often considered taboo or unsettling, leading to a culture of avoidance and silence around the topic. When we do talk about death, we use euphemisms and vague language. Instead of saying “died,” we use phrases like “passed away,” “no longer with us,” or “lost.” This can soften the impact of the reality of death, but at the same time, it reinforces the avoidance of a subject that everyone must eventually confront. 

Many people also harbor an almost superstitious fear that talking about death will somehow magnify their mortality — that saying the word out loud somehow makes them more vulnerable to illness and death. This irrational fear almost certainly stems from the fact that talking about death does make it seem more “real.” But rather than making us more vulnerable, acknowledging the reality of death is empowering. It allows us to examine how we want to live through the end of our lives, and likewise, have frank discussions that are necessary with the people who are important to us.

The Impacts of Avoidance

Avoiding discussions about death can have negative impacts both on individuals and society as a whole. Despite numerous accounts of “near-death experiences,” no one has ever come back from being fully dead to describe what it was like. So thinking about death triggers a fundamental human fear — fear of the unknown. From an evolutionary standpoint, this fear makes perfect sense. Avoiding unpredictable situations kept our early ancestors safe from all sorts of dangers and predators. Even today, moving cautiously into the unknown is generally more prudent than rushing headlong into a situation we know nothing about. 

But avoiding the things we fear can also be self-defeating — keeping us stuck and unable to move forward with our lives. Similarly, by not exploring what it is that frightens us about death we run the risk of being stuck in avoidant thought patterns and behaviors that numb us to the fact that we are all going to die. And that avoidance leaves many of us totally unprepared when we come face to face with death — our own or that of someone we love. 

Developing “Death Literacy”

Death literacy is a term used to describe the knowledge, tools and resources necessary to successfully navigate end-of-life options and care. First introduced in a 2022 Lancet Commission report from a worldwide consortium of experts in end-of-life, it is based on the conclusion that, in our society, healthcare providers have “medicalized” death to the point where it is no longer viewed as a natural and normal part of life. Trained to fight death to the end, healthcare professionals often fail to provide individuals with frank information about when to shift their focus from curative to comfort care. They are often slow to introduce palliative care, which can begin at diagnosis, and far too slow to recommend hospice care for individuals who are clearly at the end of their lives. As a result, our society is enculturated to think of illness and frailty as battles that we can win. Death doesn’t enter into the conversation until the very end, when the opportunity for exploration and meaningful conversations about the end of life is all but lost.

Developing death literacy is essential to both individuals and communities. Individuals cannot make truly informed choices about how they wish to live at the end of their lives unless they understand the full range of options, including the potential benefits and limitations of aggressive, life-prolonging medical care. It is crucial to recognize that for some, particularly those from groups historically denied care, a “full court press” is a deeply valued choice. Conversely, communities and society can face challenges when the healthcare system defaults to expensive, aggressive treatments without ensuring patients and families fully understand the potential outcomes. As Michael Connelly, former CEO of Ohio’s Mercy Health, said in an interview with Hospice News, “No dying person should be in the ICU.” This perspective highlights a concern that many are not offered alternatives, yet our ICUs are filled with people who are dying. Twenty to 30% of individuals admitted to the ICU never go home, underscoring the importance of ensuring all options, from aggressive intervention to comfort care, are understood and accessible.

Developing death literacy, therefore, begins with an understanding of the reality that life is finite and modern medicine, no matter how sophisticated it becomes, cannot extend life indefinitely. It also includes adopting a new healthcare paradigm that acknowledges the reality that the “more is better” approach to care at the end of life is deeply flawed. While eighty percent of Americans say they want to die at home, only 25% actually do. This discrepancy is not just a matter of ignored wishes; for many, it is not medically, physically, or financially possible. This gap cannot be closed unless we begin to talk about death and how we wish to live—both now and at the end of our lives—while also advocating for systems that make those wishes achievable. 

Talking About Death

Talking about death is challenging, especially with the ones we love. But framing the discussion in terms of how we want to live through the end of our lives can be far less daunting and offers opportunities for honest communication about values and goals. By sharing our vision for the rest of our lives with our loved ones, we create a bridge to discussions about how we want the end of our lives to unfold. 

Before we can even start a conversation, however, it is essential that we take inventory within ourselves. In ancient times, this process was outlined in a body of religious literature titled “Ars Moriendi,”  or “the art of dying,” which was written in the aftermath of the bubonic plague. The plague killed an estimated 50 to 200 million people between 1346 and 1353 — nearly two-thirds of Europe’s population at the time. In its wake, the clergy felt compelled to warn parishioners that the time to prepare for dying wasn’t some time in the future, but now. And the way to do so was to learn to live well so that they could die in a state of repentance and grace.

There have been many iterations of Ars Moriendi through the centuries, but the concept of living one’s life according to a value system that reflects one’s deepest held beliefs has persisted throughout. As bioethicist and physician Lydia Dugdale explained in an interview with SevenPonds, 

“…The underlying theme was always that one needed to attend to living well to die well.That meant thinking about what kind of character or habits you wanted to cultivate. Were you a person of integrity, of honesty, of solidarity? Did you invest in your community? Then there were the more existential questions: Why are we here? What is this life for? The idea was to think about these things in the context of your community so that you would cultivate a sense of peace throughout life, instead of arriving at the end in spiritual or existential distress.

In other words, the art of dying well is really a matter of living well to the end. Thus, exploring what gives your life meaning today can help you explore and discuss what you would like your life to look like when you are nearing its end. 

Some questions that may help you formulate your thoughts about these important matters are listed below. As you reflect on your answers, consider how they can help you shape your life now and in the future, including as you approach the end of life. 

• What does a good day look like to you? What relationships and activities add pleasure or meaning to your life?  
• What parts of your life do you believe are essential to your well-being? What would you not want to live without?  
• What are the three top values you live by? 
• What or who gives you comfort when you are going through a hard time? 
• Who do you turn to for support and advice? 
• Do you have any regrets? How would you remedy them if you could? 
• What is your purpose in life? What important roles do you fulfill? 
• If you were going to die soon, who would you want to speak with? What would you want to say? 
• What three words would you use to describe how you would like to be remembered after you die? 

Once you have explored these ideas sufficiently, you can share your reflections with your family and loved ones. If you’re not sure how to begin that conversation,  you may want to try saying something like “I just answered some questions about how I want to live the rest of my life and how I want the end to look. I would love to share my answers with you. I’m also wondering what your answers would be. Can we find a time to talk?”

Talking About End-of-Life Care 

Beyond general discussions about values and goals, talking honestly about death should include conversations about specific scenarios that may arise as one nears the end of life. This can be an outgrowth of a values-based conversation or a separate discussion if that seems appropriate. The goal in either case is to try, to the greatest extent possible, to determine what kind of medical care you would or would not want if you were seriously or terminally ill. 

The Conversation Project, a public engagement initiative of the Institute for Healthcare Improvement, offers a number of excellent free tools and resources in multiple languages to help individuals and families start conversations about goals of care. The Conversation Starter Guide, for example, includes a number of questions about how involved you wish to be in planning your care and the level of care you think you would like to receive if you were seriously ill and close to death. It is an excellent resource that can help you and your loved ones to focus on the questions that may arise if you need medical care. It also offers useful suggestions about how to begin the conversation, tips on what to discuss and how to follow up after your talk. Some issues you may want to discuss include:

• How much information do you want your provider to share with you about your diagnosis and treatment?
• How involved in treatment decisions do you want to be? 
• Do you want accurate information about your prognosis or would you rather your healthcare team keep that information to themselves?
• Do you want to know if your illness is terminal? 
• If you were seriously ill and unlikely to recover, how much care do you believe you would want?
• If you had a choice, where would you like to die?
• Who do you want to be with when you are dying? 

The Conversation Project also offers a conversation guide for caregivers of people with dementia who wish to begin a conversation about values and goals of care. There are other guides as well, including a guide to choosing a health care proxy and a guide for caregivers of children who are seriously ill. All of the guides are available to the public at no charge.  

Talking to Children About Death

Children are exposed to death in many ways. In our society, especially, children regularly see depictions of death, both real and dramatized, in movies, television shows, video games and on the news. This is a shift from the past, where children living in multigenerational households or on farms often witnessed the natural cycle of life and death as a more integrated part of daily life. Today, they have “active shooter drills” in school, and far too many of them have witnessed violence and death on the streets where they live. During the COVID-19 pandemic, millions of children across the globe saw their parents, grandparents and other relatives die. And according to recent research, over 1.4 million children in the United States alone lose a family member to drug overdose every year.

When we don’t talk to children about death, these encounters can be frightening or overwhelming. Additionally, they may encourage inaccurate beliefs or fantasies about what death really is. Even very young children may have questions about what they have witnessed or heard but be reluctant to voice them because the prevailing social paradigm is that talking about death is “taboo.” On the other hand,  the more openly the adults in a child’s life talk about death and dying, the more likely it is that the child will feel safe discussing their questions, concerns and fears. 

Talking to a child about death can feel daunting, but it is possible to have a frank conversation if you approach it in a calm, unemotional way. This is far more likely to occur if you bring up the subject before the child is exposed to the death of someone they love — talking to a grieving child about losing a loved one is far more difficult than explaining the concept of death in more abstract terms. 

In either case, conversations with a child about death should be, first and foremost, age-appropriate. To learn more about children’s understanding and behavioral needs at specific developmental stages, see our article “How Can I Talk to My Children About Death”  in the topic Grief and Loss.

Additionally, there are many excellent books about death and dying for children and young adults that can help you broach the subject with children. To find a selection of books SevenPonds has reviewed, visit our Healing Library and browse the section Books for Children About Death. 

Promoting Death Positivity 

Death positivity, like death literacy, is a term that was coined in the not-too-distant past as a way to help people in our society return to the realization that life inevitably ends. As recently as the 1900s, death was a regular occurrence in everyone’s lives. There were few hospitals and no ICUs, and people who died were not brought back to life with sophisticated treatments and hi-tech machines. When an individual became ill or injured, they were treated by a local physician in the family home and cared for by family members and friends. If the doctor could not cure them, that is also where they died. Death was, in a genuine sense, a part of life. 

Since the mid-20th century, however, illness and death have been medicalized to the extent that most people never think about the fact that everyone dies. Those who talk openly about death are often viewed as morbid or “weird,” and their attempts to engage friends and family in death-related conversations are typically poorly received. Sadly, it is generally not until a loved one is diagnosed with a severe illness or someone dies that a conversation takes place.

It is possible, however, to overcome others’ reluctance to talk about death if you approach the discussion with confidence and sensitivity. Start from the premise that talking about death is valuable, and avoiding it promotes uncertainty and fear. A simple statement like “I know you may think it’s morbid, but I believe we need to talk more about death. After all, we are all going to die someday,” can be a great conversation starter. You can also approach the subject with a question, for example, “Have you ever wondered what it’s like to die?” Understanding that many people are more afraid of the process of dying than they are of death itself is also a place to start. You may even introduce humor into the conversation, saying, “ I don’t think I’ll mind being dead, but I am not thrilled with the idea of getting there.” The goal is to normalize death as a natural part of life and to help others become comfortable with thinking about how they want to live their lives right up to the very end. 

Another way to promote death positivity is to participate in death-related community events. One example: death cafes are community-led events where individuals gather in an informal setting to talk about death in a confidential, non-judgemental atmosphere. They are sponsored by the nonprofit “social franchise”  Death Cafe, which lists events all over the world. You may search for a death cafe near you or, if none currently exists, organize one yourself. The website offers a free guide to help you plan, organize, promote and run a death cafe session that walks you step-by-step through what you will need to do. If you have the time to travel to a national conference, you may also want to look into End Well, a nonprofit dedicated to enhancing death awareness and death positivity that hosts an annual symposium about end-of-life issues each year.

Summary

In summary, conversations about death and dying are still largely taboo in Western society, much to our collective detriment. When we avoid talking about death, we feed into the uncertainty that underlies many of our fears. On the other hand, open conversations about death and dying promote death literacy and provide us with the tools, resources and language to express our values and goals. This, in turn,  allows us to explore our attitudes about dying and consider how we want our own end of life to unfold. Most importantly, it brings us face-to-face with the finite nature of all things and allows us to live and die with an attitude of acceptance and grace. 

Sources

“Why we’re so terrified of the unknown”. BBC. https://www.bbc.com/worklife/article/20211022-why-were-so-terrified-of-the-unknown

“Developing death literacy.” Progress in Palliative Care. https://doi.org/10.1080/09699260.2015.1103498

“Lancet Commission on the Value of Death”. The Lancet. https://www.thelancet.com/commissions/value-of-death

“Ars Morendi”. Encyclopedia of Death and Dying. http://www.deathreference.com/A-Bi/Ars-Moriendi.html

“More Than 1.4 Million US Children Have Lost a Family Member to Drug Overdose”. American Journal of Public Health. https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2024.307847?emci=1cb67e19-327c-ef11-8473-6045bda8aa34&emdi=f0578699-7d85-ef11-8474-6045bda8aae9&ceid=1944680

“Former Mercy Health CEO: U.S. Needs to Embrace ‘Death Literacy’”. Hospice News. https://hospicenews.com/2023/11/21/former-mercy-health-ceo-u-s-needs-to-embrace-death-literacy/ 

“In the ICU, what is a good death?”. Northwestern Now. https://news.northwestern.edu/stories/2024/03/what-is-a-good-death-in-the-icu#:~:text=Critical%20Care%20Medicine.-,Approximately%2020%2D30%25%20of%20people%20who%20die%20in%20the%20U.S.,of%2Dlife%20care%20actually%20delivered.