Most terminally ill patients aren’t ready for the end

Most Kenyans, who admired the late Safaricom CEO Bob Collymore’s preparedness for the end, are scared of discussing death.

“This may be because of fears that such discussion may hasten the end,” suggests a recent study on quality of death and dying in Kenya.

The study involved 129 caregivers of deceased cancer patients at the Eldoret, Nairobi and Nyeri hospices. Most said the patients had been poorly prepared for the end.

Nearly all the adult patients had hardly prepared or discussed their burial arrangements, reports the study published last month (4th June 2019) in the Journal of Global Oncology.

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The authors attribute the poor preparation for death or funeral arrangement possibly to local beliefs that such talk was like beckoning death.

Effective pain control

However the study by the University of Toronto, Canada, University of Ferrara, Italy and a Nairobi based research firm, MWAPO Health Development Group says many patients had cherished time with their spiritual advisors, family and friends.

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The study compared the quality of death in Kenya for the terminally ill with a similar group in Canada and reports a much more challenging experience for Kenyans.

“Caregivers in Kenya rated patients’ pain control as bad which is consistent with lesser availability of palliative care in the region,” says the study.

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On the other hand, the study says end of life care in the Canadian group, a wealthy county, is characterised with high and effective pain control procedures. But even among Kenyans, the poor have been found to have more fear of death and higher lack of preparedness than the rich.

“Income, age, marital status, religion and attitude to death are significant predictors of end of life planning for most Kenyans,” says Dr Stephen Asatsa a Counseling Psychologist and lecturer at the Catholic University of Eastern Africa.

Last year, Dr Asatsa presented a study at a conference in Australia which indicated an overwhelming unpreparedness for death among Kenyans.

The study carried out in Nairobi County involved 320 participants aged between 20 and 64 who were Protestants, Catholics, Muslims, Hindus, traditionalists and Atheists.

The study says poor Kenyans, those earning less than Sh10,000 per month compared to people earning Sh100,000, reported highest fear of death. They are also more unlikely to plan for end of life.

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While the poor and middle class are likely to want to cheat death the study shows much higher acceptance of death among Kenyans earning more than Sh100,000 who are also more likely to plan for their end.

Dr Asatsa, says the lack of planning for death may partly explain the huge wealth held by the Unclaimed Financial Assets Authority.

The authority is currently holding unclaimed cash valued at Sh13.1 billion, 1,451 safe deposit boxes and Sh555.5 million units of shares made up of unclaimed dividends, shares, wages, dormant bank accounts, gift vouchers and life insurance policies. On religion, Dr Asatsa says atheists, traditionalists and Catholics reported highest fear of death compared to other faiths.

The least fearful of death are the Hindu, Muslims and Protestants respectively.

Highest fear

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“By marital status, single people had the highest fear of death with the least fear reported by the divorced and widowed,” Dr Asatsa told Saturday Standard on Wednesday.

But there is a growing feeling among a section of Kenyans that it is time to start planning for death.

“Planning for the end is a difficult, terrifying and confusing moment in one’s life especially if it is against the backdrop of a life threatening illness,” says Dr Esther Munyoro Cege, the head of pain and palliative care services at Kenyatta National Hospital.

Dr Munyoro while addressing a meeting on Advance Directives (AD) at Nairobi Hospital called on patients, families and healthcare professionals to plan for the last days.

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