Starting conversations about the end of life: Practical tips from Marie Curie staff

Do you actively avoid having conversations around death and dying? If you do, you’re not alone – according to new research, over 40% of adults in the UK do too.

You might be worried about getting emotional, not want to upset or burden someone, or worry about saying the wrong thing. Or you might just not know where to start. But almost a third of people regret not having these conversations with family and friends before it was too late.

For tips on how to spark these conversations, we spoke to the people who have these conversations up and down the country each day: Marie Curie staff. Their tips include…

When it comes to starting conversations, there’s no ‘right’ time,’ says a Healthcare Assistant in Moray, Scotland. But talking about it ‘sooner rather than later’ can be helpful.

‘Ideally before crisis arises,’ says a Marie Curie Palliative Care Pharmacist in Cardiff. ‘Having these discussions when everyone is healthy can remove the emotional burden and urgency, allowing your loved ones to clearly understand your preferences regarding medical care, living wills, and funeral wishes.’

‘But,’ says a colleague in London, ‘be sure to find out if the person close to you is ready and willing to talk about it. There’s never a “right” time, but it’s always best to engage as soon as possible.’

Take one of our Edinburgh-based Occupational Therapist’s advice: start talking ‘anytime at all. Everyone should be talking about it to normalise future planning.’

You don’t need to wait for something specific to come up – everyday topics can get you started. ‘Use natural everyday triggers like personal experiences, news stories, personal values,’ suggests a Healthcare Assistant in Essex.

Anything can be a jumping off point according to a Belfast-based Clinical Nurse Specialist. ‘During dinner, what would you want as a last meal? During a movie, who would play you in your life movie? On holiday: where would you like to go to before you die?’

‘Music can be a good opener: discussing what music they like, and then if they have thought about what music they want at their funeral,’ says our Occupational Therapist. ‘Or talking about what matters to them, and then leading this into what would matter to them if they became seriously ill. Use a news story, or own personal experience, to make the conversation feel less intimidating.’

Everyone knows these conversations can be tricky. Nearly 30% of us worry about saying the wrong thing in these situations, but no one expects the perfect words.

‘Let the person know it’s not easy to talk about and that we’re all human. Take deep breaths, remembering it’s ok to feel this way. It’s a tip to be applied not only to the person you’re talking to, but to remind yourself it’s not easy to talk about too.

And often, you don’t need many words at all. ‘Be an active listener,’ says our Moray Healthcare Assistant. ‘You've asked the question, now listen to the answer. Pauses or silence are okay. Not every moment has to have talking in it.’

‘"I understand" is a common phrase people use in conversations, but it’s unlikely you actually understand,’ says our Cardiff Pharmacist. ‘“I appreciate” can be a better phrase.’

It’s important to be empathetic, but remember that we can never fully understand what someone else goes through– nor should we pretend to.

‘Everyone’s experience is their own. We may all have the same experience, but we will feel it and go through it our own way,’ says a lead Allied Health Professional at the Marie Curie Hospice, Newcastle. ‘Try not to bring your own experience with grief or supporting a loved one who’s ill into it, as everyone's feelings and situations are very different.’

If the conversation doesn’t go as you hoped, ‘don’t get anxious or upset about it,’ adds the Allied Health Professional. ‘Things don't always go to plan and that's okay. It doesn't mean that future conversations won’t go to plan, just that one at that time. The person may not have the energy, time or head space to talk at that moment.’

‘If the conversation isn’t going well, be honest about it,’ suggests a home-based Peer-Support Officer. ‘Say, “Can we start again? Would you like to leave this until another time?” Forcing the conversation can lead to more upset and possibly an argument.’

‘Pause,’ says our Essex Healthcare Assistant. ‘Validate and recognise others’ feelings. Don’t push the situation. Step back and try again later when everyone is ready.’

Marie Curie has teamed up with Superdrug to set up free pop-up nail bars and show that the simple act of sitting with someone – like having a manicure – is an opportunity to open up and have difficult conversations.

Marie Curie and Superdrug’s free pop-up nail bars will be live on 20 August in Superdrug Silverburn and Superdrug Cardiff St David’s. Book your Mani Curie manicure here.