The Conversation: Dying Matters' Blog

Vanessa Shaw, Palliative Care Educator, Bolton PCT (aka the Bolton Blogger), on how Bolton staff used comedy to encourage dialogue about death during Dying Matters Awareness Week.

Bolton PCT staff Carmel Wiseman and Sharon France, above, during Dying Matters Awareness Week 

In Bolton, we approached Dying Matters Week by gathering a mixed group of staff representing the whole health economy from acute to community and hospice. The group unanimously agreed with the mission statement of the Dying Matters Coalition that the way society views death directly impacts on the death and dying experience and more openness will mean improved quality and better support for patients and families.

However, we also realised that when push came to shove, many staff were not comfortable talking about death, dying and all the surrounding grey areas. How can we expect people to talk about something with patients and families that we as professionals will go to extraordinary lengths to avoid?

This became the premise and driving force behind the Dying Matters Week. We acknowledged that our immediate ‘society’ of staff needed some support and deserved the recognition that caring for patients and families is not necessarily synonymous with having the necessary skills or confidence to discuss the who-gets-what decisions, the legal stuff, the often difficult phase towards the end of life to strategise, how long they would want the doctors to keep them alive and what our patients would like to happen after death? 

Some things can be talked about more impersonally - but other things are much more personal, like how you want to be cared for - and mean having a ‘proper chat’ with the people that matter.

The group commissioned an external agency with a brief to create a short film and after a great deal of discussion and angst around linking humour and death, we decided to fraternise with the enemy and bring in the comedians......

Fears seemed to underpin many of the reasons for side-stepping these discussions – things we’re frightened of can often be the monster we keep in the wardrobe…(think Harry Potter and boggarts) so if we don’t talk about it maybe it’ll go away. Yet, instead, the monster becomes more powerful and more scary. The group came to the conclusion that laughter could be the answer to some of these dilemmas and help to start the process of banishing staff boggarts, leading to conversations with each other and subsequently with patients and families about how and where they wished to die.

So we went ahead and organised numerous ‘Tea @ 2’ events across Bolton, invited staff  to drop in, ensured cakes were on-hand and played the DVD. We hoped the DVD might make people laugh, but we also hoped it might make people think and talk about it afterwards – either way there would be cake!

Despite small numbers of staff, we felt the DVD opened the doors for some valuable and relevant discussions that are likely to filter into clinical arenas and have a positive impact on patient and family experiences of palliative and of life care in Bolton.

'Dying for a Laugh' stars Ardal O'Hanlon, Jenny Eclair, Dave Spikey, Ricky Tomlinson, Shappi Khorsandi and Royal Bolton Hospital consultant and after-dinner speaker Kevin Jones. The film was produced by PictureWise Productions. Watch Dying for a Laugh