Bereavement affects everyone at some point in their life - it is universal but also deeply personal. That said, what do we really understand about the nature of bereavement? Are we, as a society, any good at handling its complexities? Or even just being with those who are bereaved?

Joining me to help answer these questions are two experts when it comes to bereavement. Graeme Bell is a hospital chaplain with previous experience in ministry. Peter McMillan is a Practice Development Practitioner who has spent many years working as a nurse in Care of the Elderly. Together they have formed a team to deliver education around death, dying and bereavement for NHS hospital staff in a course called "Solas" (see link below).

We discuss bereavement definitions, what it can feel like for an individual, societal attitudes, common misconceptions and share some of our personal and professional healthcare experiences. We also look at "anticipatory grief", exploring what this means and how it is recognised.

Here are some links to resources mentioned in this episode:

Solas Bereavement Training (for NHS Lanarkshire Staff)

 https://forms.office.com/e/iCJKQYVjqk

Cruise bereavement support 

 https://www.cruse.org.uk/

Dementia UK

 https://www.dementiauk.org/

Irish hospice foundation 

 https://hospicefoundation.ie/

Marie Curie 

 https://www.mariecurie.org.uk/services/bereavement-support-service

What is the key to letting go of a loved one at the end of their life?

We have a death defying but also sometimes a death denying culture in this country. Death remains inevitable at some point though and this reality can clash with our denial. Our understandable discomfort here has contributed to the current clamour for Assisted Dying.

I wrote an article for a Sunday newspaper recently about this issue. In this podcast article I narrate my article and hope it can bring some clarity as to why we need to change the culture in this country - not the law.

A Bill that would see Assisted Dying legalised is set to go before the Scottish Parliament this year. But what are the implications for medical professionals and their patients?  
Two consultant doctors discuss this and share their personal clinical experience in the care of patients who are approaching the end of life. 
They explore safeguards in the Bill to protect the vulnerable and examine potential consequences for those who lack capacity or have mental illness. 
An alternative or "3rd Way" to sustain the viability of the NHS into the future is considered at the end of this episode. 

A bereaved daughter gives an open, honest and sincere account of her mother's journey with dementia, from diagnosis through to her eventual death at home.
We discuss the impact of the illness on her Mum and a hospital admission near the end of life that was fraught with many challenges.
There are many things to learn from Mairi's Story; for individuals diagnosed with a chronic incurable illness, their families and the wider healthcare profession too.

A look at frailty from the perspective of a consultant in geriatric medicine. Following on from the previous episode where we explored frailty in the community setting, Dr Helen McKee shares her experience and insights into caring for frail patients in an acute hospital.
Helen outlines why hospital admission can sometimes be harmful for frail patients and outlines some novel approaches in their care.
We talk about the benefits of discussing care preferences for patients with severe frailty and how this is particularly relevant when approaching the end of life.

Link to the Lanarkshire "Hospital at Home" service:

https://www.hospitalathome.org.uk/lanarkshire-hah

Just over half of our over 65 year old population live with a degree of frailty. So what exactly is frailty? Can it be prevented or controlled? What are the implications of and prognosis with a diagnosis of frailty? What are the benefits of early recognition?
I'm discussing these and related questions with Dr Paul Baughan, GP and National Clinical Lead for Palliative & End of Life Care with Healthcare Improvement Scotland (HIS).
To find out more about the work HIS are doing to help people living with frailty please click on the link below:

https://ihub.scot/improvement-programmes/living-well-in-communities/our-programmes/living-and-dying-well-with-frailty/

"My doctor has referred me to palliative care - does that mean they've given up on me and I'm going to die?". This is a common and understandable concern for patients who have a life limiting condition when they first hear about the referral.
In episode 6 of Talking Mortality, we explore this and some other misunderstandings about palliative care. Dr Karen Harvie who is a consultant in palliative medicine, helps to bring some clarity and realism.
Reflecting on her years of experience caring for patients with palliative care needs, Karen shares her wisdom and guides us through some of the frequently encountered myths about end-of-life-care. 

What is dementia? If someone has dementia, what is their prognosis and outlook for the future? What happens when a patient no longer has the capacity to make decisions about their own healthcare? What about dementia care at the end of life?
In this episode Dr Calvin Lightbody discusses these issues with Dr Gillian Docherty who is a consultant in old age psychiatry. They also discuss powers of attorney, anticipatory care plans and palliative care for dementia patients.

You wouldn't go on holiday without some degree of planning. It makes sense to pack your case in advance, thinking about what you might need for your trip. An overstuffed case can be burdensome (not to mention expensive!).
Similarly when it comes to anticipating the journey at the end of one's life, things really do go better with some degree of planning. 
In this episode Calvin and Robin talk about advance / anticipatory care plans. What's included in these plans? What are the potential benefits of this kind of thinking? They also discuss some of the ethical issues here and some of the challenges facing the medical profession.

A discussion with Rev Tricia Johnston, hospital chaplain, about spiritual pain. We examine what spiritual care is and how it is particularly relevant for patients who are nearing the end of life.
Focusing on purely physical aspects of pain can overlook this important cause of anguish. Some guidance on recognising spiritual pain is provided along with some tips on addressing an issue that for many can take us out of our comfort zones.

What is meant by the term "critical illness"? What are the possible outcomes for someone who is deemed to be in such a condition? How can we determine what the prognosis is in such circumstances?
Dr Calvin Lightbody is joined by Professor Robin Taylor to discuss these questions and explore what makes a good "prognostic conversation". The issues around truthfulness and hope at this difficult, uncertain time are covered. They also explore some of the barriers to open, realistic conversations.
The episode concludes with suggestions on how to address this sensitive issue.