Passages Newsletter ISSUE THREE (Oct 2009)
Passages in the News: "The Missing Piece in End of Life Conversations"
(reprinted from Arizona Daily Star, August 2009. Passages was cited as a community resource for end of life education.)
"A good death does honor to a whole life" ~Petrarch
It happened again this week – twice.
"If I had only known…" of families preparing for the imminent death of their respective loved one. No one had alerted them to the signs that their loved ones were approaching death. No one told them that it was time to replace a push for treatment with a push for comfort care. No one told about the dying process and how to keep their loved ones more comfortable.
The unknown is frightening and we understandably want to avoid it, but at what cost? When decisions are based on fear, misinformation or lack of information, there can be devastating physical, emotional and financial consequences on both patient and family.
The critical question is not if we are going to die, but how we are going to die. We often hold onto a belief that more is better, and that technology always holds the promise of saving us from dying, even if for a little while. Quality of life is sacrificed for the hope of quantity and we must ask ourselves if we are prolonging living or prolonging dying.
Compassionate and honest education about the natural process of dying is the key to making these difficult end of life decisions. When the body is preparing for it’s final months, weeks and even hours, many natural processes kick in to promote comfort. When families understand the wisdom of the body as it works to protect itself, they usually make decisions that honor that process.
When families understand the wisdom of the body as it works to protect itself, they usually make decisions that honor that process.
For example, we know the use of artificial nutrition and hydration at the end of life not only offers little or no benefit, but can actually increase discomfort and even hasten dying. We know that the natural and normal cause of death for a number of diseases is pneumonia, once considered "the old man’s friend." We know that physical pain is not a part of the dying process, but that if it is a part of the disease, it can be managed. We know that the dying process will usually lead to a coma, which allows the person to essentially “die in their sleep.”
Healthcare personnel must improve their knowledge and communication about the dying process. The patient and family must ask more questions, matching the answers to their own goals and definition of quality of life and document their wishes.
Let’s provide road maps and comfort on the final leg of our journey.
Tani Bahti, RN, CT, CHPN
Founder, Passages – Support & Education in End of Life Issues
Author of "Dying to Know – Straight Talk About Death & Dying."
Passages in the News: "Declining health, independence make some elderly give up"
(A link to azstarnet to an article which was posted on August 13, 2009. Passages is cited in the callout at the side of the article under 'Education, Medication, Understanding the Dying Process.)
To read the full article, please click here.
