Talking About Dying: Help for everyone in facing death and dying

By Elaine Sugden, Philip Giddings, Martin Down and Gareth Tuckwell

First Dictum edition. Completely revised and updated.

Practical and spiritual guidance for anyone facing the challenges of dying and death — whether their own death or that of a family member or friend.

The four authors draw on their personal stories, as well as on years of medical and pastoral experience. Their writing is full of sensitivity, empathy and wise understanding.

Each chapter focuses on a different area or question, so you can find what you need with ease. The final chapter concludes with a clear message of hope.

'This is one of the most practical books I have come across. The compassion, experience and faith of its authors shine through. I commend it very warmly indeed for the guidance it offers and the hope it provides.' Michael Lloyd, Principal, Wycliffe Hall, Oxford.

• Language: English
• Publisher: Dictum Press
• Release date: Mar 6, 2024
• ISBN: 9781915934017

Book preview

Dictum Press, Oxford, UK

dictumpress.com

© Elaine Sugden

Philip Giddings

Gareth Tuckwell

Martin Down

First published by Wilberforce Publications, 2017

First Dictum Edition, 2024. Completely revised and updated.

ISBN 978-1-915934-03-1

Ebook ISBN 978-1-915934-01-7

Scriptures taken from the Holy Bible, New International Version (NIV). Copyright 1973, 1978, 1984, 2011 by Biblica Inc. Used by permission of Zondervan. All rights reserved worldwide zondervan.com. The ‘NIV’ and ‘New International Version’ are trademarks registered in the United States Patent and Trademark Office by Biblica Inc.

All rights reserved. To republish any part of this book, please seek permission through the Publisher. A citation of title, authors, publisher, and year of publication would be required.

Editorial note: Almost all names cited in the text have been changed to retain privacy. On one or two occasions, those who shared their stories with us have preferred to keep their own names. Where a story has been borrowed from another publication, the title of the publication has been cited; and, for easier reading, we have occasionally given a name to a person who was, in the previous publication, known only by an initial. In some cases the story has been shortened.

Cover design: Kate Harvey

Internal design: Chris Gander

In memory of Myfanwy

A beloved wife, mother, teacher and encourager

Thanks be to God

Contents

Preface

Foreword to the first edition by Lord Mackay of Clashfern

Start here

Why and how we need to talk about dying

Philip Giddings

Chapter 1

Coping with life-threatening illness

Elaine Sugden

Chapter 2

Difficult decisions

Elaine Sugden

Chapter 3

Talking about dying: When? Where? How?

Elaine Sugden

Chapter 4

Coping with the unexpected

Philip Giddings

Chapter 5

Suicide

Elaine Sugden

Chapter 6

The death of a baby

Elaine Sugden

Chapter 7

Talking to children

Elaine Sugden

Chapter 8

Talking about life after death

Martin Down

Chapter 9

Facing up to fear

Martin Down

Chapter 10

Praying for healing

Gareth Tuckwell

Chapter 11

Practical Matters

Martin Down

Chapter 12

Suggestions of ways to help

Elaine Sugden and Philip Giddings

Endpiece

Where to find more help

Useful Websites

Bibliography

Appendix 1

Advance Care Planning

Appendix 2

Preparing for an expected death at home

Appendix 3

What to do after a death at home

About the authors

Index to the print edition

Preface

In the course of putting together the first edition of this book, issues about dying and death became starkly real when my wife, Myfanwy, to whose memory the book is dedicated, suddenly and entirely unexpectedly died of a heart attack, aged sixty-nine. There was no warning, no time to prepare, no opportunity to say goodbye. It was a devastating experience. Never before had the full force of the expression ‘my other half’ come home to me.

Still conscious of that awful day, I have continued to reflect on the challenge of having to face up to the unexpected death of a loved one, and on the importance of thinking and talking about death and dying beforehand, rather than treating it as the ‘great unmentionable’.

Perhaps the most important lesson to learn from that painful episode is that since death is both inevitable and unpredictable, we all owe it – not only to ourselves but to our loved ones – to be prepared. To that end, we offer this book.

Philip Giddings

January 2024

Foreword to the first edition

If we are expecting an important event to happen, we will usually wish to prepare for it. Some of us will start to prepare early and make detailed arrangements. Others will leave the preparations to the last minute, so that they require a degree of haste which may damage their completeness. How many of us have left applying for a passport until it is almost too late to book our holiday? Few of us will make no preparations at all.

This book is about an important event which is certain to happen, and it urges us to prepare. That event is our own death. When will it occur? Where will it occur, and in what circumstances? What are its consequences? How can I prepare for an event about which, at the present time, I know so little?

The four authors are Christian people with a wide range of relevant experience on which to draw. They set out the great variety of occurrences that lead up to death – from the sudden and unexpected, to a long terminal illness. They use the first of these to stress the utility of talking about death now, and they go on to give a rich variety of advice about matters that should be covered in addressing all the circumstances in which death may occur.

Then comes the question of what happens after death. Is death the end, and, if not, what preparation can I make for what follows? This issue is addressed in a way which I consider readers will find frank and helpful, whatever their views may be before they read it.

Our inclination when we and/or loved ones are enjoying good health, is not to consider how matters may change. This book is a courageous and very well-informed call to take a realistic view from which great benefit could flow.

Lord Mackay of Clashfern

Start here

Why and how we need to talk about dying

Describes wrestling with how to respond to hearing from an old friend that he had inoperable liver cancer – and why silence will not do. Summarises what is covered in the rest of the book.

Philip Giddings

What could I say? My old schoolfriend Duncan had just rung to tell me the bad news. I knew he had not been well, but it was a shock to hear that, after many tests and treatments, the doctors had concluded he had inoperable liver cancer, and only months to live. He was very matter-offact. I could not help wondering what he was really thinking, and whether he was prepared for death. Typically, he did not want to discuss it, and expressly forbade me to tell friends we shared since school.

As the months crept by, I wrestled with what to say to Duncan, his wife, and our friends. Should we visit him and, if so, for how long? Yes, we did – but briefly. What to say at Christmas – probably his last? How could we support his wife? We are of a generation in which men ‘don’t do feelings’. In our society, there continues to be a wall of silence around the subject of death and dying. All kinds of euphemisms are used to avoid the plain truth. Even medical and caring professionals struggle with how to put it. Too often, we say nothing at all. So after the death of a friend or relative, we find ourselves saying, ‘I wish I had been able to say or do . . .’

We are easily put off by fear – our own fears, and the ones we guess would trouble the dying, or others close to them. So we take refuge in talking about trivia and banalities because to introduce the subject of death might seem morbid or demoralizing. We collude with the assumption that the best way to deal with dying is to ignore it – to hide our anxieties and sorrow in diversions which we hope will numb our own pain at the prospect of losing someone we care about.

This book has been written from a shared conviction that silence will not do. We need to talk about dying and death. It is an unavoidable part of human life: death comes to us all. We can try to ignore its coming, but sooner or later it comes. And before we face our own death, most of us have to deal with the pain of losing someone close to us – the brute fact of separation from that person. Our own life, and the lives of those close to us, will all come to an end.

To talk about dying and death will often be helpful to the dying person, and to their relatives and friends. This is especially so if, as is often the case, talking leads to action on our part or the part of others. We should take opportunity to show care and love, in word and deed, when we can. ‘Talk about’ means, of course, listening as well as speaking, and even sharing silence together. Many of us find it difficult to share our deepest emotions, and that is when an arm round the shoulder or squeeze of the hand speaks more eloquently than mere words.

There are also practical benefits from talking about the approach of death. There are preparations to be made, such as making or updating a Will, planning the funeral, making contact with folk with whom one has lost touch, perhaps taking the steps to heal a long-standing breach with a relative, friend or neighbour. Discussing these and other matters can help us, and others who are close to the dying person, to deal more positively with the death itself and its aftermath.

Yes, but how? What can we say? It is one thing to feel, as I did when Duncan rang, that we ought to talk about dying and death. It is quite another to know how to go about it. As we have discovered whilst preparing this book, many people want to talk about death and dying, particularly to close relatives and friends – but do not know how. We trust this book will be of help. Let death no longer be the great unmentionable, but something we talk about honestly and constructively.

Chapter 1 looks at the different ways in which people respond to life-threatening illness. Surprising as it may seem, for some, life is enhanced by their diagnosis. They discover and cherish the people and experiences that really matter to them. By contrast, as we shall see later in Chapter 9, some are paralysed by the uncertainty and fear which such an illness brings, even to the extent of refusing to accept what seems inevitable. Whatever our response, there will be difficult decisions to be discussed and taken, especially by those nearest and dearest to the dying person.

In most cases, discussion begins with a doctor or consultant, talking about the diagnosis and how to treat or manage it. That is never easy, so in Chapter 2 we consider how we approach such meetings. Patients and relatives naturally want to continue treatment, and hang on to hope of recovery. Hope is at a premium and can too easily become focused on the doctor. ‘Surely there is something you can do.’ Difficult questions can arise at any point: at the initial diagnosis of terminal illness; during treatment – curative or palliative; in decisions about withdrawing treatment; or not attempting resuscitation. Here we also deal with ‘Advance Decisions’ (also known as ‘Living Wills’).

A recurrent theme throughout this book is that we lack control over the circumstances of our own death. We don’t know when we will die. Neither do we know where we will die, or how we will die. If we have the choice, is it better to die in hospital where medical expertise is at hand, or in the more familiar surroundings of one’s home? Then questions arise on the time-scale of our death. Since mortal disease can often involve significant pain, we may face pressure to shorten that period of pain, for example by ceasing treatment. This has been central to the debate on the controversial questions of euthanasia and physician-assisted suicide. In Chapter 3 we tackle these difficult questions of when, where and how, and draw on some remarkable experiences of the work of palliative care professionals and hospices.

Sometimes, however, death comes unexpectedly, even suddenly. (As I mentioned in my Preface, my wife died completely unexpectedly whilst I was writing my contributions to the first edition of this book.) In such cases, there is no time, or very little time, to talk about dying. Sudden death is the subject of Chapter 4. Such death may be the result of a car accident, or an accident at work, or at home, or during a holiday abroad. It may be the result of crime or war or a so-called ‘natural disaster’. All of a sudden we are confronted with the stark reality of living without our loved one, our neighbour, our colleague. Do we go into denial, and try to carry on as if nothing has really changed? Or do we try to find someone who understands, with whom we can talk? How do we deal with the difficult questions about who, if anyone, is to blame?

From here we turn to two types of sudden death. In Chapter 5 we address the tragedy of suicide and how to cope with the practical and emotional issues it raises. And in Chapter 6 we consider the death of a baby, either as a result of a miscarriage, stillbirth or, as in the case of my own son Andrew,