Very stimulating to discuss end of life questions with an audience made up of those who provide services for the aged.

We were at a networking breakfast meeting organised by Louise Mace, managing director of New Way To Stay, held on Thursday, November 14.

The talk zeroed in on the way the elderly are often sidelined in discussions about their own illnesses and bodies. Yet illness is more likely as we age and the older we get, the more likely we are to die of illness.

How do we invite big conversations (forget about end-of-life questions – threatening and difficult at the best of times) – if discussions of any sort are not led and encouraged in the group environments that the aged live in?

A psychologist in the audience, who specialises in working with the elderly, observed that when she started her professional life she was the only psychologist she knew whose practice was for the elderly. Yet psychologists can help people come to terms with life as they age and help improve it – as well as encourage healthy reflection on what their life means.

The representative of a palliative care organisation asked “how can we spread the message that palliative care is not just for the very end of life?”

It’s a good question. There are now many people in our world who have had several hospital admissions and each time left hospital to live well, despite their terminal illness, because of the support of palliative care. Paradoxically, many of these do better than those who are afraid of the idea of palliative care.

Why do we wait for a royal commission into aged care to observe what we already see, that the elderly are devalued. How do we make cultural change?

A way to overcome these social problems is to take these conversations outside of hospitals – and into the community. To bookshops and libraries for example!

And here’s a couple of  ‘what ifs’.

• What if we all knew our rating on a frailty scale index, so we can practise how to stay in control of the discussion about our health, even when we’re very old?
• If we can’t talk about the death word, this usually goes hand in hand with not being able to talk about diseases and diagnoses as they emerge in old age. What if we encouraged people to talk directly about these, even for example, their dementia?
• What if we had a death rating system for nursing homes, where the place’s capacity to handle an expected death was scored, like the rating system for food service in cafes? There might be five stars awarded. One would be for how easy it is for families to raise the subject of a future death with staff. One would be for how well the institution handles the existential questions that arise for patients (what is the meaning of my life?)

For advice and advocacy for older Australians New Way to Stay has an easy to navigate website.

Watch how the service helped Lisa Cohen, daughter, here.