An angel figurine tops a headstone at St. Peter's Cemetery, New York. CNS photo/Gregory A. Shemitz

Family discussions about end of life are vital, says study

  • May 9, 2018

When Katherine Arnup’s mother had a brain aneurism in 1990, she and her siblings were faced with tough choices.

The family never really talked in detail about it, but her mother had always feared being a burden to her children. It was a hard decision for Arnup and her siblings, but they knew they were respecting her wishes when they waited for her to die. But when she didn’t, the siblings decided to opt for brain surgery.

Arnup said their mother never fully recovered, but she lived a joyful life for another 26 years. 

“She had a lot of joy in those years,” said Arnup. “I’m glad that’s the decision we made, that’s for sure, and I guess the biggest lesson out of that is you don’t know what’s going to happen. You can’t really plan 100 per cent.”

With 16 years of experience as a hospice volunteer under her belt, Arnup said there is no “one size fits all” answer to address the needs of dying people and their families. A person cannot plan for every eventuality of their end-of-life care, but it is important that these desires and fears be addressed in a healthy manner.

“Dying is a community effort and it always has been,” said Arnup. “It takes a village to help a dying person just as it takes a village to raise a child.”

On May 8, the Vanier Institute of the Family published an updated research study on “Family Perspectives: Death and Dying in Canada.” Arnup wrote the study as an update to her 2013 report. 

The biggest difference between the reports, Arnup said, was that in 2013 the topic of death and dying was still taboo. Since assisted suicide, or so-called medical assistance in dying (MAiD) was legalized in June 2016, the silence has been broken. 

“The issue of death has been increasingly in the public eye, in particular in medical assistance in dying, but also about palliative care, around talking about death,” she said. “Death and dying have a huge impact on families, so the Vanier Institute felt it was very important …. I think this is the largest report they’ve done.”

The 2018 study examines the different aspects that shape how Canadian society deals with death and dying. Like most Western countries, Canada is facing a demographic shift. 

A 2016 study from Statistics Canada indicated that a 53 per cent increase over the past 15 years in people 65 and older. The increase in the over-85 population has been 85 per cent. 

Arnup addresses the common fears people have about aging and how dying impacts the community.

“A lot of people say, ‘I just want to die in my sleep,’ or ‘I want to die suddenly and painlessly.’ Well, it doesn’t look like that,” said Arnup. “About 10 per cent or less of people die suddenly and the rest of us don’t.”

For most people, the period of dying is on a “continuum of aging” and because of this, most people have fears that creep in the back of their mind about their deteriorating ability and becoming a burden to their family. Arnup said it is never too early to bring up these discussions so the family can be better prepared to deal with the challenges ahead.

Fr. Don Renzo Pegoraro, chancellor of the Pontifical Academy of Life in Rome, says there is a stigma that sees aging as a disability. 

Without their autonomy and cognitive capacity, older people have a fear of being “a vegetable” and “dying without dignity,” he said in a lecture May 3 at University of St. Michael’s College in Toronto.

The Catholic Church teaches to value elders as “riches of the Church” because their wisdom and experience deserve the utmost respect. However in Western countries, like Canada, the senior population is often isolated 

According to the 2016 census, for the first time one-person households were the most common type of household. For our senior population, almost one-third of senior women (33 per cent) live alone, a 31-per-cent increase from 2006. About one in six senior men (18 per cent) live alone, which is up from 11 per cent in 2006.

Pegoraro said this societal trend can emphasize a great spiritual challenge of aging that we, as a society, cannot overlook. 

“More people go through ‘existential modalities’ when faced with death,” said Pegoraro. “So we are talking about the dying process, about the medical process, but we don’t speak too much about the meaning of death.”

There has been a growing tendency in society, he said, to see death as a thing to control and less as an intelligible part of a meaningful life. No matter what the religion, there is a universal convention for a human being to seek ultimate meaning, including in their death. Therefore, he said, it is the role of the community and the Church to reaffirm the intrinsic dignity of all human life. 

“We have a strong role to encourage faith and hope also in the process of aging. It is not only a problem of health and medical... but that the end of your life has a meaning and there is a role in society, with your presence and not with your productivity,” he said. 

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