Five surprising findings about death and dying

Just thinking about death triggers odd behaviour, shows research. 

In this world nothing can be said to be certain, except death and taxes, as Benjamin Franklin famously wrote. Few of us find taxes exciting, but death – even just thinking about it – affects us profoundly in many different ways. This is why researchers across so many different fields study it from their perspectives.

10 dec 2015--Here are five research findings – biochemical, medical, genetic, sociological and psychological – that you may not be aware of.

1. Decomposing human flesh smells (sickly) sweet
It is difficult to describe what the stench of death is like, but most people agree it is bad. However, the smell of human decomposition is actually very complex, involving over 400 volatile chemical compounds.
We share many of these with other animals, but a recent study found that there might be five esters – organic compounds that react with water to produce alcohols and acids – that are unique to humans. This is compared to 26 in other animal species from frogs and robins to pigs. The interesting thing about them is that they are also produced by fruits, especially when they rot. Those familiar with the smell, such as forensic scientists or morticians, often report a "sickly sweet" smell when describing corpses. Now we might know why.

2. No, your nails and hair won't keep growing
You may have heard that our nails and hair keep growing – at least for a while – after we die. This conjures up creepy images of exhumed corpses with an urgent need for barbers or pedicurists. The idea probably came from actual observations of hair and nail "growth", but it's all an illusion. The truth is that the rest of our bodies shrink due to dehydration, making the nails and hair look longer.

Shorter chromosome ends (telomeres) means shorter lifespan. Credit: AJCann/Flickr, CC BY

What we think of as hair and nails are actually already dead: the only living parts are the the hair follicle and nail matrix under the skin. But these organs require hormonal regulation to produce hair and nails, not to mention the supply of ingredients like proteins and oils which cease upon death, or very soon after.

3. Telomere length predicts lifespan
For a long time we thought that our cells might be immortal, and that under the right environmental conditions, they would go on replicating forever. But, as discovered in 1961, they don't: after some 50 to 70 divisions, they stop. A decade later a hypothesis was put forward: telomeres – repeated DNA sequences at the ends of our chromosomes – shorten with every division, and when they get too short, divisions stop and the cells die.
Since then, there has been increasing evidence that telomere length can be used to predict lifespan, and not just in humans. However, not all research confirms this, and it is not yet clear whether shortened telomeres are the cause of ageing or just a symptom. If telomere length does control ageing, then it may be possible to significantly lengthen lifespans by manipulating their length. At the moment we still know too little about telomeres to do this, but watch this space.

4. The fear of death declines with age
It seems counter-intuitive to think that we would fear death less as we get older, but studies run in the United States have shown this is the case. One study found that people in their 40s and 50s, expressed greater fears of death than those in their 60s and 70s. Similarly, another study found that people in their 60s reported less death anxiety than both people in middle age (35 to 50 years) and young adults (18 to 25 years).

Does regular contemplation of death make you a bigot? Credit: JDHancock/Flickr, CC BY

Yet another study found that after a peak in their 20s, participants' death anxiety tended to decline with age. For men, the decline plateaued in their 60s, whereas for women, there was some evidence for a slight bump between their 40s and 50s. I found similar patterns in my own research for a forthcoming book – but only in the United States. I saw no such trends in Brazil, the Philippines, Russia, and South Korea.
All of these studies also survey people of different ages but fail to follow individuals across their lifespans. It is therefore possible that the relationship between age and death anxiety is driven by a generational effect: maybe our forebears were just made of sterner stuff than we are.

5. Thinking about death makes us prejudiced
Briefly describe the emotions that the thought of your own death arouses in you. Jot down what you think will happen to you physically as you die and once you are physically dead. These are instructions that have been given to thousands of people across over 200 studies over the past 25 years.
The results suggest that thinking about death – compared to thinking about more banal stuff, or even other sources of anxiety – makes people more tolerant of racists; harsher toward prostitutes; less willing to consume foreign goods; and even makes liberals less supportive of LGBT rights..
However, it also makes people want to have more children and to name their children after themselves. In other words, thinking about death makes us want to pursue symbolic immortality, the vicarious living on through our offspring or through groups we identify with. There is even some evidence that, in the face of death, nonreligious people are more willing to believe in God and an afterlife.

This story is published courtesy of The Conversation (under Creative Commons-Attribution/No derivatives).


Source: The Conversation

Oncologists are stressed and have difficulty discussing death with patients, study finds

A group of oncologists have revealed in a new study by Ben-Gurion University of the Negev (BGU) researchers that communicating about death and dying with their patients is one of the most difficult and stressful parts of their work.

4 jun 2013--In the United States, 577,190 deaths from cancer occurred in 2012, according to the American Cancer Society.

The online paper published ahead of print in the Journal of Oncology Practice reported that despite this important element of their work, oncologists receive little training in this area, and many do not communicate well with patients. The research included interviews with doctorsabout what they found difficult and what they believed they did well.

"To our knowledge, this is the first qualitative exploration of communication about the end of life from an oncologist's perspective," explains Dr. Leeat Granek, a professor at BGU's Faculty of Health Sciences.

"What makes our study unique is the opportunity to get into the oncologists' heads, to understand what they perceive to be the goals of effective communication about the end of life, as well as what makes it difficult for them to achieve these goals. Through the analysis, it became apparent that there is tension between what are perceived to be good communication strategies and the significant number of barriers to implementing them."

The researchers found that the strategies for effective communication about end of life included: being open and honest with patients, and having ongoing early conversations about treatment goals, while balancing hope and reality about end of life. Barriers to implementing these strategies fell broadly into three domains: physician factors, patient factors and institutional factors. 

• Physician factors are difficulties with treatment and palliative care; personal discomfort with death and dying; diffusion of responsibility among colleagues; using the "death-defying mode", i.e. not accepting the inevitability of death and treatment failure; lack of experience; and lack of mentorship.
• Patient factors include patients and/or families being reluctant to talk about end of life; language barriers; and the younger age of patient.
• Institutional factors are stigmas surrounding palliative care; lack of protocol about end-of-life issues; and lack of training for oncologists on how to talk with patients about end-of-life issues.

Dr. Granek concludes that further research and intervention are necessary to aid oncologists in achieving effective communication about end-of-life issues. Dr. Granek and co-researchers interviewed a group of Canadian medical oncologists from three hospitals in Canada. Funding was provided by the Juravinski Cancer Centre Foundation, Hamilton, Ontario.

Provided by American Associates, Ben-Gurion University of the Negev

Exposure to death and dying can have a positive impact

Exposure to death and dying does not negatively affect palliative and hospice care professionals and can actually have positive benefits, states an article in CMAJ (Canadian Medical Association Journal).

07 dec 2010--A study of palliative and hospice care professionals in five centres across Canada over was conducted to explore how death affects their personal lives and practices. Since these professionals are constantly around death and dying, it was thought that their insight could benefit others. Participants reported that being around dying people has allowed them to have a better understanding of the meaning of life, has helped them become more spiritual and has helped them come to terms with their own mortality.

"Participants reported that their work provided a unique opportunity for them to discover meaning in life through the lessons of their patients, and an opportunity to incorporate these teachings in their own lives," writes Shane Sinclair, Spiritual Care Services, Tom Baker Cancer Centre, Calgary, Alberta, and CIHR Postdoctoral Fellowship with the Manitoba Palliative Care Research Unit, University of Manitoba. "Although Western society has been described as a death-denying culture, the participants felt that their frequent exposure to death and dying was largely positive, fostering meaning in the present and curiosity about the continuity of life."

"Participants attested to the weighty nature of their vocation, but this was far outweighed by the many affirming life lessons that participants incorporated into their own lives and practices," concludes Sinclair. "Although the end of life is arguably the most challenging phase of life, it may also be the most meaningful, providing hope to those who are living with an incurable illness as well as individuals who will inevitably face their mortality in the future."

In a related commentary Dr. Pamela McGrath, International Program of Psycho-Social Health Research, Central Queensland University, Brisbane, Australia writes that the important message to learn from Dr. Sinclair's research is that "with support and the opportunity to incorporate the experiences into personal and professional lives, doctors can find caring for the dying meaningful and professionally satisfying. This message challenges widely held misconceptions about the inherently morbid and negative nature of the health professionals' experience of caring for the dying."

Provided by Canadian Medical Association Journal

One In Five People Will Face A 'shameful' Death - Could It Be You?

Most people are unprepared for the shameful reality of how they could die, warns the author of a new book charting the social history of dying. Although the majority of people imagine they will grow old and die in their sleep, surrounded by friends and family, one in five people will die what previous generations would consider a 'shameful' death - alone, ravaged by dementia and without dignity. The deaths of more than half of the population will be 'managed' by medical professionals following serious injury or ill-health, with a small proportion dying suddenly, and often unexpectedly. The rapid increase of the shameful death is being fuelled by an ageing population and a lack of foresight over how to deal with the ultimate consequences of the medical advances which keep people alive for longer. "Most people think only fleetingly about how they will die, and usually it surrounds some romantic notion of dying in our sleep at home," said Allan Kellehear, Professor of Sociology at the University of Bath and author of the new book A social history of dying (please note - this is NOT an academic text). "This notion couldn't be further from the truth; we are significantly more likely to die a lonely prolonged death in a nursing home or hospital, preceded by multiple organ failure, pneumonia or dementia.