The CareSearch team hosted a MOOC on death and dying (Dying2Learn) in 2016 with over 1,000 participants from 18 countries. The aim of the MOOC was to explore community attitudes in relation to death as a normal part of life, and to open conversations around death and dying. In week one participants were asked to look at language, and to ‘think of alternative words (or euphemisms) that are used to describe death’. We were surprised when we saw 471 participants providing 3,053 alternative words and posting blogs about language.
 
Overall, the most frequently cited euphemism for dead was ‘gone’ (with 485 mentions), followed closely by words associated with ‘pass / passed’ (with 447 mentions), and with the most frequently cited colloquial phrase ‘pushing up daisies’. As language has changed over the years – think how often you hear the words ‘she passed away’ - it was interesting to see quite a few historical words and phrases used, such as ‘six feet under’ (circa 1660).
 
When using alternatives to saying that someone has died, we found that there is a need to be careful of causing misunderstandings and confusion when using euphemisms in everyday language. Examples of these are the words ‘gone’ and ‘lost,’ both of which are now commonly used. One participant talked of an aunt who was waiting to hear of her husband being transferred elsewhere: “After a phone call one morning letting her know that her husband had 'gone', she inquired as to which nursing home he was transferred to; whereby the caller awkwardly clarified that her husband had in fact died”. The use of plain language would have prevented a difficult conversation at a sensitive time.
 
The word ‘lost’ was cited 51 times in the activity and is again a word that can be easily misunderstood in context. A participant was talking about a phone call that she had received from a friend who had ‘lost’ mum: “I was confused and said, 'Why? Where did she go? How can she be lost?” Other participants talked of receiving condolences such as “I’m sorry you have lost your son”, only to wonder facetiously whether they should feel careless or consider that they had misplaced him.
 
There were many comments about the use of euphemisms with a common theme that using the words ‘dead’ or ‘dying’ could upset people and while the majority of participants said that they speak openly themselves they could understand why others don’t. Over two thirds of those participating identified as health professionals, and it was apparent that while many are comfortable talking in plain language, they will often  use the word ‘died’ in one context but ‘passed away’ in another. There were many comments about using euphemisms when others do, and being guided by them in conversation.
 
Euphemisms do indeed have their place but it does beg the question, that if we are all going to die (and let’s face it life has 100% mortality), why do so many people experience difficulties in speaking clearly about death and dying?  We must remember that language is important in communication and being able to comfortably and openly talk about death and dying is important. The MOOC is just about to start again and we are keen to see what variations we will see this time around.




Deb Rawlings, Research Fellow CareSearch, Discipline Palliative and Supportive Services, Flinders University