Many Nova Scotians unprepared for death, palliative care doctor says

The downside of life-saving medical advances in the last 50 years, is that many Nova Scotians have no immediate experience with death, and are unprepared to face the prospect of taking their last breath, a palliative care doctor says.

Palliative medicine specialist, Dr. David Dupere, is delivering a free lecture on the subject this Thursday at Dalhousie University in Halifax.

I think it is quite possible now for someone to reach their 50s or even 60s without having experienced a single death in their lives.- Dr. David Dupere

Dying happens later in life

Dying was more commonplace100 years ago, Dupere said.

It was more common to hear someone say: "My sister died in childbirth, my cousin's baby died of the measles, cousin Bob got run over by a tractor," he said.

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Progress in the fields of medicine and public health have ensured that dying is now more common in the later stages of life, Dupere said.

"I think it is quite possible now for someone to reach their 50s or even 60s without having experienced a single death in their lives," he said.

TV deaths unrealistic

This means that many people are unaware of what dying actually looks like, Dupere said. Many people assume that the dramatic deaths typical of TV shows and movies are the norm, but they aren't, he said.

Dupere said there's a danger in ignoring the prospect of death, and that Nova Scotians are better off preparing for the inevitable.

He suggests having a will in place, naming a substitute decision-maker, and outlining your wishes for resuscitation if your heart stops.

N.S. has 'amazing' palliative care

Nova Scotia has an "amazing" palliative care program, especially for a small, relatively poor province, Dupere said.

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It started with a pilot project 25 year ago, and has grown into an effective program, he said. "It's not perfect, but there is nothing like it in Canada," Dupere said.

Focus on managing symptoms

People often assume palliative care only applies to somebody on their death bed, he said, but it is a type of care that applies to anybody who is no longer trying to cure a disease and prolong life, and has accepted the fact that the end is coming.

The focus is on managing symptoms, and maintaining a good quality of life.

Dupere tells patients "90 per cent of the time that we will spend together will actually be because you're very much living," he said."The 10 per centat the end is the dying part."

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