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Death is a constant companion through life. So why are we afraid of discussing it?

Death is the one constant which unites us all.

Donal O'Keeffe

A BITTER DAY, as a white coffin is carried along a West Cork hillside. Afterwards, red-eyed relatives drink whiskey at the graveside but tradition grants no shelter from cold or loss.

At dusk, a motorboat bobs on a river as two strangers spread ashes on the water, pouring a life away.

Voices raised in song, porter flowing, old stories retold as a life well-lived and loved is celebrated even as the sadness of its end is ignored.

We tend not to talk about it, but death is the one constant which unites us all. Not even taxes are as certain as death. Folklore aside, there are no death exiles, no Maltese bolt-holes in the graveyard, no Netherlands of the netherworld.

I have, of late, had friends die and their deaths have almost forced me to think about my own mortality. Almost. I’m a middle-aged Irish man. We avoid just about everything and thinking about death is something we avoid really well.

Death is a constant companion through life

My friend Jesse – I’ll call him Jesse, he’d have liked that in-joke – was a gifted musician. His ‘Tupelo Honey’ was a country mile sweeter than Van’s. A near-lifelong smoker, just turned 50, he was shell-shocked at the diagnosis of lung cancer. There wasn’t time to process the bad news. He was dead in six weeks.

My friend “Jean-Paul”, lonely and a long way from home, took to the drink and the drink took him. He died slowly, horribly. I used to visit him in hospital, as he shrank and yellowed and grew ever lonelier for drinking buddies who would not visit.

My friend “Larry” was the funniest man I ever met. He had the warmest, dirtiest, most infectious laugh. He spent most of the last decade fighting depression. He commented approvingly to me last year about a piece I’d written for TheJournal.ie about my (almost accidentally) talking a young man down from a bridge outside Cork.

Larry’s body was found last month, not far from that bridge.

I don’t pretend any special insight and I’m sure you have similar stories. After all, death is a constant companion, all through life.

How the State deals with issues relating to end of life

Last week, on Tonight with Vincent Browne, Senator Marie-Louise O’Donnell announced that the Taoiseach has asked her to look at how the State deals with dying, death and bereavement across all Government departments. “The State,” she said, “has a role to play in the quality of how we come on to the planet and how we leave the planet.”

Vincent being Vincent, of course, turned the entire section into a skit about Enda wishing him dead and, I felt, the Senator’s point was lost in Browne’s whistling-past-the-graveyard bla’guarding.

A call to the Department of the Taoiseach clarified: “The exercise will seek to identify best practice and suggest areas for improvement in how the State deals with issues relating to end of life.

A particular focus will be the provision of clear information in respect of available services and support.”

Thinking of government departments dealing with death and bereavement, Health is the obvious one but Education comes to mind too. Are teachers trained adequately to deal with the death of a student? Are supports in place to help children suffering bereavement?

Do we do our best to support people? 

Social Protection has been described as “a minefield” when it comes to benefit payments on the death of a loved one. The scrapping of the bereavement grant still rankles. From anecdotal experience, the Department of Foreign Affairs does Trojan work for Irish families when citizens die abroad. In Justice, the funeral industry is in dire need of regulation and the 2007 Coroners Bill lies lapsed on dusty Oireachtas shelves. The list goes on.

One area which Senator O’Donnell says she intends to look at is that of statutory compassionate leave. At the moment there is no obligation upon employers to grant paid leave to employees who suffer bereavement, a grey area for both employers and employees.

Another area which it would be hoped might be looked at is the way in which the State farms out so much of end of life care to the charity sector. For instance, up until relatively recently, the Irish Hospice Foundation was funding about 85% of the State’s paediatric palliative care programme; five out of eight outreach nurses and one full-time consultant with an interest in palliative care.

We shouldn’t be afraid to talk about death 

Where we die – as well as how we die – is also something which matters a great deal to many people. According to a poll carried out last year by the Irish Hospice Federation, three quarters of Irish people would prefer, if given a choice, to die at home but only about a quarter actually do or will. In fact, whether it will be possible for someone to die at home is dependent in large part to where they live in the country. Only about 18% of Dubliners will die at home, compared to 35% or so in Donegal. Just another example of how our health system fails us at our most vulnerable.

As I said earlier, I can offer no special insights on death – any more, I suspect, than you can. Life is seldom fair and death is even less so. I’ll always remember a five-year-old boy I knew, a decade ago. A funny, clever little kid I played football with when his family visited. He complained of a bad headache one Thursday evening and the doctor sent him straight to hospital. By Saturday he had died of meningitis. I have never seen grief like that and I never want to see it again.

Sometimes this world is just too cruel.

Perhaps we should all re-examine how we deal with death

Without being morbid, death is there, waiting for us all. It might be soon, it might be too soon and, for some – sadly – it might not be soon enough. But however long or short a time you get – to steal a line from Neil Gaiman – you get what anybody gets: you get a lifetime. Death shouldn’t define our lives – any more than our births do – but we shouldn’t be afraid to talk about it either.

Perhaps it is not just the State which should examine how it deals with death. Perhaps we all – middle-aged men included – would benefit from taking a look at the Forum on End of Life’s ‘Think Ahead’ initiative. It’s a comprehensive planning tool which is intended to help us all start the conversation about the end of life. It goes through key points of information such as medical history, care preferences, legal issues, financial information, funeral arrangements, even care options for your pets when you’re gone.

Death is a part of life. We shouldn’t be afraid to talk about it. Personally, I think that if there is any greater meaning to death, or to life, then – perhaps – in the end, the best any of us can hope is that Pericles was right: “What you leave behind is not what is engraved in stone monuments but what is woven into the lives of others”.

Donal O’Keeffe is a writer, artist and columnist for TheJournal.ie. He tweets as @Donal_OKeeffe.

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