Cracking open death: Death conversations in primary care

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 familycentred 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.