Many people think that having a conversation about dying is reserved for those with cancer. We tend to forget that there are other, often chronic, illness such as heart failure, which also need careful management of the expectations of end-of-life care. Although there have been so many advances in heart disease, people do still die from it.
Since I started work as practice manager for a cardiologist, I have had the privilege to learn about some of the patients' stories. These patients often face lengthy illnesses, frequent hospital visits and invasive procedures. Sometimes, the heart is too damaged and nothing more can be done.
The specialist I work for feels strongly that patients and their families should have as much time as possible to come to terms with the fact that they are entering the last months of life. It isn't always possible to give an exact time scale, which is why the conversation must be sensitively timed. He also tells patients that he speaks from personal experience, because until you have experienced the loss of someone very close to you, you cannot possibly understand the turmoil of emotions that goes with planning for the end of someone's life.
Enlightened families ask questions about how to access extra care, register a do not resuscitate order, and make plans for the smooth handling of their affairs. If your doctor (specialist or GP) isn't having that conversation with you and your family, please make sure you initiate it, because doctors like the rest of us, feel nervous talking about death. After all, they studied medicine to preserve life.
A conversation about dying shouldn't be about the end, it is about planning for the end. In many cases, there is still plenty of living to do, and families should strive to do this, laying down memories for the future.