1. ‘pushing up daisies’ isn’t helpful
Why
‘pushing up daisies’ isn’t helpful
Encouraging open and honest conversations about dying

2. ‘Dying Matters Staffordshire’ Campaign
Being delivered by Staffordshire County Council’s Public Health Team on behalf of the Staffordshire Health and Wellbeing Board
Campaign based on the findings of the Director of Public Health’s Annual Report: ‘Time to Talk – Getting it Right at the End of Life’
End of Life is also a key theme in the Staffordshire and Stoke-on-Trent Sustainability and Transformation Plan (STP)
The ‘Dying Matters, Staffordshire’ campaign will run from the 19th March until the 11th May 2018.
Annual report available from (under Social Care and Health/Public Health and Wellbeing/Director of Public Health Annual Reports)
In the report there were 7 recommendations, and one of which was to have a public campaign about planning for the end of life, to raise awareness of this important issue, so that’s why the Health and Wellbeing Board are driving this campaign.
- Part of the STP – so the campaign is part of a bigger piece of work.

3. ‘Time to Talk – Getting it Right at the End of Life’ Summary:
Life expectancy in England and Wales has doubled over the last 150 years
However, the number of years we now spend in ill-health has also increased
Healthy Life Expectancy is 64 years for both men and women in Staffordshire (meaning we can expect 15 or 19 years of ill health)
Staffordshire’s population is getting older
Focus should be on improving quality of life, as well as quality of death
- Bullet 1 - Nationally, life expectancy is 79 years for men, 83 years for women (2015)
- Bullet 2 – Our number of ‘healthy’ years of life hasn’t kept up with increases in life expectancy
- Bullet 4 – Staffordshire’s older population is growing faster than the national average – meaning end of life is becoming an increasingly important issue

4. Why focus on End of Life?
The end of life experience needs to improve for people to have a ‘good death’ (need to think about the where, when and how)
Anticipating and planning for care in the last year of life is vital
However, people find talking about death and dying difficult, and raising the issue early is a key barrier
Unfortunately, many people die with their end of life wishes not being met or even articulated
End of Life (EoL) – generally recognised as being the last year of someone’s life
Bullet 1 – The National Survey of Bereaved People (2015) (VOICES) suggests that whilst everybody has their own idea of what a ‘good death’ is, for most people it involves being without pain, in a familiar place with close family or friends and being treated with respect.
Bullet 2 - For a lot of people, the EoL experience is often unplanned – which can lead to poor experiences and outcomes for the person and their family.
Bullet 3 – This is not just individuals, families and carers, it also extends to health and care professionals and the wider community – still seen as a “taboo” issue
Bullet 4 – Main reason for the ‘Dying Matters Staffordshire’ campaign

5. Where are we now?
Nearly three-quarters of people (74%) had not discussed what their wishes would be if they did not have long to live
For 61% of these people, this was because they either felt ‘too young’ to discuss death, or because death ‘felt a long way off’
79% of people didn’t have any written plans for their end of life care, financial wishes or funeral plans
Just one third of people (34%) had told their loved ones where they wanted to die
- Few people prepare properly for the end of life. Recent surveys have found that:
- 1st, 2nd, and 3rd bullet – Findings from Ipsos MORI survey
- 2nd bullet – Finding from the National Survey of Bereaved People (Dying Matters commissioned literature review - unpublished, Kings Fund 2010)
- 4th bullet – The National Bereavement Survey (2015) found that of those who expressed a preference, most people (81%) would prefer to die at home (compared to 42% who did die at home). Also, only 53% of people died in their preferred place of choice.

6. End of Life Personal Experiences:
"The only other time I discussed the whole resuscitation thing was with a doctor over the admission bed in A&E. He quite coldly asked me right in front of Dad, who was still responsive, to make a decision: if he went into cardiac arrest should they resuscitate or not? He explained that it was a high possibility that Dad would suffer serious brain and physical damage. I thought about it and said ‘no’ to resuscitation. But that was my decision, not Dad’s. I’ll never know whether he could hear or understand that conversation. I hope he didn’t."
Part of a Personal Blog (written by a person from Staffordshire) for the Dying Matters Staffordshire Campaign.
Just one example of why its really important to have open and honest conversations about death and dying with your loved ones, so they are not left having to make extremely difficult decisions on your behalf, and worrying whether they’ve made the right decision.

7. ‘Dying Matters Staffordshire’ Campaign Aim:
“To encourage adults (without advanced long term conditions), to start talking to someone about dying, death and their own final wishes”
- So a broad target audience - aimed at ‘well’ adults – as want to encourage people to plan ahead, also, it’s probably a little easier to discuss if people are ‘well’.
- A Staffordshire wide steering group have been involved in developing the campaign e.g. the name of the campaign, tone, graphics, etc. have been informed by the group.

8. Partnership with Dying Matters
We have partnered with the national charity ‘Dying Matters’ and have localised the campaign for Staffordshire.
Staffordshire landing page on the national Dying Matters website –
Dying Matters already have a wealth of information, support and resources on planning for the end of life.

9. ‘Dying Matters Staffordshire’ Campaign Branding
Main campaign message – Make your dying wishes known while you’re well. It always seems too early, until it’s too late.

10. ‘Dying Matters Staffordshire’ Approach
- Our images represent common euphemisms for death such as ‘pushing up the daisies’, ‘kicking the bucket’, ‘popping your clogs’ - the sheer number of phrases we use shows that we’re not very comfortable speaking about death and dying openly – we avoid saying the actual words.
- But once people are engaged, we switch to why speaking in euphemisms really isn’t helpful, and encourage people to have open and honest conversations about death, dying and their own final wishes instead.

11. ‘Dying Matters Staffordshire’ Key Messages
Drop the euphemisms. Let’s speak openly and honestly about dying and death.
Visit for advice and resources.
Other related messages:
If we don’t talk about our end of life wishes, then they probably won’t be fulfilled as no-one will know what they are.
Talking with family and friends about what you want at the end of your life will give them the confidence they’re doing the right thing.
Making your will is a good start, but there are many other decisions you can make too.
Around a quarter of deaths happen unexpectedly. This means that most of us will have time to plan for what we want, but some of us won’t. Don’t wait until it’s too late.
- Show examples of leaflets from Dying Matters:
e.g. ‘Putting your house in order’ leaflet – covers 5 actions: 1) Make a will, 2) Make a funeral plan, 3) Start planning for your future care and support, 4) Sign up as an organ donor, 5) Make sure your loved ones know your plans.
If we don’t talk about our end of life wishes – Quote from member of the public “My husband wouldn’t talk about dying and it was horrible. I didn’t know what he wanted at the end of his life. So I’m not doing that. I’ve done my funeral plan and my will, and I’ve told my kids what I want. They didn’t want to hear it – but at least they know, so they won’t have to go through what I went through”.
Other decisions e.g. Power of Attorney, Do Not Attempt Resuscitation Orders (DNAR), Advance Care Plans (Advance Statements, Advance Decisions – ‘living will’).

12. Ways to get involved Speak to someone about your own final wishes
Take a look at for further information/ practical tools
Promote the campaign in your organisation, and with clients (if applicable) (a Stakeholder Information and Resources Pack will be available) E.g. share our social media posts on Twitter and Facebook, display posters, share leaflets, promote on plasma screens, etc.
Encourage others to run end of life events/sessions/chats (e.g. grave talks)
- 3rd bullet – Campaign schedule planned e.g. social media, events/meetings, stakeholder list produced – to keep partners informed, etc.
- 4th bullet – A guide has been produced on running end of life sessions with either new or existing groups (see Stakeholder Information link). Further resources (e.g. short films which can act as conversation starters on end of life issues e.g. ‘I don’t want that’ film) are available on the Dying Matters website. We may possibly run some training on running end of life sessions – currently gauging interest.

13. Thank you