As a person enters the final stages of their life, their family finds themselves in an emotional and stressful situation. Important decisions about the person’s end of life care must be addressed when reality sets in that medical intervention has become futile. Sharing this difficult news with the patient and their family is a daunting task for even the most caring and compassionate health care professionals.
Making the final preparations for a person’s passing requires several difficult conversations which must take place sooner rather than later, said Sister Betty Gulick, Director of Pastoral Services at The Village at Marymount in Garfield Heights.
“It is helpful to assemble a team of caring professionals to initiate these discussions and to open communication regarding end of life issues with the patient, their family, physicians, and care providers,” Sister Betty said. “This team will assess the needs of the patient and family to provide support as needed.”
The end of life team begins by assessing the patient’s situation. The team decides whether or not to involve other health care providers in the patient’s care and determines support resources from which the family can benefit. Identifying the heart of the family’s concerns and questions the patient has about their prognosis and treatment options must be addressed by the end of care team.
“The initial meeting with the family can be help the family or medical staff to consider what is happening to the patient from a different perspective,” Sister Betty explained. “The physician or family member may request a conference. All parties gather with open minds to fully assess the person’s condition and next steps in the care plan.”
End of life decisions
As a person nears death, end of life decisions are set in motion. Several factors must be determined, including whether or not the person wants to be on life support and have their life sustained. The objective is to help carry out the dying person’s requests about end of life care.
To prevent key decisions from being made at the end of life stage, it is valuable to prepare advanced directives while the person is able to convey their wishes for their care. Ask the person for their consent to discuss their end of life care – it will assure them that you will respect their wishes and honor them when the time comes.
“Listen carefully to what they say,” said Suzanne Nall, RN, LNHA, executive director at The Village at Marymount and a Brecksville resident. “Let them know that what they are sharing is important to you. Show empathy and respect by addressing their wants and needs in a truthful and open manner.”
Preparing the person spiritually is a key component to their end of life care, Sister Betty said.
“There are many spiritual or religious issues a person may face and struggle with,” Sister Betty said. “Meaning and purpose, guilt and forgiveness, or loss of faith are some of these issues. We need to offer thoughtful spiritual support and offer the person a comforting presence. Listen with an open heart.”
Sister Betty suggests using spiritual resources as appropriate — offer prayers, Scripture readings, poems, and music. “The person providing end of life care is not alone in this journey,” Sister Betty said. “Know your own limits. You may want to involve the clergy, the chaplain, and other resources in the person’s care.”