There comes a time in every life, that we deal with the reality of life's natural course, and knowing it ends with our death or that of a family member. This becomes very real, when we, or someone we love, has a terminal illness.
It is wise to have a discussion and follow through getting affairs in order. Life at times does not always provide an opportunity to plan for an unexpected event, one that can take the life of any one of us. It is those in our family that need the security and the peace of mind. Legal affairs that are in order will be something for which your family will be grateful.
*A living will is essential to express your wishes regarding your care. This can be in place long before an illness.
*Power of attorney in place: appointing someone to make any decisions for you in the event that you are incapacitated.
Counseling a terminally ill patient and their family, can best be done by the professionals that are available and those that specialize in this field.
However, the reinforcement of the day to day needs can be done best by those closest to the patient.
Counseling a terminally ill patient is about sensitive to them. Being aware, that dying is real with the ambivalence, that is part of the process. If the course of the disease has left them frail, and in pain. They may welcome death as relief. The greatest pain they may feel now is leaving the ones they love.
The aggressive care a patient has received during an illness has already taken a toll on a family as well as the patient. They may well, have used all of their physical and emotional reserves. It is most often the love of our family and friends that supports us during an illness and at this time.
It is a normal response during a terminal illness, to have some problems with anxiety, agitation and depression caused by the progression of the illness and the challenges related to its management. It is important to have good medical care for the optimum management and better quality of life, for a terminally ill patient.
There is in place in most hospitals today is a multi disciplined team approach for the care of the terminally ill. Social workers can and do support and counsel patients and family. Counseling is woven into the routine interventions whenever possible.
When in the hospital, a patient may have been introduced into " Palliative care" which affirms life and regards death as a normal process.
"Neither hastening or postponing death. Palliative care and Hospice care, recognizes the need for assessment of pain, and other symptoms, and the care necessary for physical and emotional functions that improve the over all well being, and the medical outcome of patients during any phase of life." Appropriate medication to manage anxiety and pain are part of care.
I remember as an Oncology nurse how meaningful it was to help patients accomplish the smallest of events, which would make their day special. We often brought pets from a patient's home, to be with a patient. We opened windows to let in the sunshine and breezes. We moved family into the room with the patient, managed to pull off having the hospital cafeteria send up food daily for families. We had weddings at the bedside. Our focus was on them to give them meaningful joys.
Hospice is a community resource for the physical care and the emotional support and counseling that will benefit both the patient and family at home. There are resources in the community that can help with the things needed for care at home.
Spiritual resources can be according to your faith and should be sought early in an illness. Your church or your religious affiliation will then follow you and your family, as needed.
As a family member or friend of a terminally ill patient, you can be there for them. With gentle hugs and silent moments, your presence means more than words can ever say. Your presence providing comfort, support, and the unconditional love. That is our last gift to one another.
Multidisciplinary Care of the Terminally ill Patient
Sean O' Mahoney MD
Nessa Coyle RN,MS,FAAN
Richard Payne MD,"