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End of life in aged care facilities

The last thing that will happen to us is that we will die. And for the very elderly it is likely to happen very soon. Yet there’s a cone of silence on the subject.

While some aged care facilities are now doing ‘guards of honour’ to acknowledge the deaths of other residents, others still follow the more established practice of whisking bodies away in the middle of the night, as though hiding the death will suppress fears and questions.

It’s wrong to assume the elderly in aged care facilities don’t want to talk about death. Yes, some definitely do not, but many do, according to clinical psychologist Jane Turner.

Jane has found that the older people are when they enter an aged care facility, the less likely they are to have had the opportunity to discuss death and dying: “Yet end of life issues, unsurprisingly, can cause great anxiety.” 

“It is very important that we give our old aged residents the opportunity to talk about these things. The importance of talking about this with residents and their families, in aged care facilities in our communities today, is completely overlooked.”

Typically, 66 per cent of aged care residents are depressed at the time of death, yet there are very few referrals to psychologists to help the elderly deal with their issues, because we normalise depression in old age, so there is difficulty accessing funding for psychologists working in this space.

In the typical aged care facility up to 75 per cent of operational spending goes on wages, which leaves only 25 per cent for everything else, including these important services. Maybe this could change.

Other ways to improve conversations around death would be to have carers who are equipped to deal with questions of emotional and psychological well-being. The latter subjects are not currently included in a Certificate III in Aged Care, the most common qualification for such workers.

Even without psychologists we could engage people with more relevant conversations in late life, including conversations about death, helping people talk about their ideas and their fears.

We could invite families to be part of these discussions too. There could be information put on noticeboards to invite family members to talks, to develop the language and other skills to talk about end of life issues.

All these initiatives could have the counter-intuitive effect of actually decreasing the rate of depression and anxiety in aged care facilities.

Jane Turner blogs at:https://amazingageingpsychology.com.au/blog/

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