Death and Dying Health Article

Definition

Death is the end of life, a permanent cessation of all vital functions. Dying refers to the body's preparation for death, which may be very short in the case of accidental death, or can last weeks or months in some cancer patients.

Description

Quality and method of death differs between cultures, circumstances and degrees of preparation. For many years, the terminally ill did not have choices in their manner of death, often enduring excruciating pain before the inevitable end of life. In recent years changes have been made to allow for a better quality for end of life, such as hospice care and preparatory actions by the patient.

It is important to recognize the differences in the ways people grieve. Each culture socializes a person in a certain way to deal with death. Death affects a person cognitively, behaviorally and socially. The death and grieving attitudes of a person affect the subjects of death, dying, bereavement, suicide and euthanasia. While a person may be able to verbalize feelings about death, internal contradictory feelings of anxiousness are common. Each person handles the subject individually, and seeking appropriate assistance will help the person to come to terms with the event in his or her own time and way.

Hospice care

A diagnosis of terminal illness is a sad and traumatic circumstance. Hospice care provides quality, caring services for both the patient and his or her loved ones. Most communities have a variety of hospice providers. A physician or hospital patient services can assist with provider names. The yellow pages of the phone book, or referral services from United Way, the local council on aging, Visiting Nurse Association or the American Cancer Society are other information sources.

While the patient should be the one to choose hospice care, it is always appropriate to discuss all care options. Hospice staff are sensitive to concerns of both patient and family members and assist in the planning process as requested. Most physicians are aware of the services provided by hospice and will cooperate fully.

The hospice program will work closely with the physician to optimize the patient's care. The patient will sign consent and insurance forms, which are similar to those signed for hospital admission. There is also a form that states the patient's understanding that hospice care is aimed at pain relief and symptom control (palliative), rather than curative. Should a patient's condition improve and hospice services are no longer necessary, or the patient is in remission, services can be discontinued and the patient may return to regular care options. There is no obligation to remain with hospice care if it is not necessary. Should the patient need readmission to the program, medical insurance and Medicare may allow additional funding for this purpose.

Once hospice services are approved, the provider will perform a needs assessment, then assist in locating the equipment necessary for the patient's care. Quite often, the earlier needs are minimal, increasing as the illness becomes more serious. The purpose of hospice care is to make the home environment a comfortable haven for the patient.

The hospice team prepares a plan of care that is tailored to the patient. This will address the amount of care necessary to maintain the patient's comfort and wellbeing. The staff visits the home regularly and provides instruction on patient care, as well as answers medical questions and supports the caregivers.

As the illness progresses, care becomes more difficult. Hospice plans provide staff around the clock to consult by phone or to make visits if deemed appropriate. Respite care is also available for exhausted caregivers, so that the home can remain functional.

Hospice patients are cared for by a team of doctors, nurses, counselors, social workers, clergy, and volunteers, among others. Each provides assistance based on area of expertise. Additionally, hospices provide supplies, equipment, medications and other services related to the terminal illness. Hospice does not hasten nor does it delay the death process. However, hospices do provide specialized care that eases some of the anxiety and worry that accompany oncoming death.

The management of pain is very often an issue in terminal illness. The mission of hospice is to address all types of pain, not only the physical. Support is available to assist the patient in achieving the highest quality of life possible under individual circumstance. This may include physical and occupational therapists to keep the patient as self-sufficient and mobile as possible. Music therapy, art therapy, massage and diet counseling are available. The latest medications and devices for relief from pain and other symptoms is available. Also, counselors, some of whom are clergy members, assist both the patient and the family as needed/requested. However, hospice programs are not affiliated with religious groups and do not expect participants to adhere to any particular belief system.

The goal of the hospice program is to keep the patient both as pain free and alert as possible. Constant communication with the patient and caregivers assist in the high success rate of the hospice program. After the loved one's death, hospice programs provide both individual and group support for caregivers for at least one year, longer if necessary.