What Aspects Of The Dying Process Motivate Terminally Ill Individuals

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.

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.

The process of making decisions for terminally ill patients at the edge of death is a difficult and complex one. The case study, A Difficult Death draws on Dave, a middle-aged successful man, diagnosed with pancreatic cancer and is terminally ill. Together Dave, his wife Mary, and their daughter Bethany must face Dave’s demise and the emotional toll that it has taken on the family.

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

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.

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

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.

I currently work for a hospice company in the Sales and Marketing department and I am very familiar with how difficult it is to have the conversation about the end of life. In our department we try to assist doctors, nurses, case managers, social workers, etc. on how to have that end of life conversation. Not only does hospice provide palliative care but we are also very much involved with providing the education that is needed. Since I’m in the educational and awareness side of hospice it was interesting to see real life scenarios and get feedback from the doctors and the families.

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

Furthermore, these presumptions were not entirely correct. Although, my patients were in their late 70s, with limited mobility, reduced cognizance, and from lower socioeconomical class backgrounds, I did not contemplate the actual humanistic qualities of my patients. I completely neglected to acknowledge the unique lives I was about to enter. Alternatively, looking back with some disappointment, I was not able to conduct a deep, meaningful conversation about the implications of death. I predicted I would discuss different views of death and dying, but this subject is much more personal than I imagined. In conjunction, I did not encounter a bitter attitude from my patients, as I predicted. However, both my patients’ conditions determined their willingness to engage upon each visit. Sometimes patients were too tired to hold a conversation, often overwhelmed by questions about their lives. During one visit I asked my patient about his hobbies when he was younger. He proceeded to discuss the wonderful recreational vehicle cross-country trips he and his wife would take. This led to sorrow about the loss of his wife, dog, and inability to conduct the trips in the future. Aside from the unpredictable interactions themselves, I did not forecast how my patient’s conditions would dictate our visits together.

Death is one of the most significant life events people experience. Most people want to die a peaceful death and desire the same outcome for their family and friends. Medical advancements have resulted in people living longer lives with chronic illnesses. Despite the advancements in medicine and the available treatments of today, sometimes the patient is still unable to escape intolerable suffering; the patient’s quality of life diminishes.

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

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.

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.

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