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Julia Brassolotto [00:00:01]:
So much of public health is around promoting health and avoiding death, and rightly so. We want people to breathe clean air. We don't want to have a built environment where there's high risk of accidents and collisions and people being killed. We want to address health inequities so that lifespans aren't predicted by things like postal codes. So it makes sense we want to prevent death. But sometimes then we can end up with such a risk aversion focus that we avoid some of the inevitability. So when we only have that one discourse of avoidance, there isn't a normalization of this is also going to happen for certain.

Julia Brassolotto [00:00:44]:
So how do you learn to live with death well.

Sally Chivers [00:00:52]:
Welcome to Wrinkle Radio, where the stories we tell about aging matter. I'm your host Sally Chivers and I am so glad you're here. I'm joined this episode by Julia Brassolotto. She's going to teach me how to get friendly with death. Don't worry, we're not rushing you to your demise. We're asking you to notice that death is actually all around us, and we need to learn how to live with grief.

Julia Brassolotto [00:01:27]:
The title is meant to be provocative because it invites someone to ask, well, what would a death friendly community be? And we're mindful of the fact that there are all kinds of atrocities and tragic deaths happening all the time. We're not suggesting a friendliness with that. That still is tragic and that still is something that we have to grieve and try and prevent. Death friendly: What we're trying to get at there is to get people to think about it and to say, in which ways are communities not friendly towards death? We maybe have this very risk focused or avoidant approach where we think we want to prevent death at all costs or extend life at all costs and value youth, that aging is a reminder of our mortality. When we become fearful of death and dying and we don't speak about it, these fears can escalate and spill out in other ways that become othering of older people.

Sally Chivers [00:02:14]:
That's Julia Brassolotto, associate professor in the public health program in the faculty of Health Sciences at the University of Lethbridge. On Wrinkle Radio, we fight ageism by pushing back against fears of aging and fears of older people. So my ears really perked up when Julia explained that becoming more friendly with death can help us resist our fears of death and dying, and that can help us undo ageism.

Julia Brassolotto [00:02:42]:
There are studies that have looked at students who are studying psychology who have death anxiety were less likely to want to work with older patients in their practice. We saw similar things where younger people who had death anxiety or severe fear of death, were less likely to socialize with older people. Older people served as a reminder of their mortality. There was this process of othering of saying, that's not going to be me. That's something that I don't want to happen. I'm going to do all the right things and avoid or prolong or extend. We saw that as an interrelated fear, that ageism was also sort of fueled by fear of death. We thought, well, if we could get friendlier with death, more accepting, or have a healthier relationship, then maybe that would also have benefits for combating ageism.

Sally Chivers [00:03:27]:
I remember visiting my grandmother when she was in her nineties and she was looking up a phone number of someone else that I was going to be visiting while I was in England, where she lived. I glanced over at her address book and I noticed so many entries were crossed out. And in her spidery cursive, she'd written “deceased.” The friendly in death-friendly, as Julia described it, isn't about losing all of your friends so that your only companion that remains is death. It's coming from age friendly, the WHO movement to--at the level of cities and communities--make the world more hospitable to people as they age. In that context, friendly is pleasant, but it remains quite superficial, almost at the level of customer service. This concept of death friendly builds on the potential of age friendly, but it's deeper and more profound. When we think of death as a person,

Sally Chivers [00:04:33]:
We might think of the grim reaper banging on our door, carrying a scythe, ready to cut us down at our prime. Not someone that we want to welcome and get to know. But as Julia explained to me, if we ignore death as part of our existence and as part of the existence of people around us, then we miss some of the key factors that are important to older people as they navigate their own changing world. It was noticing this that led Julia Brassolotto to work with Albert Banerjee in coming up with the concept of death friendly communities.

Julia Brassolotto [00:05:14]:
Albert and I had been doing observations at a senior center when we were doing field work in Ottawa, and we spoke with this one woman who had said that after her husband died, she barely left the house for 13 years. She said I was practically a shut in. I thought about ending my life. I just didn't have any connection outside of my home anymore, except for my children. And then her daughter encouraged her to join the senior center. She told us this great story about how meaningful the senior center was. We could have walked away and said, well, that tells us about the power of these organizations, and it does. But we went to lunch afterwards, and I said, part of that story was that after that death, she was completely disconnected from her community, and she was processing all of that alone.

Julia Brassolotto [00:05:52]:
So it was also a story to us of unattended grief. We thought about, how do we handle that in age friendly communities? Where do people go to process that? How do communities create spaces for ritual, for honoring loss, for using art, for meaning, making around death, and making that public and visible? So that's what sparked this whole endeavor.

Sally Chivers [00:06:14]:
This story is such a beautiful counterpoint to the messages we're bombarded with about social isolation and loneliness, how dangerous they are, and how we need to protect older adults from them. Yes, this woman was alone. Yes, her daughter was concerned that she was becoming isolated, but there was a reason for it. She had this profound loss that she needed to be able to grapple with alone and in community. As Julia taught me, we've lost the skills that are needed for that. Maybe some of us never had them.

Julia Brassolotto [00:06:48]:
Frances Weller is a psychotherapist and has this idea that we ought to have an apprenticeship with sorrow and longing, that loss is a communal thing in North America. We really treat it as an individual problem. You know, the Kubler Ross model of the stages of grief, that that's something that an individual works through instead of having communal ritual or practices. I love the language of apprenticeship because it focuses on skill development, but also on the intergenerational part of that, about passing along wisdom. This idea that the better we can become with these skills, the more that we can learn to process loss, not in a way of getting over it, but sitting with it and honoring it and finding ways to mark the occasion that we become better resources for our communities and that we fortify our interior and we can better withstand loss. It doesn't mean it hurts any less, but that we're better prepared to navigate that.

Sally Chivers [00:07:48]:
I love this idea that we are apprentices throughout our lives, and not just for skills that help us contribute to the workplace, but also skills we need for the deep work that's part of being human. We live in this death avoidant culture, and many of us have the privilege to ignore learning about mortality and grief until we're fully stuck in it. So we don't know what resources are or aren't there until too late. At that point, most of us turn to palliative care and hospice communities for help. I think it's fair to say that many of us think the only help we'll really need is the medical stuff. Julia explained that the palliative care community understands that it is so much more than that.

Julia Brassolotto [00:08:33]:
Alan Kellehear and Julian Abel have done some work around this idea of compassionate communities. Coming out of the notion that public health hasn't done well with death, we've really institutionalized it and relegated it to the world of medical professionals. It's drawing out of the WHO work: this idea that health is everyone's business and taking on the notion that death is everyone's business. A compassionate community brings death back into community. So it's not just in hospitals or nursing homes or hospices, but saying this is something that requires skills. There's a lot of research that shows that people often rehospitalize someone while they're dying at the time of the actual death, because that's the moment they're afraid of. Having sequestered death to hospitals and healthcare institutions, it becomes less familiar to us. We don't have the practices then, or the knowledge.

Julia Brassolotto [00:09:24]:
The compassionate communities approach invites a reskilling, makes it visible. That's where the friendliness comes in. Not that we have to be cheerful about it. It's not a naive friendliness, but it's intimate and it's relational. Saying we might be less fearful if we understand it and know it and see it. It could still be painful, but at least then we have a place for it and a place for grief. It's not something we have to carry individually.

Sally Chivers [00:09:48]:
Julia Brassolotto and Albert Banerjee were really well positioned to see the potential in this compassionate community idea and the potential in the age friendly movement. Noticing what each could bring to each other to help address what they're missing. Namely, more attention to aging and growing older in compassionate communities, and more attention to death and dying in the age friendly movement.

Julia Brassolotto [00:10:14]:
People who belong to particular cultural groups or faith organizations may have practices, rituals and supports in place to manage the dying process and the grieving process, but the secular state actually hasn't created so many of those for us. Because the age friendly movement focuses on municipal levels of governance and the city as a unit, we thought that there was great opportunity there because that's supposed to be the level of government closest to the people. Bringing the two together and saying one focuses a bit more on palliative care, but isn't really looking at the aging process leading up to it. It's more focused on as people are dying and the bereavement work that happens after that. But with age friendly, we saw this focus on aging, the evening of life, to use Kierkegaard's turn of phrase, but nothing about what happens when the sun goes down. Right? So this is the evening of life, and there was no conversation about death.

Sally Chivers [00:11:03]:
I'm really on the fence here about whether it makes perfect sense that the age friendly movement tends to sideline death and dying, or whether it is absolutely nonsensical. On the one hand, as we age, we do need to reckon more with our mortality because it is ever closer. On the other hand, the age friendly movement is really harnessed around the idea of active aging. This mythological notion that we can take control of how we age by taking these individual actions, often health focused, drinking water, walking our steps, etcetera. That really neoliberal idea, that way of thinking, buys into a myth that we can control absolutely everything and that we're going to live forever. This fear of death, though, it's so pervasive. So I'm going to take a step back here and share with you what Julia said when I asked her why people fear death.

Julia Brassolotto [00:12:01]:
I think it's so personal. Everyone has their reasons, but I do think a piece of it is the unfamiliar. We don't remember not existing, even though we've not existed before. Right? This is what we know, especially because a lot of us don't have experience being present for the act of dying. That is an unfamiliar process. So it's scary. We tend to only be exposed to it when it's a trauma or unexpected. We like to believe that we're in control of a lot of things.

Julia Brassolotto [00:12:28]:
There was a study that had looked at Canadian print media, specifically magazines. I believe the biggest narrative around the representation of death that came out was this idea that it is something within our control. So it was about, in some cases, medically assisted dying. But even in palliative care and hospice care or hospital care, this notion of what do we choose in our last moments? How do we want to go out? Assuming that people have agency and that this is something over which we can exercise control, death is this reminder that we're not in control. We don't necessarily get to choose these things. It's humbling. It makes us vulnerable, reminds us how precious this is. There's no promise of our next breath.

Julia Brassolotto [00:13:10]:
In the West, death has been sequestered to hospitals, hospices, long term care homes. So there's a lack of familiarity that we have with it. But I also think there's other intersections there with other social identities or locations. That's a part of it. For example, Austin Oswald did his PhD work with older gay men in New York City. There was one man who he went for coffee with who said, I'm fairly socially isolated now in my I believe he was in his late seventies. I lost so many friends to AIDS in the eighties that the thought of making friends my own age right now, who I might have to witness their death, is too painful to bear. He would either stay home or he would go out and spend time with much younger people because there were added layers of trauma there.

Julia Brassolotto [00:13:57]:
There were other fears.

Sally Chivers [00:14:01]:
This is a really interesting contradiction. Some people are afraid of death because they're not familiar with it. Some people are afraid of death and dying because they're overly familiar with it. I'm curious how a death friendly community makes room for the experience of a gay man who lived through the eighties and a young person who survived atrocities that killed their family members, and an older woman who's made little sandwiches for every church funeral for the past six decades, probably lemon squares and a wealthy 40 something whose only perspective of death comes from procedural crime dramas.

Julia Brassolotto [00:14:33]:
One of the nice things about the idea of a death friendly community is that there isn't a one size fits all approach. Recognizing that different communities have different needs, that how death is experienced by people who are unhoused is going to look different than people who are in institutional care, people who are also imprisoned. There's going to be a lot of different end of life care needs. There isn't a one size fits all, even within the same city. But even within that you're going to have different religious traditions. You're going to have different cultural groups and traditions that come with those. So making sure that there's opportunity for meaningful end of life practices. But also then what can the city do that isn't already covered by those groups? Part of that is connecting people with services.

Julia Brassolotto [00:15:16]:
Some of it is around framing and intention. Some of the compassionate communities charter looked at things like schools and workplaces, unions. Do people get bereavement leave? Is it effective? The type that they're afforded, the work that goes into supporting someone when they're dying, or the grief work that's required after someone's dying? Seeing that as part of family care, making that more visible, fighting for those kinds of supports, making it visible in schools, we might have something like Remembrance Day. Are there other ways that schools can remember different losses? We had a classmate of mine die in a car accident when I was in grade three, we had a grief counselor come into the class for, I think it was a couple of days. We had these workbooks. We all got to reflect upon our relationship to that student on what we thought death was, where we thought he was now, what he meant to us, and how we'd remember him. Just putting aside curriculum for a couple of days to meet students where they were and say, this isn't business as usual. You lost a classmate.

Julia Brassolotto [00:16:19]:
Taking that time to all be together, to share and to reflect. Having a community that has an intentional infrastructure to support that and recognize it as a part of life instead of business as usual, you're meant to work through these things on your own, sort of independent of all of that. I think there is a lot of work to do at the municipal level that's congruent with age friendly. But to me, a death friendly community, then, is bigger than that. I think if you have that infrastructure with supports and services and visible death and grief in a community, there's these other parts that are really interesting. Then each institution or each organization or household or friend group is prompted to think about it, to do meaning making and use art, and to hold space in different ways, because it's just more accepted. Being in grade three and losing a classmate, that's not expected. Well, in long term care you expect that people will die.

Julia Brassolotto [00:17:12]:
But I'm thinking of our colleague Sienna Caspar. She was doing observations in a long term care home for a research study. She was sitting in on the meeting where it was a shift change. The staff who'd been at the previous shift report to the ones coming in for the next one. It was a large long term care home. Someone said, oh, we have a new resident moving into. I'm going to make up a room number 308. A health care aide who was there.

Julia Brassolotto [00:17:32]:
Her face just fell. She turned and looked to someone. She said, there's a new resident in 308? That was the first time she realized that the previous resident who was there had died. No one had told her she was finding out right before, probably an eight or twelve hour shift, and had had no opportunity to say anything to the family, to pay respects in any way. Sienna said she just sat there sort of crestfallen for the remainder of the meeting. She said, look at this unattended grief here. This is a context unlike a grade three classroom where we should expect that people will die.

Julia Brassolotto [00:18:06]:
You see an unfriendly towards death attitude spill over into all these organizations or institutions, and it's business as usual. But if we say no, we should pause. How are we going to remember this person? How are we going to give them a send off? Is there a way that other residents get to say goodbye? I don't know the full story. Maybe there was some of that, but for this particular care staff member, they came in and found out that someone they'd cared for, for I don't know how long, months, years, had died just by room number.

Sally Chivers [00:18:35]:
I remember reading something when I was a graduate student. I would have sworn it was Kathleen Woodward. I'm certain it was in the book figuring age. I cannot find the reference, but it was someone talking about their older parent dying, someone in their nineties, and how it was almost expected that there would be no grief and how wrong that was, how ageist that was, and what it prevented communally and beyond. I find what Julia says here so compelling. Yes, the death of an older person living in long term care is more expected than the death of a child when you're in the third grade, and no one's trying to argue differently. Nonetheless, there is grief around all forms of death. We need tools that help us work through that, whether we're in grade three or whether we work in long term care where we are experiencing an up against death all the time.

Sally Chivers [00:19:35]:
I really appreciate now how developing a death friendly community approach will go a long way to address the ageism that lies beneath the concept of an untimely death. Of course, we are more likely to need those skills later in life, but the important thing is to think of this as a process that involves skill learning and as Julia explained, apprenticeship so that we're more ready for death and dying and grief whenever it comes.

Julia Brassolotto [00:20:06]:
I remember getting my hair cut a while back and talking to my hairdresser, who said, what are you working on research wise recently? I told her about current research. We were talking and her 84 year old grandfather had died when she was helping her grandmother clean out the house and make arrangements. She said, okay, well, what were the plans? She said, oh, we didn't want to talk about that. It was too morbid. This is an 84 year old couple. There's a book called Advice for Future Corpses. It's fantastic because she talks through a lot of these just practical realities around here's what's going to happen as the person is actively dying.

Julia Brassolotto [00:20:37]:
Here are things you're going to need to sort out financially afterwards, that there is work that goes into all of that too. We don't prepare people for that work often. There's no conversation until we're confronted with it. A death friendly community is inviting a reskilling and a re familiarizing ourselves. That's why the metaphor of apprenticeship is so resonant for me. This idea that as we age, we become the elders in our community. There are things that we knew intellectually when we were younger that were theoretical. With more time, they become less theoretical.

Julia Brassolotto [00:21:08]:
There's a different knowing and then being able to share that wisdom and pass that along and say to others, I've been there, I've experienced loss. I know the pain. I'm not just trying to comfort you through it, I'm sitting with you. It's not about getting over it. It's working through it and working with it and becoming more skilled at that, I think, is a way that we can honor that process of aging.

Sally Chivers [00:21:30]:
This got me wondering whether a need for death friendly communities comes from the secularization of society. Is this something that faith organizations could and should be attending to, except that we've turned away from them, and as people seem to potentially be turning back to them, would that then eliminate the need for death friendly communities?

Julia Brassolotto [00:21:53]:
Faith organizations do much of this work. There is a number of services that faith organizations provide in terms of grief support groups or palliative supports. But again, that's not going to serve everyone in the community. We have a heterogeneous population. Some members of the community will get their needs met that way, but there will be a number of people who don't. Perhaps there might be services or supports that rely on the belief system of that faith that are incredibly comforting or meaningful. But there also might be things that then aren't attended to, like some of the meaning making that happens afterwards. Maybe some of that might be taken up, well, in a complementary way, not as a replacement, that that work can still continue and should, but that for people who aren't members of those groups and people who are, there are other things that we can do.

Julia Brassolotto [00:22:39]:
Because you might be doing that work in your faith community. But if then you go into the workplace and everyone gets uncomfortable when you talk about the loss that happened, no one's sure if they should ask about, you know, your spouse who just passed. No one knows what to say. I think that reskilling around death has ripple effects in every area of our lives. I remember someone at work, their spouse passed. There was a card passed around, people were signing it. Someone made the comment later, it's nice to be one of the early ones who signs, because then there are still things you can say that sound original, because by the time you go to sign as the last person. Everyone has said, I'm sorry for your loss.

Julia Brassolotto [00:23:15]:
People don't know what to say. I think so much of this is also about the rapid pace of a neoliberal society. It feels that we're rarely afforded the time to do things slowly and intentionally. What if instead of at your lunch break, quickly pop in and sign the card with classic message of condolences, If there was time to pause and say, our colleague is really hurting now, probably the most she's ever hurt? How can we honor that in a way that's meaningful and specific to this context and sort of repeating the lines that you're supposed to say when someone dies, and thinking about rituals and practices and supports that are tailor made to the conditions? I think that having that invitation and having that space is more death friendly because then there's more opportunity for meaning making, for things like connection to place, connection to other people, all of the qualities of mortality.

Sally Chivers [00:24:14]:
This got me thinking about rituals around grief in this contemporary secular moment. I also think of the meal train. We throw chicken Caesar salad and fajita kits, and a lot, a lot, a lot of pasta at people who are grieving. I think a lot of people in mourning never want to see lasagna again, and their freezers just get full of that stuff. There's a real statute of limitations for the lasagna, though, and there isn't a statute of limitations for grief. A lasagna is relatively easy to make or buy and hand off in a one and done way. It may or may not help the people that you're feeding. They may or may not even have an appetite yet.

Sally Chivers [00:24:58]:
Meaning making is a longer, slower process. I asked Julia to give me an example of what that might look like in a death friendly community in the current moment.

Julia Brassolotto [00:25:09]:
my friend and Colleague Mia van Leeuwen, a drama professor at the University of Lethbridge, put on this event called Waking Death through Art, a month long series. There were workshops and talks, and there was performance art, and there was song. There were visual arts installations at our local art gallery. Everything was free to the public. It was such a busy time, and yet so many people came out for these things. There was such an appetite for it. Some people had said, well, that sounds morbid, but I actually found at the events I attended, you connect with people so quickly about something that's this profound, and it was such a great way of bringing people together. That was a partially community funded event, certainly community supported, but things like that are part of what I picture with a death friendly community where there's art, and there's conversation and there's learning sessions.

Julia Brassolotto [00:25:56]:
There's flashlight cemetery tours and talks about indigenous and specifically in our region, Blackfoot ways of knowing about death, bringing people together to enrich their thinking about it. Or death cafes at the local bookstore. There were people from all different age demographics. There were lots of seniors there. There were a number of undergraduate students. Some people had brought their young children. There was a parade that went around our local art gallery that went around the block.

Julia Brassolotto [00:26:21]:
There were stilt walkers, and there was, I think it was 70 foot crocheted skeleton as well. There were masks that had been made, and there was singing. And then we came inside and there was a silent dance performance that happened to kind of put some of those props to rest until they were used again in other events later in the series. But it really just was communal in terms of that. It was community, but it also felt like it created community, and it was just people coming together to gather, to share fears, to share fascination. Everyone was probably bringing something different to it, right? Maybe different things that they were grieving, different things they were fearing. It didn't feel like you were alone with those. And using art to make meaning and tell stories.

Julia Brassolotto [00:27:03]:
These might be specific stories in each person's performance art or visual art or storytelling, but there's a universality in that. I just thought it was beautiful.

Sally Chivers [00:27:19]:
She's already started to answer it in that last response. But as you know, on Wrinkle Radio, I always ask guests to talk about how the topic affects them personally. So I asked Julia specifically how her work on death and dying has shifted her perspective on mortality.

Julia Brassolotto [00:27:38]:
I do think about it differently now. It's valuable that you said mortality in particular, because it's not just my death. The death piece: There is still some fear there because it's unknown, and I don't think I can control it. So then how do I surrender to the process? And mortality calls us to pay attention to the life we have. Knowing that we will die. My own death feels frightening if I'm the protagonist of the story. But if I think about myself as part of a family, as part of a community, as part of a species and an ecosystem, it decenters me. And not that people shouldn't grieve when I die.

Julia Brassolotto [00:28:11]:
I hope that they do. But the one leaf that falls off of a tree in the fall, that's one part of it. But it's part of a life cycle and part of an environment in which seasons change and pass. If I can understand myself as part of that ecosystem, then it takes away, I think, the magnitude of it. If I can place myself as part of a larger whole, and I'm not the main character in the story, that has helped orient me, and it also helps direct my choices around service, not in a religious sense for me, but of being of service and things we can control. I think it's this piece again around neoliberalism too, though, realizing that there is also a grief that comes from recognizing the disconnect between how things are and how we imagine they could be. There's a pain there of recognizing that the conditions aren't conducive to good health, good work, good relations between people. I think using that as fuel to try and imagine it to be better.

Julia Brassolotto [00:29:09]:
Maybe that sounds Pollyanna. I don't mean, you know, imagining a better world, but I guess there is a grief that does come from recognizing that disconnect and then saying, I want to be really intentional about the way I use the time that I have here and slowing down. And that slowing down piece comes all the time. There are so many paradoxes around mortality, but that recognizing you have finite time really doesn't make me want to speed up and cram in everything. It makes me want to be very careful and intentional and thoughtful about the time that's spent. And again, not just the quickly signing the card for a colleague in the lunchroom, but taking time to ask how you could actually support them, and furthermore, having the time to act on that and to do it well.

Sally Chivers [00:30:01]:
Thank you, Professor Julia Brassolotto, for teaching me and Wrinkle Radio listeners about death friendly communities and for your patience as I took my time doing this episode as well as I could while balancing the rest of life and work. In the final days of editing this episode, I had to make the agonizing decision to send my dear old, old dog Daisy to her final rest. I won't compare that to human suffering or other forms of grief, but it did make me think differently and reflect on everything Julia has taught us in this episode. I dedicate this episode to Dear old Daisy, even though she'd be unimpressed with that as she was with pretty much everything. Wrinkle radio is now going into a hiatus from releasing episodes for the summer months. We will be back in the fall with more episodes about how to understand and fight fears of aging. Before we go, I want to leave you with something a little bit different. I am so grateful to Ivor Game,, a singer and songwriter from Middlesex, who sent me a copy of his just released single "We're Getting Older".

Sally Chivers [00:31:24]:
As he describes it. It's a gentle song about aging memory. And it's a love song, too. I hope you enjoy it.

Ivor Game [00:31:41]:
I'm getting older. Sometimes I lose my memory I'm getting older. Sometimes I lose my energy. Where on earth did I put yesterday? I'm getting older. Regrets, they never dare to stay. But as I told you I can't recall them anyway. I'm just happy in the afternoon breeze and grateful for the day we're getting older. And how each day I love you more with each new calling.

Ivor Game [00:32:52]:
You walk with me through every door. Go on. Put the kettle on and I will pour. We're getting older.

Sally Chivers [00:33:27]:
This has been Wrinkle Radio. I'm your host, Sally Chivers. Thank you for listening. I hope you have a beautiful summer or winter if you're in the southern hemisphere, and that you put the kettle on for someone you love and make time for grief and joy. And remember, don't panic. It's just aging.

Michael Shynes [00:33:49]:
I wanna grow older. I wanna grow wiser. I wanna grow flowers in a house that's made of you. Sit and watch the sunset. Get some wrinkles on my forehead. I want to build fires in a house that's made of you…