Death Café: Tea, Cake, and Conversation

Wednesday, September 4, 2019

On a warm June evening, about 75 people gathered at the Duke University School of Nursing (DUSON) to drink tea, eat cake, and talk about death.

Participants were seated at tables, about a dozen in all, in a large room in DUSON’s Pearson building. On each table a set of cards posed questions along the lines of Where would you like to die? Have you ever seen someone take their last breath? What words would you like on your tombstone? What can we learn from dying? What would you miss most in dying? What would your final request be? Do you have any desires for rites, ceremonies, special food or music at a service after your death?

At one table, six young and two middle-aged women riffled through the cards and picked out promising questions to discuss among themselves. The conversation was slow and tentative at first, but soon blossomed and grew to include topics like organ donation, advance directives, life insurance, assisted suicide, books (Me Before You, Being Mortal, and When Breath Becomes Air), burial and cremation, life and death of grandparents, the ideal age to die, how to publish an obituary in the newspaper, whether it’s better to die suddenly or with warning, how to bring up death with family members, wishes of the deceased vs. wishes of the survivors at memorial services, young people who act old, old people who act young, and how to be the latter.

The young participants were students in the DUSON Accelerated Bachelor of Science in Nursing (ABSN) program. As such, some of the conversation related to things they had observed in the hospital: encountering death in unexpected places like the maternity ward, or watching family members resist palliative care for their loved ones because they thought it meant giving in to death. There was also a lot of talk about how to process these experiences in a healthy way rather than burning out or becoming cynical.

The gathering, called a Death Café, was organized for students taking a class called “Gerontological Nursing: Caring for Older Adults and their Families,” but it was open to all in the Duke community.

Gerontological Nursing is taught by Jill Brennan-Cook, DNP, RN, CNE, assistant professor in the School of Nursing, Michael Cary, PhD, RN, associate professor in Nursing, and Deirdre Thornlow, PhD, RN, CPHQ, assistant professor in Nursing and senior fellow in the Duke Center for the Study of Aging.

The three call themselves “Team Gero,” and work so closely together that they tend to finish each other’s sentences.

“Students may not have had a lot of encounters with death so they are uncomfortable talking about that with families,” Cary says. “We give them this space to practice.”

Thornlow adds, “Talking about death and advance directives are conversations we want them to have with clients before it becomes an emergency.”

Team Gero has hosted several Death Cafés in the past. Death Café is an international organization ( that encourages people to create opportunities for people to gather and discuss death.

“It always is really fun,” Brennan-Cook says. “It’s to get people to talk about death and appreciate their finite life here.”

This article was written by Mary-Russell Roberson, a freelance writer who is covering the aging and geriatrics beat for the Department of Medicine.