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Easing the Dying Process

Published by Chapster on 2004/4/22 (6204 reads)
Taken from a monthly segment that we do on KEOM 88.5FM, this article talks about the experience of fear when dying and ways to ease the dying process, especially the use of hospice.

Easing the Dying Process
KEOM & ElderHope
Taped for broadcast April 22, 2004

Q:So, Mike, what are we taking about today?

A: Today, I thought we’d talk a little about the dying process. The dying process is often so filled with fear. One psychiatrist said that there are three fears that we have when it comes to dying: The fear of what death will physically be like, the fear of what may lie beyond, and the fear of not existing in this way anymore.

Q: Those are some profound concerns. Do they mirror your experience with those who are dying?

A: Absolutely, especially the first one, the fear of what death may be like. For most people, I think the primary concern is that there will be unnecessary suffering. And, indeed, in some cases there is. But, that suffering can controlled, if not eliminated, by the use of hospice care providers. Hospices are skilled in symptom management. In almost all cases the worst of the symptoms, given some time to adjust medications and treatments, can be improved.

Q: You mention the need for time...

A: Right. That is extremely important. Good hospice care tries to balance the control of symptoms with the ability of the patient to enjoy and embrace as much of life as is possible. This is often a difficult balancing act, trying to let a patient be as alert as possible, while still keeping the most odious of the symptoms such as pain, nausea, and shortness of breath managed.

Unfortunately, many families resist the knowledge that their loved one is dying until the very last possible moment, leaving a hospice or care team little time to successfully treat the patient. In a recent study, most states received a grade of D in end-of-life care because the average length of stay on hospice care was between 15 and 30 days. That is really not enough time to get the benefit of hospice. In many cases it takes several days to a week or more just to get the medications optimized. It often takes significantly longer for the staff and family to mesh in terms of clarifying goals and objectives for the patient. Really, there isn’t enough time to do that with only two weeks.

Q: And, when we began today, you mentioned the dying process, that people often have a fear of the process. Is that always the case?

A: No, not always. Some folks have come to a place where they and their families are really ready. Indeed, most families tell me that though they are sad at the loss of their loved one, they are relieved that the suffering is over. They say, “She never would have wanted to live that way. She was sick for so long.” Patients themselves often as for me to pray that they will be able to go and be at peace. Actually, this is the hope of hospice: That we can give choices to those who are dying.

Q: What kinds of choices?

A: Some of the choices are things like: Who they want to be around them when they die, the things they want their loved ones to know about them, the kinds of care they want and the level at which they want their symptoms controlled, and even the opportunity to do some things that we might not think we still had the chance to do. In some cases patients are able to begin to get around in limited ways, and go some places that they would not have been able to go, had they not had hospice care. Once the symptoms are controlled on a consistent basis, lots of times patients are able to again feel some hope about life and living. They learn the lesson that we all would benefit from: To live one day at a time. I think we are all afraid of what we do not know. It’s naturally scary to us, even if we do this kind of care for a living. But, it does help to know that there are those nearby who are skilled in caring for these kinds of situations, and that, when we have a terminal illness, we do have choices in how we come to the ends of our lives.

Tags: end-of-life   dying   death   process  

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