People’s experiences of death, dying and bereavement are only partially determined by formal health and social care services. A broad-based alliance of organizations and individuals was established in Scotland in 2011 with the aim of influencing a wider range of social, cultural and other environmental factors which impact on people’s experiences towards the end of life. A small central resource hosted by the Scottish Partnership for Palliative Care (SPPC) provides infrastructure, resources, promotion, events, and advocacy for the alliance.
This article describes the origins, rationale and work of Good Life, Good Death, Good Grief (GLGDGG) a national alliance of organizations and individuals working to promote more open and supportive attitudes and behaviors relating to death, dying and bereavement in Scotland. The article considers challenges and responses, achievements and learning during the six years since the alliance’s inception. More information about GLGDGG can be found at its website.
GLGDGG is an alliance of organizations and individuals committed to creating a Scotland where:
1. People are well-informed about the practical, legal, medical, financial, emotional and spiritual issues associated with death, dying and bereavement
2. There are adequate opportunities for discussion of these issues, and it is normal to plan for the future
3. Public policies acknowledge and incorporate death, dying and bereavement
4. Health and social care services support planning and enable choice and control in care towards the end of life
5. Communities and individuals are better equipped to help each other through the hard times which can come with death, dying and bereavement.
Many individuals and organizations accept and understand that to improve people’s experiences of death, dying and loss there is a need to move beyond traditional service-centric thinking and activities. While it is true that “palliative care is everyone’s business,” it can be difficult to translate this exhortation into practical actions relevant to a range of contexts. Rather, public health approaches to palliative care encourage communities to develop their approaches to death, dying, loss and caring.
Public health approaches to palliative care are focused on:
1. Helping to prevent social difficulties around death, dying, loss or care
2. Minimizing the harm of one of the current difficulties around death, dying, loss or care
3. Early intervention along the journey of death, dying, loss or care.
Public health approaches aim to change the setting/environment for the better, are participatory, and ideally should be sustainable and capable of evaluation. These approaches can be underpinned by a variety of methods, such as:
1. Community engagement
2. Community development
3. Health promotion
5. Changes to the social or policy environment
6. Social marketing
Public policies which acknowledge and reflect the experiences of death, dying and bereavement provide a more helpful context in which to make progress. By engaging with policy making processes GLGDGG has helped to ensure that this agenda is more frequently featured in relevant public policy.