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Our changing relationship with death and dying - a conversation

Author: Louis Weinstock and Ivor Williams
19 January 2017

Our relationship with death and dying is changing. In the following conversation, Louis Weinstock, Psychotherapist and Co-founder of Bounceworks and Ivor Williams, Senior Design Associate at the Helix Centre and Co-founder of Humane Engineering, discuss these changes and what they mean for us.

LW: Do you think there is a growing awareness in the western world of death as something we could have a better relationship with?

IW: There is definitely a growing awareness - I think it’s largely driven by the ageing baby boomer generation. They are the largest generational cohort in history and they are beginning to age and appreciate their own mortality in a far more engaged way than previous generations.

With high-profile celebrity deaths, grief and bereavement is becoming more publicly acceptable, and the baby boomers are planning their later life much like everything else they’ve done so far: with high expectations of an individualised consumer experience. Death is becoming tangible - defined by services, experiences - in a way which was hidden previously.

That, coupled with declining religious belief in the UK, means death and dying is something we often tackle personally rather than relying on traditional institutions and structures for meaning.

The challenge is whether we can take what worked before - before the emergence of what is considered an ‘over-medicalised death’ - where care was delivered at the close, family level with a focus on comfort, or whether a new set of modern practices emerge.

IW: Do you see a change in people’s approaches to dying? Is there an emerging set of trends that people are particularly focused on?

LW: I think as conversations about death are being freed from the shackles of old institutions, people are slowly starting to take matters into their own hands, and changes in law and policy are helping. In the UK more people are choosing to die in the comfort of their own home: in 2012, 44% of people died at home or in care homes, compared to 38% in 2008.

The rise in death doulas (essentially a person skilled in helping you die well and not in a hospital setting) is also testament to people choosing to opt out of traditional institutions like the NHS and make more personalised choices about the end of their life.

Another interesting trend is the emerging weaving of modern forms of creativity into the art of dying. A colleague recently organised a month-long event called Life Death Whatever on behalf of the National Trust, with artistic installations, workshops, and even DJ sets designed to aid reflection on death and dying.

The phenomenon of the Death Cafe movement shows that there is a willingness to engage with the subject of death and dying in innovative ways. There are now some 2,400 Death Cafes in 32 countries around the world, all run by volunteers.

I am concerned that for some more disadvantaged communities, the art of a good death is less accessible. Choosing to die at home requires the right kind of home, resources, and the right family support that could help that process.

This is one major reason we decided to create Apart of Me, the digital sanctuary for young people and families when someone close to them is dying. We wanted a tool that could be accessed by all.

LW: How do you think the principles of design could help to improve: a) people’s ability to talk about death and use this awareness of death to live a more fulfilled life b) improve the chances that people from all walks of life could have a dignified and peaceful end of life?

 

IW: We are often blocked by cultural and social taboos around discussions around death, which preclude any personal progress around ‘living with death’: many cultures still hold the belief that talking about death will cause it to happen. In the UK this can be typified by calling someone ‘morbid’ in their apparent ‘fascination’ with death.

Design can be used to normalise many aspects of death, or re-frame the rituals, events, situations or artefacts of death to allow us a new way of looking at a terrifying but necessary part of our lives.

A suspension of disbelief is key to design sometimes - to let things bubble and brew without making a decision - and this attitude can extend itself into how we tackle other problems. It does require time, and if nothing else, time is what everyone can benefit from when it comes to coping and accepting the realities of dying, regardless of age, gender, creed, culture or background.  

IW: What role do you think other disciplines, apart from technology and design, have in creating greater impact on people’s lives? How can the psychologist or doctor work with designers and technologists to answer people’s needs?

 

LW: It is important to understand the ‘design’ of our minds and bodies, so that we can create effective, responsible, and compassionate solutions. But we can not understand this design fully, without considering the biological, psychological, and social influences on our health and wellbeing.

This is where the holistically-minded health professional can be of great benefit. From my point of view, as a mental health professional, It is becoming more difficult to create quiet, thoughtful spaces where we can allow our feelings a space to breathe. I believe that health professionals can bring both a deep clinical understanding of mind/body ‘design’, as well as a good overview of the latest science into the creation of solutions that fit with the times.

For example, in his book The Other Side of Sadness, Professor of Psychology at Yale, George Bonnano, shares extensive research documenting an innate human resilience to grief:

"The good news is that for most of us, grief is not overwhelming or unending. As frightening as the pain of loss can be, most of us are resilient. Some of us cope so effectively, in fact, we hardly seem to miss a beat in our day-to-day lives.”

This kind of scientific evidence from an experienced health professional helps to bust some myths around grief, namely that it is always an extended process that goes through set stages. In fact, it seems that, given the right support, some of us are wired to get over even our most heart-breaking tragedies, often very quickly.

The design of many therapeutic  provisions - including pharmaceutical - is such that they can feed into a limited, problem-focused understanding of mental health difficulties and ‘traumas' such as grief, and thereby not allow for the full scope of responses, including the possibility of a quick, natural recovery.

 

 

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