Responding to a request to die - CarerHelp Knowledge

Responding to a request to die

This page addresses what to do if the person you are caring for says they want to die. It also explains what Voluntary Assisted Dying (VAD) legislation is, in case the person you are caring for raises this.

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Sometimes seriously ill people will say that they want to die or will ask for help to die. This may come as quite a shock to you. You may experience feelings of concern, fear, sadness, anger, or shame.

This wish to die may not be something you would normally think this person would say within your culture or faith. However, there are many different reasons why someone would bring this up including:

  • They are just expressing that things are very bad for them right now
  • They are frightened of what will happen to them
  • They don’t want to be a burden on their loved ones
  • They want to have a sense of control on when and how they die
  • They may be depressed
  • They may be in a lot of discomfort and pain

How do I respond?

It can be difficult to know how to respond. If you feel comfortable you may like to try to:

  • Explore why they are talking about wanting to die
  • Listen without making any judgements or criticisms
  • Encourage the person to share how they are feeling
  • Reassure them that you are there for them
  • Suggest that they talk to their health care team about how they are feeling and offer to be with them while they talk to the health care team if they would like

Depending on the reasons why a person says that they want to die, there are ways to address each of these concerns. The health care team may be able to alleviate a person’s concerns if it relates to fear of the future, or provide effective treatments for any pain or discomfort, or depression. They may be able to suggest other ways for a person to feel in control such as involving them in decision making about their care and also about their death.

The person you are caring for may also need reassurance from you that they are not a burden on the family, that you want to provide care and that you will be supported through the caring process. Caring for someone can be rewarding and create an opportunity to develop closer relationships

What is Voluntary Assisted Dying (VAD)?

A small number of people who ask to die choose to find out more about their options to end their own life. In most states and territories in Australia it is illegal to provide assistance to help someone die. Laws legalising the assessment for and the provision of medication to ‘assist’ someone to die have been passed in some states of Australia.

VAD is a process which assists someone to end their own life by taking a combination of medicines provided by a medical practitioner that will result in death. It is very important that you look at your own state or territories laws on VAD as they are different and may change. The main things you need to know about VAD are:

  • VAD is voluntary so the decision must be made by a person who has the capacity to make an informed choice. A person cannot be pressured or coerced into requesting VAD
  • The request for VAD has to be consistent over time
  • The person has to meet the criteria for VAD which will vary by state.

For more information on VAD please go to your State or Territory Department of Health website. Queensland University of Technology provides up to date information about euthanasia and VAD laws around Australia. VAD is operating in Victoria, Western Australia and Tasmania. VAD will commence in South Australia and Queensland in January 2023, and New South Wales in November 2023.

How will it impact me as a carer?

If you discover that a person you are caring for is pursuing VAD it could be difficult to know how to respond.

Just as you would in any end of life care conversation, if you feel comfortable you may like to try to:

  • Explore why they are pursuing VAD
  • Listen without making any judgements or criticisms
  • Encourage the person to share how they are feeling
  • Reassure them that you are there for them
  • Suggest that they talk to their health care team with any questions or concerns they have about VAD. End-of-life care teams in particular will have been trained about the legislation in your state, and will be well-equipped for these discussions. If a person is seeking information about VAD, your state government’s health department is responsible for providing it.

Different carers will have different levels of comfort about how they care for a person who is going through the process.

It is important that you think about your own values and needs in this context. You do not have to agree to be involved with the VAD process. You may need to take space from the person you are caring for or ask for more assistance from others, such as family, friends, or professional caregivers. This can be a good way of ensuring that their care needs are being met without placing you in a difficult position.

You may have questions about the VAD process and want to talk to someone but not know who to talk to. You could talk to your own health care team or general practitioner. There will be contact phone numbers on the State Department of Health websites that you can call to get more information about end of life care support.

You may also choose to attend an appointment with the person you are caring for so that you have an opportunity to ask questions or raise your concerns.

You may not find out about a person’s VAD until very late in the process or after the event has taken place. This could be quite a shock to you and put a lot of additional stress on an already stressful situation. Please consider talking to a health professional about how you are feeling.

You may be concerned about how you will feel after the death of a person by VAD. Please contact your health care team or your General Practitioner to talk about these feelings and get a referral for bereavement support.