Death may have no dominion, but what about dying?

David Lynch


David Lynch

Death may have no dominion, but what about dying?

We wake the dead better than the rest, that's for sure. We take personal loss on the chin like a true heavyweight and jab a quickfire joke in reply, if needed. Death simply has no dominion over us Irish.

And there is something rather special about how this nation deals with death. As befits our collective personality, we can draw humour from the darkest of moments and situations. That's not to say we don't grieve and feel the searing pain of loss as much, if not more, than most.

No. We hurt, We bleed. We cry.

It's just that we cannot and will not let it better us in the long run.

You'd think that this stoic, 'devil may care' approach would be of huge benefit for those days, months, perhaps even years leading up to the inevitable. But it doesn't seem to. We have a particular problem dealing with a decent 'exit strategy', so to speak.

By 'exit strategy' I'm talking about how we deal with the growing problem of an older population requiring daily assistance as they approach the end of their lives. The standard course of action goes depressingly - but not always - like this:

An elderly relative begins to need more attention at home due to failing health. This is followed sometimes by an unfortunate accident or medical emergency which places that person in a hospital for a period of time.

Recovery is, naturally, slow. With further failing health a family member steps in to assist on a daily basis back at home. Of course, with a full-time job themselves this is a heavy burden which can only go on for so long. Tag-team family support is implemented.

District care nurses slip into the picture now as the level of care needs to be ramped-up. As this inevitable escalation increases the obvious final outcome is a nursing home.

There is something almost mechanical and coldly industrial about this process. It feels more like dealing with a defective product than a person.

'Have you tried this yet?' Yes?'

'Okay, then try step 2. If that doesn't work, we'll look at step 3.'

It's all so tiring and predictably heartbreaking for everyone concerned. It misses the point entirely. And what is that point, I hear you say?

That it is inevitable.

This is going to happen to us all in the end. So why do we tip-toe around it so gingerly?

Yes, it is uncomfortable and yes it hurts so very much to watch a loved one struggle terminally, but again it will visit us all - if we're actually lucky enough to live a long and fruitful enough life up to that point.

Perhaps the next generation of elderly people will have it better when they arrive at this stage. Preparation and financial planning is important of course. But it's only a part of any solution.

We need to change our cultural approach to the act of dying. Dying does not take place over a few hours or days as a family holds vigil around the bedside of a loved one. Dying is a part of life.

Again, not to dampen spirits here, but we are all born to die. The quicker we realise this the sooner we can better deal with dying and give people the deserved support and investment - emotionally, culturally and financially.

The system needs changing too. The people within it - the nurses, the carers and the numerous other health professionals who make up this 'end of life' universe - are not being given a fair crack of the whip. They, equally, deserve much better from us.

The situation we find ourselves in right now is far from ideal, but it would be so many more times worse without those diligent and hardworking people who expend their time, energy and emotions on what are essentially strangers.

We shuffle elderly people off to nursing homes that are walled-off and out of sight of the rest of the population. We cannot countenance the idea of having to witness mortal demise on a daily basis.

But it's not like this everywhere.

In France, for example, quite a few nursing homes have been built right next to schools in recent years. This is a wonderful and simple development. Both the youngest and oldest in our society can co-exist in daily life, this can only be good thing for all. Basic inclusion is all that is at work here.

And here's a second one from another of our continental neighbours.

In Holland, college students can live rent free in nursing homes on the basis that they spend 30 hours a month in the presence of the elderly residents. Essentially the students get free accommodation in return for hanging out with people in a social context. It makes such undeniable sense.

Not only does this ensure that the staff at these homes can focus on providing the very best of primary care, but the residents of the homes get to spend some much-valued time with young people. Meanwhile the students get to foster a real appreciation for the older people in their society in return.

And all this doesn't even begin to look into the massive financial benefits for both the state and the individual.

Something similar to the above, in this country, would go some way towards stopping what are increasingly being termed 'care ghetto's' from expanding.

Education is vitally important before any of this can become a reality, however. We must impart in our children the understanding that older people are valued and important members of our society - they deserve reward for what they have contributed, not banishment.

In recent years, many primary schools in Ireland have started to take this on board with 'Grandparent Days' becoming an important part of the calendar year for many schools throughout the country.

Of course without the will of the people and the strength of a government to look into this issue and push for real change, none of this will materialise.

The phrase 'respect your elders' is something we need to take real heed of.