It seems we, as a society are reluctant to talk about death and dying. We tend to fear it and prefer to focus on defying it, despite the fact that we will all experience it – and as our population is ageing, it is even more relevant to discuss death and dying.
Death is a foregone conclusion… but let’s talk about what makes a ‘good death’ and whether in Home Care is a better alternative to a Nursing Home or hospital care during this sensitive time.
Firstly, it is important for those caring for a Loved One, parent or Elder to know that they are not expected to provide End of Life care alone. Daughterly Care Caregivers have been able to support clients with in Home Care through both, Palliative Care and End of Life Care alongside the family, the Community Palliative Doctors and Nurses, the family Doctor and spiritual or religious support people.
Our Caregivers believe that, although death is different for everyone, there are ways to minimise the stress and anxiety that can surround this time in a person’s life, and that it is possible to experience a ‘good death’.
Here are some of those ways:
Advanced Care Plan
Having an Advanced Care Plan^ or Care Directive enables you to have control of your health care now and into the future. It is especially relevant near the End of Life, which means your specific treatment as well as your goals, values and beliefs are known. If they are known then they can be respected by health providers and those closest to you, including your family and Loved One.
Nominate someone you trust to represent you when you can no longer make decisions for yourself. An Enduring Guardian can legally make care and accommodation decisions on your behalf, by following your Advance Care Plan. An Enduring Power of Attorney to manage your money can make financial decisions for you.
Pain Management
Watching a Loved One dying is hard but it can be worse if you think they are dying in pain. Fortunately, pain can be controlled with various drugs and can be managed by Registered Nurses, Enrolled Nurses and visiting Doctors. Morphine is most commonly used and is excellent. It blocks most pain and helps with breathing difficulties while giving a slight euphoria [a feeling of happiness or of having no worries].
Loved Ones close at hand
Many people are comforted by having family and Loved Ones close at hand at this stage of their lives. In Home End of Life Care provides the flexibility to each individual’s needs when it comes to family members and visiting friends.
Dying with Dignity
Did you know that 70% of people prefer to die at home with dignity, rather than in a Nursing Home or hospital, yet only around 14% actually do?*
Dying at home is more comfortable, pain free and importantly, dignified. Most Australians state their least preferred places to die would be in a hospital bed or a nursing home. Whether you are a patient or a Carer, the last thing you want is a lot of different people around with whom you are unfamiliar. Dying at home provides security and peace of mind that you or your Loved One are being cared for by people you already feel comfortable with and trust.
Taking care of the Carer
Daughterly Care Caregivers know that ‘caring for the Carer’ is also important to a peaceful and good death. Even with all the arrangements in place, this is a highly emotional and sensitive time so they ensure the Carer’s needs are looked after as well.
This can also include Respite Care – allowing the Carer time to themselves for a brief period so they can return to their Loved One re-energised and better able to care for them through this emotional period. It could also include assisting the Carer with other tasks such as cooking meals for the family, taking the dog for a walk, collecting mail from a post box or grocery shopping.
A peaceful passing with no pain.
Our Palliative Live in Care client, Mr M had just passed away with Daughterly Care’s Caregiver, Margaret caring for him. Margaret said, Mr M had asked for eggs and toast for tea, which he ate without assistance. He said, he was in no pain. The family had all been to visit and had said their goodbyes for the day. Mr M had been conversing with Margaret and was in good spirits.
Margaret had just finished tending to Mr M and went out of his room for a few moments when his son came in and asked if his dad had been making breathing noises. Margaret replied, “No” and they walked back into his room to find that his father had just passed away peacefully.
After Margaret had hugged all the family and finished her duties, another son, James offered to carry her bags out to her car. On the way to the car, James told Margaret that he was extremely impressed with Daughterly Care’s Palliative Care services and thanked her for all she had done for his father and their family.
End of Life Care attends to ‘whole of person care’ as an individual faces the end of their life. Our wonderful Nurses and Caregivers are here to help provide End of Life Care. It is our privilege to assist during this time so give us a ring to discuss how we can help you on (02) 9970 7333.
If you have had experience with caring for someone through their End of Life, do you have any suggestions to enable a ‘good death’?
Please let us know in the comments area below so the knowledge can be shared.
Sources:
http://www.advancecareplanning.org.au/individuals/what-is-advance-care-planning
*Grattan Institute: grattan.edu.au
Hi Kate – I have worked with many dying residents in the aged care facility that I worked in up the Coast and that’s what gave me inspiration to upgrade my skills to do my Diploma of Nursing, so that I could work in palliative care and assist people with a good death. I really feel strongly about this, to talk about and plan how you want your ending to be, as near as possible and where you want it to be, as near as possible, to me gives the person some kind of connection to what is happening to them. To be able to talk about the past that still lingers in their thoughts, to reflect, rejoice, thank and accept this part of their lives. Death and dying is so much a part of life I feel.
Beautifully said Irena. Thanks for sharing. You are absolutely right and we have seen that in our work, many people enjoy life right until the end. When Verlie’s mother was dying she got out of bed and sat in her armchair in the lounge room and ate watermelon with all her family talking and laughing with her. It was such a happy filled few hours and about 4 hours later she died.
My most recent experience was with a gentleman who had cancer right through his body, he was bedridden and needing all ADLs and daily support to be comfortable as possible .His wife although elderly was there to make him his breakfast every morning. This gentleman was stoic till we needed to call in the palliative care team he reluctantly aggreed to have morphine for his pain full well knowing his control was ebbing away. Within the week he was gone and I will never forget the warmth and appreciation shown to me while caring for their families patriarch. ,
At any time when I needed support a Daughterly Care coordinater was there to assist me with questions asked by family ie process in place, RN support or further equipment required.
Calmness throughout his passing was evident as the family supported mum and each other.
I feel honoured to be part of Daughterly Care Pallative Care team.
Wendy, we are blessed to have you on the Daughterly Care Palliative Care team. Families are always appreciative of what you do in that intense yet special time for them. I love the way you step back and give families time together and thoughtfully cook a cake for visitors who come to say goodbye or cook a family meal for the adult children who have come to spend time with their parent each night after work. And yes, the will to live is very, very strong and Elders often make the decision to delay pain relief for as long as humanly possible because they want to be ‘present’ for as long as possible and you have greater control over that process when you die at home.
While caring for Mr B I experienced how important our support as a Caregiver is, for a dying person and their family.
Mr B lost a long battle with cancer, during which time his wife and other family members spent as much time as possible with Mr B at his bedside in the nursing home. They did not want him to be alone for the whole time. I would sit all night beside his bed trying to make Mr B feel as comfortable as possible (wiped his face, gave mouth swab, holding his hand…). When
Mrs B arrived on the last morning, her husband passed away peacefully while we both were holding his hands.
My support was a very much appreciated by Mrs B during this very emotional time which gave her comfort knowing that her husband would not be by himself when it was his time to go.
It was also important for Mrs B to know that she didn’t have to be there on her own either. She spoke a lot about her past during her husbands last hours.