Exploring the Inevitable Over Tea and Cookies

“Death cafes” — where people gather to discuss death and dying over tea and cookies — have gained momentum in recent years offering a unique way for people to come together and discuss a topic that is often shrouded in discomfort and avoidance.

It’s estimated that there are now about 18,900 death cafes in 90 countries, with the United States hosting more than 9300 on a regular basis. This trend reflects a growing desire to break the taboo surrounding discussions of death and dying.

But these casual get-togethers may not be for everyone, and their potential benefits and harms may depend on who attends and who facilitates the discussion.

Death cafes are informal meetups where people openly discuss death and mortality in a relaxed setting. They are hosted by a facilitator, like Nancy Macke, certified end-of-life doula based in the greater Cincinnati area and owner of Compassionate Transitions.

“These gatherings provide a supportive environment for a wide range of people, including those with terminal diagnoses, chronic illnesses, curiosity seekers, and individuals grieving the loss of loved ones,” Macke told Medscape Medical News.

How Do They Work?

These free events are typically advertised on community bulletin boards and held in public spaces. Libraries are a great spot to gather because they typically allow the host to bring in snacks and beverages, Macke noted. 

She tries to host a death cafe once a month and said attendance can vary widely; some gatherings will see as few as two participants, while others draw larger groups, reflecting the varied interest levels in different times and locations, Macke said. 

When hosting a death cafe, Macke said she typically introduces herself, and then asks people to introduce themselves and share what prompted them to attend, which usually triggers a discussion.

Death cafe conversations are largely participant-driven, with no set agenda, allowing people to share personal stories, beliefs, and feelings related to death, often resulting in a sense of relief or community connection. “They are not therapy sessions,” Macke said. 

In her experience, Macke has found that many people report feeling less anxious and fearful of death after attending a death cafe and express gratitude for the opportunity to talk about death and dying in a relaxed atmosphere.

Macke said death cafes may serve as a valuable adjunct to end-of-life care, helping patients and families process the emotional and psychological aspects of dying. Holding these discussions in nonclinical settings may help normalize these conversations outside of a medical context.

Potential Risks?

Normalizing the conversation around grief is crucial, regardless of where it takes place, Kara Rauscher, LCSW, trauma services coordinator with Nashville Cares in Nashville, Tennessee, told Medscape Medical News.

“Many of the clients I’ve seen for grief counseling feel incredibly isolated in their grief. As a society, we are uncomfortable with grief and don’t always know how to hold space for people who are grieving. It is not uncommon to hear phrases like ‘move on’ or ‘just let go of it’ — but that’s just not how grief works,” Rauscher said. 

“Death cafes could be very helpful for some people but may not be helpful for others and should not be viewed as a substitute for counseling or therapy with a trained mental health provider,” Rauscher cautioned. 

Therese Rando, PhD, clinical psychologist and clinical director of The Institute for the Study & Treatment of Loss, Warwick, Rhode Island, also cautioned that death cafes have the potential to be helpful or harmful.

“Exposing ourselves to healthy death conversations and realizing that death is an inevitable part of life can help a person lead a more fulfilling life, prioritize things that are important to them, and recognize that there is not a limitless supply of tomorrows, so they need to make good choices,” Rando told Medscape Medical News.

But the benefits or harms that are realized depend on who is attending and who is facilitating these death cafes, she noted.

“It’s fine to have a group of people coming at it from an intellectual point of view, or even if they have had a loss, they might be able to address some of their existential or philosophical questions. But you could get somebody who’s really raw or on the edge or who has psychological issues, and a death cafe may not be suitable for them at that point,” said Rando, author of the book How to Go on Living When Someone You Love Dies.

“It must be recognized that for some people, casual discussions about death and dying could — although not necessarily will — exacerbate anxiety, if they are not facilitated by trained individuals,” Rando added.