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Call the death midwife

70-80 per cent of people in the western world want to die at home, but only 16 per cent actually do. Could ‘death midwifes’ help us re-claim death?

By Cat Rodie
There is no point beating about the bush. We’re all going to die at some point. And while we can’t do anything to change that, we can take steps to ensure that when the time comes, it is a ‘good death’.
Of course we probably all have different ideas about what a ‘good death’ might look like. But according to the Grattan Institute’s Dying well report, a good death includes elements such as dignity, privacy, access to spiritual or emotional support and a chance to say goodbye.
An increasing number of terminally ill people have been engaging a spiritual palliative care specialist or death midwife.
Sharon Tregoning is the director of Design Your Own Death. She says that death midwifery is essentially being with someone as they die and being “fully present” to their needs.
“It’s driven by the person who is dying and their loved ones. There is no standard approach. It’s about where they are in their journey and whether or not they are at peace with it,” she says.
Tregoning says that in the 21st century, death has been too medicalised.
“Health care was designed to deal with disease, not people.” She explains.
“They don’t look at the patient and their experience.”
The reality of this is that in many cases the dying are isolated. Most people die in hospitals or nursing homes, not in their community.
Tregoning says that the role of the death midwife is to bring death back into the community.
“We don’t even talk about death anymore,” she says.
In fact, Tregoning says that death has become such a taboo that people have no idea how to behave around a dying loved one.
Although it is a little morbid, the idea of planning your own funeral is now quite well accepted. Some funeral homes have built their business on the premise that you should pre-plan your own funeral to avoid the inevitable grief it will cause our loved ones.
And it’s not just the funeral logistics – it is common for the dying to request hymns or prayers for their own funerals.
But while having a say in your own funeral arrangements is common place, the concept of designing your own death is still confrontational.
“We plan holidays, we plan pregnancy and birth, why don’t we plan for a good death?” says Tregoning.
Most Australian states and territories have a health directive that can capture your medical wishes. But the non-medical wishes are just as important. Tregoning suggests that people also fill in an end of life plan form that asks questions such as where you want to be and who you want to be present (Tregoning notes that asking ‘who don’t you want to be present is also important.)
The reality is that a huge proportion of deaths happen suddenly, with no warning. So when you do have the opportunity to plan for your own death then Tregoning says you should make the most of it.
“It’s an absolute gift – create precious memories that will be treasured forever, work out what you do and don’t want and then make it happen.”
Of course no one really wants to confront their own mortality – but Tregoning hopes that over time this will change.
“If we can accept that we are going to die, then we can focus on living well, living consciously and living a good life,” she says.
“We can do death better.”
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