Death Down Under Conference Report – Penny Brander

The second DDU Conference (held in Dunedin – June 28-29, 2012) brought together academics and practitioners working on a wide range of research projects and/or providing services relating to death, dying and bereavement.  While attendance was dominated by New Zealanders and Australians, participants came from as far as Singapore, Japan, the US and the UK.

Apart from the keynote speaker presentations (including: Helen Ennis’s examination of the nature & function of art photography in the context of mortality and its potential to enable viewers to speak about their own experiences  and Rod MacLeod’s reminder that the cornerstone of Hospice care and palliative education requires “listening to the voice of the patient”, four parallel paper sessions through the remainder of the conference was a challenge to attendance choices at times.

Presentations covered research and practice relating to: palliative care (focusing on health promotion initiatives), grief and bereavement, funeral practice, near death experiences and images of death.

Grief and bereavement related presentations addressed: Maori  women’s experience of grief, grief experiences for men in a NZ prison,  cultural support practices aimed at Samoan men experiencing death & bereavement, experiences of grief and bereavement for family members of those with dementia, writing about parental bereavement, use of children’s picture books to introduce death & loss concepts to nursing students, rural health professional perspectives on provision of grief and loss and the support and handling of grief & remembrance in the age of facebook.

Presentations that captured my interest included Ruth McManus’s discussion concerning the consequences of our increasing exposure to death images, Cyril Schäfer’s investigation of how the bereaved organize funeral arrangements and three papers within a session addressing health promoting approaches to palliative care.  Brief descriptions of these presentations follow.

Ruth McManus’s (University of Canterbury) presentation complimented and provided a context for Helen Ennis’s examination of photography and mortality via her argument that we are experiencing a significant move away from the ‘death taboo’ – given that death is no longer ‘pornographically hidden’.  Rather, the increasing display of fictional and actual death images might be viewed as providing “a focal point for medicalized society to simultaneously reveal and resolve deep seated moral ambiguities”.

Cyril Schäfer (University of Otago) outlined a study in progress which aims to identify “how the bereaved organize, negotiate and resource funeral practices”.  Interview and survey methods will be employed to assess the range of public and private responses to death.  Preliminary findings indicate a range of strategies are employed to organize funerals with family conflict emerging as a frequent feature of the process.  Funeral practices are also described as being “messy and inherently incomplete”.

Investigations exploring health promoting approaches to palliative care:
John Rosenburg  (Calvary Centre for Palliative Care Research, Australian Catholic University) drew attention to the need for identification and evaluation of health promotion initiatives that aim to  build community capacity associated with death, dying, grief and bereavement within Australia.  While Palliative Care Australia includes such goals in their National Standard it was suggested that, in practice, this is “limited to increasing awareness of clinical services” and that the dominant discourse addressing health promoting approaches to palliative care rest within the contexts of academia and palliative professions.  Attention was drawn to the community based activities that are in progress irrespective of Government led initiatives e.g. websites – including:

Dying matters coalition – established by the National Council for Palliative Care (NCPC) in the UK to promote public awareness of dying, death and bereavement http://www.dyingmatters.org/

The GroundSwell Project – based in NSW, Australia  which aims to engage “people in creative arts projects in order to create healthier community attitudes about ageing, illness, death, dying and bereavement”  working to fulfill the mission of opening up “community conversations about loss, ageing, illness, death and dying, changing community knowledge, attitudes and behaviours about these important life transitions” http://thegroundswellproject.com/

Debbie Horsfall’s (University of Western Sydney) presentation focused on results from the first phase of “The caring at the end of life (EOL) research project” which (drawing on participation from urban, regional & rural NSW & ACT communities) aims to investigate support networks for people dying at home.  The first stage of the project has involved exploring, via focus groups, the roles of “formal support networks” (e.g. palliative care services, community heath, various support groups, community organizations and churches) in “mobilizing, facilitating and supporting informal care networks”.  Subsequent phases of the project will aim, via focus groups and interviews, to define the scope and function of  “informal networks” and “outer networks” from the perspective of those who work within these systems.  Requirements for sustainability and protection against exploitation of un-paid carers will also be explored within these networks.

Michael Ashby (University of Tasmania) reminded us that despite half a century of intent to improve EOL care, that we still commonly hear the comment that “we do not do this well” and that there’s a need to acknowledge the changing pathways to death “with increasing numbers of people dying in old age, slowly over one to two years with multiple co-morbidities, high incidences of dementia and more significant medical decision points”.  Guided by the Southern Tasmania Area Health Services (STAHS)/Royal Hobart Hospital (RHH) project goals of achieving “health dying” (where “dying days” are viewed as being important as “non-dying days”) the experiences of delivering palliative clinical services alongside attempts to foster improved preparation for death (within the health sector and the wider community) were described.  Further information regarding the concept and promotion of healthy dying in Tasmania can be found in a 2011
presentation by the author and Jenny Fuller at:
http://www.gpsouth.com.au/Presentations/Tahpc_files/frame.htm

See below for a full listing of all DDU Conference presentation abstracts.