Talking about the end of life: advice from our nurses

We don't just offer care, but also support for people living with a terminal illness. Here we have some expert opinions on having “the big conversation” around end of life wishes, to help give you some support in this difficult time.

Hospice nursing

The National Council for Palliative Care and Dying Matters Coalition undertook a survey of over 2,000 adults recently. Although 52% agreed they have become more comfortable in the last five years talking about their own death, or that of people close to them, only 35% had made a will and 45% admitted that discussing death made it feel closer.

We know there are still barriers to conversations about death and dying, but 67% said they would help someone organise or record end of life plans, while 61% felt they knew someone with whom they could discuss their own plans.

So the willingness to help each other is there and we have called on some Marie Curie Nurses to give their advice:

“People don’t like to talk about dying – it’s like the old saying about death and taxes! I find once the conversation starts, people really open up. But it’s about finding a safe way to start that conversation, and the right time to start it. You have to give people the space to explore how they want to start that in a way that suits them.”
Clare Horgan is a Senior Healthcare Assistant, working in people’s homes around Essex
“It's all about getting them to look into the future and asking questions like ‘Have you had any thoughts about where you would like to be looked after, once we get your symptoms under control?’ and ‘If your condition changes…?’”
Sue Stirzaker is a Ward Sister at the Marie Curie Hospice, Liverpool
“Aiding these conversations is a big part of my role and we get advanced communications training. Sometimes patients bring it up themselves and it's best to let it come up naturally – don’t jump in too quickly. The conversation around place of care is a good opportunity for addressing other issues.”
Tracey Frost is a Community Clinical Nurse Specialist, based at the Marie Curie Hospice, West Midlands
“They need to come to terms with what is happening first. Then it’s about looking at the big picture and setting realistic goals, even if it’s just with your GP. People nearing the end of life don’t want to frightened, but I think that having these conversations can take some of the fright away.”
Sarah Reynolds is a Senior Healthcare Assistant, working in people’s homes around Cardiff and the Vale
“Honesty is the best policy – there will be things you'll wish you’d said and this is the moment. It's a very personal and private thing, so it’s all about breaking down those barriers, and a booklet can help to prompt the difficult questions. Remember: the journey of a thousand miles starts with a single step.”
Bill Dynes is a Staff Nurse at the Marie Curie Hospice, Liverpool
“I visited a family recently who'd clearly already had the conversation, which was really helpful. I try to open up conversation without expecting answers right away, such as: ‘Have you thought about what might happen if…?’ and ‘How do you think they would manage if...?’"
Judith Odwin is a Community Clinical Nurse Specialist, based at the Marie Curie Hospice, West Midlands

If you are living with terminal illness, or caring for somebody else, we have information and advice for planning ahead, or you could call our Support Line on 0800 090 2309 (open Monday to Friday 8am to 6pm, and Saturdays 11am to 5pm).