Physical aspect of dying people
ABSTRACT
Background: Understanding what aspects of the dying process motivate terminally ill individuals to consider hastening their death, can lead to improving end-of-life care.
Objective: Advance knowledge regarding critical events within the dying process that have the potential to give rise to physical and psycho-social suffering such that an elder wishes for or considers a hastened death.
Design and methods: Face-to-face in-depth qualitative interviews conducted with 96 terminally ill elders, 15 of whom discussed an event in their dying process that resulted in suffering so great they wished for, or considered, a hastened death. Data were content analyzed to identify and categorize the main themes and patterns involved in these elders and young people experiences.
Setting: The interviews were conducted on palliative care hospital units, and in outpatient clinics, free standing hospice facilities, and home hospice.
Results: Four critical events emerged: perceived intensive and uncaring communication of a terminal diagnosis; experiencing unbearable physical pain; unacknowledged feelings regarding undergoing chemotherapy or radiation treatment or other of equipment for dying process; and dying in a distressing environment. Respondents discussed physical and psycho social suffering that occurred at these events, and the end-of-life care practices that reduced their suffering.
Conclusion: awareness of events common to the dying process,
This author’s personal perceptions concerning patients facing a lingering terminal illness, have been shaped by over 20 years of critical care nursing experience. Facing death and illness on a daily basis requires self-examination and a high degree of comfort with one’s own mortality, limits and values. Constant exposure to the fragility of life forces respect for the whole person and the people who love them. A general approach to patients who are actively dying is to allow them to define what they want and need during this time. The nurse’s role
For this professional practice, I decided to interview a professional who deals with the subject of death and dying on a regular basis. The interview was conducted at Calvary Hospital which is located at 1740 Eastchester Road in the Bronx. Calvary Hospital was established in 1899 and works in connection with the Roman Catholic Archdiocese of New York. Calvary Hospital is a non-profit institution and it has a total of 225 beds. This hospital is one of the largest which focuses on end-of-life hospice and palliative care. Other programs include inpatient care, pain management, home care with bereavement and support programs for families and friends, therapeutic recreation, and music therapy. All these
Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely
Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.
Facing Death is a compelling documentary on, oftentimes, the final journey patients and their families will venture through together in life. The documentary seeks to capture how the patients and their families respond to the inevitability of death. The film includes families who respond to the issue by allowing their family member, the patient, to pass through the door of death without aggressive care, while there are yet other families who insist on everything being done to delay the moment of death. This topic of fighting death is attributed with producing much debate. On one hand are those who do not see the point of fighting death, however, on the other hand, there are those who believe that delaying death and staying alive is what ought to be done. Personally, from what I understand of either party, I think that I am a part of the later party. In addition, this issue naturally delves into what one believes occurs after death, as it is an issue dealing directly with death. This also compels me to view this topic from the viewpoint of the later party.
The beginning of life is celebrated. Books and resources are shared among friends and family in preparation for becoming a new parent. So, what happens as one approaches the end of life? Unfortunately, the same care and sharing rarely occurs in those circumstances and many face the prospect of dying unprepared. Though most people state they would prefer to die at home, this is often not where death occurs. Many Americans spend their last days attached to medical apparatus that keeps the body alive, but it does not allow for communication with family and often requires heavy sedation. Additionally, this level of treatment comes at a high price. As a society, we must become as comfortable in addressing the end of life process as we
Dr. Bowron also incorporates the opinions of his fellow professionals to embolden his ethos in this article. Nurses, in his hospital, share with him the desires of the elderly to embrace natural death rather than being subjected to medical advancements such as dialysis.
There has been an increase in the interest of euthanasia and assisted suicide for the terminally ill in recent years (Williams 1997). The most obvious reason for someone wanting to end their life is to end the suffering they are going through once the illness goes beyond being bearable.
When we get older and when we deal with someone else who is nearing death we misunderstand what happens and how to understand the death process, we do not know what to expect and how to handle the process.
Briefly describe the patient and his/her situation, diagnosis and prognosis, brief history of the disease, and how/why the patient entered palliative-focused care.
Suffering at the end of life stems from multiple sources, including unyielding pain, depression, loss of personal identity, loss of control and dignity, fear of death, and/or fear of being a burden on others (AAHPM, 2007). The overwhelming symptoms lead many terminally ill patients to ask their doctors to help them die (Gorman, 2015). According to Dr. R. Sean Morrison, professor of geriatrics and palliative care medicine at Mt. Sinai’s Icahn School of Medicine in New York, “their choice shouldn’t be an assisted death or living with intractable suffering” (as cited in Gorman, 2015). The American Academy of Hospice and Palliative Medicine (AAHPM) (2007) strongly recommends that medical practitioners
Thesis: Terminally ill patients suffering from unresolved palliative care requests physician assisted suicide in a quickened death, refusing to help patients from suffering may cause an extreme amount of unbearable pain.
A Death of One’s Own sheds light onto the controversial issue regarding end of life decisions, providing a few examples of people struggling with these choices. The film tells the stories of three particular individuals, Jim, Kitty, and Ricky, each with a unique end of life situation. Jim suffers from ALS and has specific care requests, 56-year-old Kitty struggles with her uterine cancer and constant pain, and Ricky is a patient dying from severe liver failure who can no longer speak and make decisions on his own. All of these individuals present different, yet similar issues regarding end of their life care. This film describes the importance of advance directives, the arguments surrounding physician assisted suicide, and this prompted me to form my own opinion on preparing my own directives and thoughts on these tough decisions.
For my last objective I wanted something that I can interpret what i’ve learned throughout this process of palliative care and turning into a physical
Our society finds it difficult to talk about dying and euphemisms are the norm. It is typical for both doctors and patients to be hesitant to initiate a discussion on dying. Focus instead is often more often placed on interventions and actions for managing symptoms. This avoidance can leave patients and their families unprepared for the inevitable death. (Schapira, 2010) It also often results in requests for therapies which may be excessive, costly and even painful in the hopes for a cure. One study demonstrates that when patients are aware that they are terminally ill, the majority are able to reach a state of peacefulness and also exhibit lower levels of distress. (Ray, Block, Friedlander, Zhang, Maciejewski & Prigerson, 2006) It is also important that family members are willing to discuss end-of-life options with their loved ones. According to elderly patients, they are most often the ones who initiate these conversations with their