Introduction:   

It was a dark and stormy night … no that is not how this idea started. In 2004, a Swiss sociologist Bernard Crettaz invited people to come talk about death in a café. He called this concept “Café Mortel” and it developed following the death of his wife. His only rules were “no prescription, no topic, no religion, and no judgement.” 

When Jon Underwood read about this idea in 2011, he and his mother, decided to hold a gathering in his home in London and called it a Death Café. He then went on to develop a website with a guide for others to host events. He described the goal as providing a “space where people can discuss death and find meaning and reflect on what’s important and ask profound questions.” 

Let’s talk about the benefits of having conversations around death and dying and how this has led to the growth of death cafes to more than 22,000 in 93 countries. 

Some context:  

In a culture that tends to be death phobic and does not believe in endings, when a death occurs it may come as a surprise. The author of the book “Die Wise” asks “Why, if dying is so common, is it so much a mysterious, troubling thing among us?” Saying goodbye is a part of life, but it understandably can invoke anxiety and fear. 

Current rituals, customs, and deaths that occur in hospitals have separated us from the physical reality. Historically, people died in their homes and over time as more deaths occurred in healthcare facilities with the funeral industry managing care of the body and burial, we have been able to keep a “respectable” distance if desired. 

Reaching far into adulthood one may have no personal experience with the dying and learned to avoid talking about it, making death an even bigger unknown than it already is.   

Along came The Death Positive Movement which has been growing over the past decade and more to swing the pendulum in the direction of supporting more open and honest dialogue and to provide education and information regarding options and rights surrounding death and dying. This is not to imply that death or the loss of a loved one is to be celebrated, but instead to acknowledge that it as part of the life cycle. 

Correspondingly, organizations such as the Art of Dying Institute, the End of Life Collective, and the Green Burial Council have formed and resources for advance care planning, home funerals, end-of-life doulas, and death cafes are increasingly available. It is important to note that the grass root movement for hospice care in the 1980s was an early response to support families who wanted to care for dying (mostly) cancer patients at home rather than in the hospital and continues to support this mission for all terminally ill patients.  

What happens at a death cafe? 

To hold a Death Café, there are guidelines for facilitators to ensure a consistent approach and adhere to the objective of increasing “awareness of death with a view to helping people make the most of their (finite) lives.” There is to be no agenda, no structure, no presentations, and no fee to attend. It is not meant to be a grief support group, but an opportunity for open-ended discussions on related topics initiated by the participants. 

It begins with a review of the history of death cafes, a reminder about listening, respecting others’ viewpoints, and confidentiality. If needed, there may be some initial questions that the group can consider. During or after the event, refreshments are served and usually this is tea and cake. The sharing of food and drink is meant to emphasize a sense of community and commonality. 

A death café can be held in a private home, a restaurant or a public venue. It can be a stand-alone event or combined with a larger program and lasts between 1-2 hours. 

Why talk about death? 

There are some who believe that talking about death invites it in the door and the idea of a death café sounds ominous, but for others this event can be a welcomed chance to have authentic and open discussions exploring the topic.  Conversations can help to relieve fear and anxiety and offer comfort through the sharing of stories and thoughts. 

On the flip side, consider the expression “death by small talk” or the chit-chat which does not tend to foster true connection and understanding. Many walk around with end-of-life experiences and never find the time or place to share them. To be able to disclose a feeling or experience in a safe environment and have someone else respond “I know exactly what you mean,” can be validating and reassuring.   

Considering our mortality can highlight the fact that our time is limited and precious, might we want to refocus or reprioritize going forward? Steve Jobs commented at a Stanford University commencement speech that, “Almost everything, all external expectations, all pride, all fear of embarrassment or failure, these things just fall away in the face of death, leaving only what is truly important.” It is another reminder that we have today and tomorrow is never a given. 

If we can envision death as a natural part of life, what would we want or not want at the end of our own? The ability to discuss it and plan ahead through wills and advance directives can be a gift to our loved ones. 

Roz Chast is a cartoonist for the New Yorker and an author and wrote about navigating the care of her parents towards the end of their lives. She shares that it was against her parents’ principles to talk about death which led to the title of her book: “Can’t We Talk About Something More Pleasant?” Despite this, while emptying her parents’ apartment, she found a poem her mother had written that included the insightful lines: “We can’t lead our lives in fear of what might be. So live each day to its’ utmost and only then you will be free.” 

Her mother may not have talked about death but she was thinking and writing about it. The goal is not to dwell on it but to be open to the wonder and the mystery of it which may help us to live life with more gratitude and an awareness of its’ brevity. 

Here in Bristol: 

We have been offering death cafes at Bristol’s Rogers Free Library over the past year. Following one of the events, participants were asked to choose up to three words to describe the experience. Top of the list was the word “community,” followed by sharing, validating, comforting, supportive, informational, and reflective. 

Having an unstructured open conversation as a format was rated five out of five by all. Other comments shared were: “It helped demystify the process” and “Death is something we all must meet.” There is an interest in continuing to offer more of these programs.   

Bonnie Evans, RN, MS, GNP-BC, GC-C, lives in Bristol and is a geriatric nurse practitioner, End of Life Doula, and certified grief counselor. She can be reached at bonnie@bonnieevansdoula.com.