End Of Life Care Analysis

When communicating with a patient, especially at the end of life, it can become difficult. It becomes hard due to the fact that not all situations are the same. There are two terms that can be used in this type of setting when caring for people at the end of life. The first term is hospice care, which “is a program of care provided across a variety of settings and based on the understanding that dying is a part of the normal life cycle.” (329) The other term is palliative care which “is the active total care of patients who disease is not response to curative treatment.” (329) For palliative care this is where the main goal “is the achievement of the best possible quality of life for patients and their families.” (329) Having an understanding
of the types of cares that a patient might need can determine whether or not someone is comfortable facing the facts about the patient.
Starting off with the uneasiness we might feel about talking with a patient.
These include: “we are afraid of facing our own mortality, we are afraid that we won’t know the “right” thing to say, we may have unresolved grief over losses and deaths of our own, and we might be uncomfortable with just “being” with the client rather than “doing” things.” (330) These are just some examples of what comes to mind when having to care at the end of life. There is a process that can be followed by creating an environment that becomes comfortable for both sides of the party. “Essential qualities of being with the dying are acceptance, being calm, and open minded, listening deeply, and proactive intervention, advocacy, on behalf of clients and their families.” (330) The steps
are:
1. Be present for the person, relating to the person and not the illness.
2. Pay attention by listening, without judgement, to the needs, wishes and personal wisdom of the dying person. Being an active listener means putting aside our own discomfort, and letting the person talk about whatever they need.
3. Showing compassion by gentle touch and offering assistance when in contact with the patient.
4. Creating a peaceful environment, in which thoughts and feelings can be shared openly. (1-4. 331)
In a sense this goes back into connection to previous chapters regarding warmth, self-disclosure, empathy, respect, and being genuine. We have to respect the wishes that the patient has, whether it’s listening to them talk or even requesting a back rub. We have to be able to be comfortable with ourselves by letting the patient in and vice versa by hearing them out. We need to be our true selves, knowing this person as given you a chance into their final stage of life and granting permission for you to be a part of. Providing warmth implies you being there and offering your hand to hold and console the person. Overall everything must come together to makes sure we have open hands and open ears in a time where a life will come to an end.
Next part of the overall process is my commitment to the patient and the family when it comes to care at the end of life.
“I will be truthful, I will not abandon you, I will ask you what you need and what I can do for you, I will pay attention on my own self-care so I can pay full attention to you, and I will bring my best self to you, including my tears and my laughter.” (331) This is just a couple from the list of commitments that will be promised to myself, families and more importantly the patients.
The final piece for caring at the end of life is having a creative expression. Being at the end of life doesn’t mean this has to be a dull process but away that gets everyone connected to one another. This can mean by bringing in a patients favorite music and playing it for them, gathering up papers and colored pencils to color a page, or even collecting magazine to use for a collage. The mind can be open to many options that can make everyone comfortable with one another. This doesn’t have to be sad process but a process that can be remembered for later on through the
years.