Cracking open death: death conversations in primary care
Rebecca Llewellyn 1 , Chrystal Jaye 2 , Richard Egan 1 , Wayne Cunningham 3 , Jessica Young 2 , Peter Radue 2
+ Author Affiliations
- Author Affiliations
1 University of Otago, Department of Preventive and Social Medicine, Dunedin, New Zealand
2 University of Otago, General Practice and Rural Health, Dunedin, New Zealand
3 Royal College of Surgeons in Ireland - Medical University of Bahrain, Adilya, Bahrain
Correspondence to: Chrystal Jaye, University of Otago, General Practice and Rural Health, PO Box 56, Dunedin 9054, New Zealand. Email: chrystal.jaye@otago.ac.nz
Journal of Primary Health Care 8(4) 303-311 https://doi.org/10.1071/HC15058
Published: 21 December 2016
Journal Compilation © Royal New Zealand College of General Practitioners 2016.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Research supports talking about death outside the end-of-life context. Benefits include allaying death anxiety to increased engagement in health promotion interventions. Nonetheless, the focus on death conversations remains centred on the imminently dying. This qualitative study investigated New Zealanders’ perspectives on the value of, opportunities for, and barriers to death conversations in primary healthcare.
METHODS: Twenty-one participants were interviewed. Participants were young older adults (54–65 years) not receiving palliative care or diagnosed with a terminal illness. Most were women who identified ethnically as New Zealand European. An immersion–crystallisation approach to thematic development was used to accommodate the multidisciplinary research framework.
RESULTS: Four core themes were identified: ‘a need to talk about death’; ‘the role of the GP’; ‘broaching the topic’; and ‘media’.
CONCLUSION: A cultural silence on death has rendered both the medical and lay community insufficiently prepared for frank and meaningful engagement with the topic, exacerbated by restricted consultation timeframes. The ease of death conversations may be facilitated by taking a family-centred approach, using community organisations and settings, and harnessing conversation entry points provided by the media. Future research should aim to develop tailored resources and frameworks to support general practitioners’ meaningful engagement with the topic of death both within and outside of the end-of-life context.
KEYWORDS: Death conversations; general practice; death taboo; mortality; patient-centred medicine
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