Why is dying so hard?!

Louise Cox Blog, Louise

In the past few weeks it has come to light that too many people are dying without dignity. Why is it that we find dying so hard? And what is a good death?

“I am not afraid of dying, I just don’t want to be there when it happens” – Woody Allen
RCN, Royal college of nursing, palliative care, end of life, dying, end of life care, nursing, end of life care e-learning, nurse resource, NHS, private health care, Alrose, Louise Cox, Kiln, Kiln design, Kin e-learningA recent study (Ombudsman service report)  has found that too many instances of poor communication, poor pain management and inadequate out-of-hours services, have contributed to patients dying without dignity. How can this be the case in the 21st century, where we consider ourselves to be intelligent and responsible? Surely we should be responsible for orchestrating our own good death?


I have been working with the Royal College of Nursing (RCN) on a couple of online resources about end of life care. It’s been a tough assignment, and I have had to research a topic that is both complex and very emotional. It is pertinent to my own mortality and has made me consider whether I have my own plans for a ‘good death’ in place.


The two resources address many of the issues that have been identified within the report, and will be presented at the RCN congress in Bournemouth in June.

Working with subject matter experts from Scotland, England, Wales and Ireland, I have spoken to carers and nurses and listened to audio transcripts of some of the worst and best care that have been given to the dying. Using my skills of empathy connecting with the learner to write content that is both relevant and valuable, I have woven in a human element that hopefully will allow the learner to realise that care for dying is not something that they need to be afraid of, but that it is a privilege, similar to being present at the beginning of life, to be at present at the end of life.

The resources use real life experiences to explain what good end of life of care looks like. For the main end of life resource, we used a parallel universe concept, that demonstrated a good and bad example of end of life care. These case studies are used to really show the learner how a bad approach to end of life care from a professional’s point of view can have a huge impact on the dying person, those important to them, their carers and the nursing team.


Emotionally demanding

It’s made us appreciate that although challenging and emotionally demanding, when nursing staff have the right skills, knowledge and attitude, end of life care can be very rewarding.

One of the outcomes of both resources is that planning for a good death is something everyone should do. If you should lose your capacity to make decisions, who would you choose to make decisions that are in your best interests? And have you told them?


When working on this eye-opening project, it often made us reassess how we view death. We regularly talked in the office about the issues the subject matter presents, they grey areas in life, and how somehow, everyone can relate to death. This project is so important because it is for nurses who care for the dying, and at the end of the day will care for one of our loved ones and maybe even us.


Everyone deserves a dignified death, and this resource might be a step in the right direction to aid nurses and carers, and help give them confidence in dealing with the dying.


The report referenced at the beginning of this article makes it abundantly clear how important it is to improve communication and educate nurses about how crucial their role is when caring for someone at the end of their life, and how every decision will impact that person and those they care about. That’s why resources like the ones we have been working on are so important. It’s important for us to get these resources right, so that they can help nurses and carers develop their skills and confidence.


Some projects are tough, and challenge us both professionally and personally, but we come out of these projects knowing that in some way we have made a difference, albeit in a small way…


Can you say the same?



Louise Cox, e-learning, Learning Designer, Kiln, Kiln design, dying, consultancy, teamwork, gomo workshop, kiln design, kiln nottingham, nottingham e-learningAbout the author

Louise Cox is a Project Manager and Learning Designer with over twenty years’ experience. She has worked on award winning learning projects. If you want to speak to Louise personally about an e-learning project then call her on 07973 638014 or email louise@kilndesign.co.uk.