Why we feel so unprepared for death
A gentle exploration of how the institutionalisation and avoidance of death has shaped our relationship to it, and why so many of us feel lost when we encounter it.
There is a particular kind of shame that comes when someone we love dies and we realise, quietly and privately, that we don't know what to do. We don't know what to say to the widow at the door. We don't know whether to mention the name of the person who is gone, or to carefully avoid it. We don't know how to sit with someone who is dying, or what death looks like, or what to do with ourselves in the long, strange weeks that follow a funeral.
We feel we should know. Death, after all, is the most universal of human experiences. And yet, for many of us in the modern Western world, it arrives as a kind of ambush, as something we have heard about all our lives but have never, in any real sense, been taught to meet.
This is not a personal failing. It is, in large part, a historical one.
When death lived with us
For most of human history, death was a domestic event. People died at home, in the beds they had slept in for decades, surrounded by family. The body was washed and laid out by the women of the household. Children were present. Neighbours came and went. There were rituals that told everyone, the bereaved and the community alike, what to do next, and when, and how to carry the weight together.
None of this was easy. Grief has never been easy. But there was a kind of knowing embedded in ordinary life. You grew up watching how death was handled. You learned, without being explicitly taught, that it was survivable and that the people left behind eventually ate again, laughed again, carried on.
Death was also simply more visible. High rates of infant and child mortality meant that most families lost children. Epidemics swept through communities. People died of infections that are now treatable. The dead were a very present part of life: in graveyards adjoining churches where people gathered every week, in the black clothes worn for months after a loss, in the prayers said at bedsides.
I’m not saying any of this to romanticise the past. It was often brutal, and grief was often disenfranchised and lonely in its own ways. But death was not hidden. It was woven into the fabric of ordinary life.
The great removal
Over the course of the twentieth century, something shifted profoundly.
Medicine advanced, and with it came the hope and then the expectation that death could be delayed, and perhaps eventually defeated. Hospitals became the place where sick people went, separating illness and dying from the home. Funeral homes took over the preparation of bodies, offering to handle what had once been a family's intimate task. Death became, gradually, a professional matter that was managed, tidied away, removed from the family and placed into the hands of institutions built specifically for the purpose.
This transformation brought real benefits. People live longer. Dying is often less painful than it once was. And yet something was also lost in this: we lost our natural fluency with death, something that had once been passed down through families, through communities and through simply witnessing it being done.
By the end of the twentieth century, it had become possible and even common, to reach middle age without ever having seen a dead body, without ever having sat with someone in their final hours, without ever having been taught anything about what grief actually feels like or how long it lasts.
The philosopher Ivan Illich described this as the "medicalisation of death", the way dying became something that happened to a patient in a system, rather than a human being in a community. The sociologist Philippe Ariès, writing in the 1970s, called it "the invisible death", death that had been hidden so thoroughly that acknowledging it became socially awkward, even indecent. Thus, we now have the taboo of death.
The pain of our silence
One of the stranger gifts that modern culture offered the bereaved was the expectation that they would recover quickly, and quietly.
Grief, increasingly, became something to be managed and concluded. In workplaces, bereavement leave is measured in days. Friends who were showing up in the first week may grow uncertain in the second month, not knowing what to say, their own discomfort beginning to crowd out the space for yours. The bereaved person, picking up on this discomfort, often learns to perform a kind of recovery to be able to say “I'm doing okay” before they really are, to stop mentioning the name of the person who died, to move the grief into private spaces where no one else has to witness it.
We did not create this silencing of each others’ grief out of cruelty. It mostly comes from anxiety. The collective anxiety that comes from never having been shown how to be with grief, how to speak to it, how to let it exist in a room without trying to fix or hurry it along.
But it leaves those grieving profoundly isolated. And it leaves all of us, in our healthy living years, without any model for how to grieve or how to help someone who is grieving.
In this silencing we have also lost the rituals. Formal mourning practices like the wearing of black, sitting shiva, weeks of structured community support and Irish keening rituals to name a few have been eroded and simplified. Where some of these ritual practices still exist they often feel unfamiliar, even to the people they are meant to support. Ritual works best when it is practised, when it is lived in from childhood. A ritual tradition encountered only at the moment of crisis asks a lot.
What we do instead
In the absence of rituals and language and a living relationship with death, we have developed a number of ways of not thinking about it.
We speak of people who have died as having "passed away," "crossed over," "gone to a better place", these soft euphemisms that serve a kindness can also, over time, make the fact of death harder to hold directly. We build entertainment that offers endless violent death, while simultaneously making natural death essentially invisible. We create an entire industry of anti-ageing, organised around the silent premise that the signs of a body moving toward death are things to be corrected and concealed.
None of this is wicked. I see it as mostly just human. Our human discomfort, finding the paths of least resistance. But this avoidance accumulates. And when death arrives (as it will, for everyone, in one form or another) we find ourselves in territory we have never learned to traverse.
We feel unprepared because we have been, in many ways, protected from preparation.
What unfamiliarity is costing us
This cost is not small.
People die in hospitals not because they want to, but because no one had the conversations in advance that might have made a different end possible. Family members are left to make decisions about dying loved ones without knowing what those loved ones wanted, because the subject had always felt too uncomfortable to raise. The bereaved grieve in isolation, convinced their grief is excessive or abnormal, because they have never seen grief modelled and they have no idea that the waves of it can last for years, that grief and love are inseparable, that there is nothing wrong with them.
The more subtle cost is much quieter, it’s a kind of constant anxiety that comes from trying not to think about something that will inevitably happen. Death anxiety is everywhere in modern culture, and it does real work on us. It drives our overconsumption and keeps us in unfulfilling lives because change feels like a small death, making us afraid of illness and ageing in ways that impoverish the years we are living.
The psychologist Irvin Yalom has argued that learning to think about death and to hold it with some steadiness rather than panic is one of the most liberating things a person can do. Not because it is easy, but because the alternative, the perpetual avoidance, costs us something too.
Finding our way back
There is a quiet cultural movement, still small but growing, of people who want to recover some of this lost fluency with death, dying and grief.
Death doulas and end-of-life doulas offer companionship and guidance for the dying and their families, this filling some of the space that was once held by community. There are more and more death cafes and grief circles offering a simple, radical thing: a space where anyone can go to talk about death over tea and cake, without there being any agenda and without a professional telling them how they should feel.
There are doctors and nurses and palliative care workers who are trying to change the conversation about dying, to make it possible for patients and families to speak honestly about what they want, and what they fear. There are writers and podcasters and essayists trying to name what the silence has cost us, and to offer something different.
There is also the more private work, which anyone can do: the conversation with an elderly parent that begins with ‘I want to understand what matters to you’. The reading of a will while someone is still alive to explain it. The quiet reflection to oneself: what do I actually believe about this? What do I want? What am I afraid of?
None of it is easy. But ease was never really what was on offer. What was on offer, once, was a kind of companionship in the face of the inevitable and a cultural acknowledgement that this is part of it, that we do not have to face it alone, that there are ways to move through it and still come out the other side.
We can find our way back toward that. Not by pretending that death is anything other than what it is, but by agreeing, together, to stop pretending it isn't there.
A closing thought
If you have ever stood at the bedside of someone dying and felt utterly lost, or sat in the weeks after a funeral wondering if you were grieving wrong, or found yourself unable to find a single word to say to someone whose world had just collapsed please know that your lostness is not a failure of your character or a lack of compassion.
You were not taught. Most of us were not taught. And the first step toward something different is simply noticing that, and being gentle with yourself about it.
Death will ask things of us. It always has. But we are not, as we can sometimes feel, uniquely ill-equipped. We are people who have been kept away from something inherent to our humanness, and are only now, slowly, beginning to find our way back to it.
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