Caregiving Help Library
Care of the Dying Part 3: Encouraging Conversations About Death |
Continued
22
At the Gesundheit! Institute workshop on The Joy of Service in 1998, Dr. Adams shared a story of what these principles of fun in health care might look like in practice. He described the death of a friend of his. Dr. Adams and his buddies stayed with their friend, on both sides if him in bed. They stroked him, prayed with him, and sang with him. They remained fully present to him, addressing his human need for companionship and love right through the final moments of his life. They helped him die as he had lived. Footnote 23
In order to help achieve a good or even fun death, some studies have surveyed the wishes of patients and families. One group of researchers asked patients and families what elements were most important to them in the communications that occur after terminal diagnosis until death. Respondents indicated that honesty and straightforwardness in communications was extremely important, as was a willingness to talk about dying. Other important factors included sensitivity when giving bad news and when patients are ready to talk about death, and listening to and encouraging questions from patients. Footnote 24
The United States' legal system provides some tools for patients to record their wishes relating to their medical treatment and potentially to their dying process. Living wills allow patients to make clear their desire to forego or receive certain types of life-sustaining treatments. A patient can also assign durable power of attorney to a loved one, empowering the loved one to make medical decisions on behalf of the patient if (s)he is unable to do so. These legal tools may serve as a substitute for conversations about one's physical preference while dying. However, they do little to address nonphysical desires for companionship, love, and open communication about the dying process.
--------------------------------------------------------------------------------
15 Rinpoche , Sogyal Tibetan Book of Living and Dying (New York: Harper Collins,1994), p. 174.
16 Martoccio, B. Living While Dying. (Bowie: R.J. Brady Co., Bowie, 1982).
17 Williams, Erin, and van der Reis, Leo. Health Care at the Abyss: Managed Care vs. the Goal of Medicine. William S. Hein & Co., Inc., Buffalo: New York (1997), p. 166.
18 The Hastings Center (Steinfels, P. and Veatch, R.M., eds.) Death Inside Out (1st ed.). (New York: Harper and Row, 1975).
19 Steinhauser KE; Clipp EC; McNeilly M; Christakis NA; McIntyre LM; Tulsky JA, In search of a good death: observations of patients, families, and providers, Ann. Intern. Med. 2000 May 16;132(10): 825-32.
20 Steinhauser KE; Clipp EC; McNeilly M; Christakis NA; McIntyre LM; Tulsky JA, In search of a good death: observations of patients, families, and providers, Ann. Intern. Med. 2000 May 16;132(10):825-32.
21 Adams, Patch, MD, House Calls. (San Francisco: Robert D. Reed Publishers,1998), p. 104.
22 Adams, Patch, MD, House Calls. (San Francisco: Robert D. Reed Publishers,1998), p. 104.
23 Wenrich, Marjorie D. et al., Communicating with dying patients within the spectrum of medical care from terminal diagnosis to death. Archives of Internal Medicine, Archives of Internal Medicine 2001 March 26;Vol.161, p. 868.
24 Wenrich, Marjorie D. et al., Communicating with dying patients within the spectrum of medical care from terminal diagnosis to death. Archives of Internal Medicine, Archives of Internal Medicine 2001 March 26;Vol.161, p. 868.
| «previous |
