Dying and Death in Canada, Fourth Edition by By Herbert C. Northcott and Donna M. Wilson

Author:By Herbert C. Northcott and Donna M. Wilson
Language: eng
Format: epub
Tags: Death—Canada, Death—Psychological aspects, Grief, Bereavement—Psychological aspects, Loss (Psychology)
Publisher: University of Toronto Press

SUMMARY

Death inevitably raises questions about meaning—the meaning of life and the meaning to be found in both dying and death. Proximity to death because of a chronic or life-threatening illness, old age, or a “brush with death” tends to motivate an individual to reflect on the meaning of life and death.

A century ago, death was expected more often and earlier in life than it is today. Now, in the twenty-first century, death is not expected except in advanced old age. The premature death of a child, a young adult, or a middle-aged person has become almost entirely unexpected and thus often extremely difficult to accept.

While individuals generally do not wish to die, some deaths are preferred over others. The ideal death occurs in old age following a life lived to its fullest extent and happens suddenly or after a brief illness, without pain, in a familiar setting where final goodbyes can be said. People tend to fear the process of dying, with its potential losses, indignities, and suffering, more than they fear death itself. People facing death often express more concern for the loved ones they will leave behind than they do for themselves.

The dying and their family caregivers generally assess their experiences with end-of-life care in positive terms. Most express satisfaction with the care received and indicate that they have received quality care. Nevertheless, some express dissatisfaction and most, when pressed, can identify elements of care that they feel could have been better and that they believe could have helped achieve a good or better death. Health care workers also wish to provide their dying patients with a good death and sometimes complain that family members make this difficult when they deny that their loved one is dying and demand futile care, for example. Just the same, most family members judge the end-of-life care received by their dying family members in positive if not glowing terms in Canada in the early twenty-first century. There are still improvements to be made, but in general Canadians evaluate the end of life care provided positively and appreciate the concern and efforts made to support the dying and facilitate as good a death as possible.

The COVID-19 pandemic that started in Canada in 2020 revealed shortcomings in the care of frail elderly Canadians, many of whom died in nursing homes while isolated from their loved ones. These deaths are resulting in a reassessment of nursing homes and institutional end-of-life care. Another significant change unfolding in Canada concerns the ongoing implementation of MAID and the preference for clinician-administered rather than self-administered lethal medications. MAID is transforming the experience of death for many Canadians, their families, and their health care providers, not just through the opportunity to get or provide MAID, but also by opening up a major social dialogue about dying and death.

This chapter has primarily focused on perceptions of dying and death from the point of view of the people facing death. In the next chapter the focus will shift to the perceptions of those who lose a loved one to death—that is, survivor perceptions of dying and death.

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