What Aspects Of The Dying Process Motivate Terminally Ill Individuals

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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, the potential physical and psycho social

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