Talking about death and dying is taboo in many parts of the world.
So it's no wonder many people avoid talking about it. Or they struggle to find the right words.
Whereas once, we were more comfortable talking about death, now we have become creative in avoiding talking about it.
We resort to euphemisms (alternative words that are softer or less direct) to soften the blow.
For instance, we talk about people "passing" or "gone" rather than they've died or are dead, just two examples from a rich history and range of euphemisms we discovered in our research.
What we did and what we found
We ran an online course, open to anyone around the world, on death and dying.
The aim was to open conversations about the topic, and to promote understanding about death as a natural part of life.
Over two years, we asked 3,116 participants from 39 countries about how they talked about death and dying.
They told us of alternative words or phrases to describe death instead of the words "death" or "dead".
They volunteered varied, often humorous alternatives such as: "wrong side of the grass", "taking a dirt nap", "worm food", "cashed in their chips" and "staring at the lid".
But the most widely used euphemism was "gone". Variants of "passed" were also very popular, like "passed away", "passed over" and "passed on".
There were also historical phrases that still make sense today, such as: "shuffled off" or "shuffled off this mortal coil," from Shakespeare's Hamlet (published early 1600s); "six feet under" (from around 1665, referring to how deep plague victims needed to be buried); and "promoted to glory" (used by the Salvation Army since the 19th century).
One common Australianism was "carked it" (also spelled "karked it"), a phrase that confused participants from other countries.
Some participants said euphemisms were acceptable if it was culturally inappropriate to be more direct.
This was particularly so for Aboriginal and Torres Strait Islander participants, who preferred "finishing up" and "passed away".
How and why do we use euphemisms?
People mainly said they used euphemisms because the words "dead" or "dying" could upset people or were too harsh.
Some participants said they had heard many euphemisms, but wouldn't dream of using some, for instance "kicked the bucket", for fear of causing offence.
Most participants said they speak openly about death and dying but could understand why others don't.
Over two-thirds of participants were health professionals, and while many of them were comfortable talking in plain language, they often used the phrase "passed away" in some situations rather than "died".
Many participants use euphemisms when others do, and are guided by them in conversation.
Is this a problem?
Does it really matter if people use such euphemisms? Not always.
But sometimes euphemisms can lead to misunderstandings and confusion. Think of the commonly used "gone".
One participant talked of an aunt who was waiting to hear about the health of her husband.
The aunt received a phone call telling her that her husband had "gone" so she asked which nursing home he was transferred to.
The caller had the awkward task of clarifying her husband had died.
Then there's the word "lost". One participant received a phone call from a friend who had "lost" her mum:
I was confused and said, "Why? Where did she go? How can she be lost?
Other participants talked of receiving condolences such as "I'm sorry you have lost your son," only to wonder whether they should feel careless in misplacing him.
Communicating about death and dying is important
Euphemisms have their place. But being able to talk openly (and clearly) about death and dying is important as it helps normalise death and avoids confusion.
If health professionals use euphemisms, they need to consider whether patients really understand what they're trying to say.
And normalising death and dying (and communicating it) helps us prepare for the death of someone we love, or to find the right language to make the best choices for end-of-life care or for a funeral.
Deb Rawlings is a lecturer in palliative care at Flinders University
Christine Sanderson is a research fellow at Flinders University
Deborah Parker is a professor of nursing aged care (dementia) at the University of Technology Sydney (UTS)
Jennifer Tieman is an associate professor of palliative and supportive services at Flinders University
Lauren Miller-Lewis is a research associate in palliative and supportive services at Flinders University
Originally published in The Conversation.
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