Health Care and the Dying
The Dying are Living !
The Dying are Human beings!
The Dying are Persons !
The term “patients” works against realizing all
three.
Persons have rights, feelings, emotions, and ought to
be given the respect, love and concern that humans deserve.
Persons deserve CARE based upon understanding and understanding
based upon the TRUTH.
AVOID
Harmful words and phrases:
1. “Dying” well
we all are, aren’t we. Who
knows the exact date and time for death?
It separates the living from those they think are different or not
like them, “dying”.
2. “Terminally Ill” as a phrase is not given an
exact definition. It is a
guesstimate!
But the phrase hurts people because it separates them
from others and serves to setup a harmful “stereotype”.
3. “Dying patient”.
This is two steps removed from a living human being!
Respect
for Persons
Respect for Personality
Personality can be maintained in the face of
impending death.
People react differently according to their
personalities. Yet there are
some emotions shared in common by many, not all.
What sort of reaction or attitude to your impending
death do you think that you would have?
What sort of reaction or attitude to your impending
death would yo want to have?
What sort of reaction or attitude to impending death
would you want your loved ones to have?
The
Theory of
Elizabeth Kubler-Ross, M.D., RN
Description of “Stages of Dying”
A theory, based upon observations
NOT a prescription!!
Cautions:
NOT everyone HAS experience these five emotions.
NOT everyone MUST experience these five emotions.
NOT everyone WILL experience these five emotions.
NOT everyone SHOULD experience these five emotions.
It is a helpful guide to understanding.
It is NOT a manual for how to die “correctly” or
“better.
You cannot impose these feelings or “stages” on
others!
Five
(5) -- more or
less
These are just the most frequently observed and in the order most
frequently observed by Dr. Kubler-Ross.
Stages
– not exact, not definite, there are overlaps and regressions and
accelerations
Dying-
NO not only for approaching death but for any event that is approaching
and is horrible and that can not be stopped or altered.
e.g., loss of job, break up of a marriage, death of a friend
There are regressions, fixations and accelerations.
The Stages
1.
Denial- easy to
get into , hard to keep up.
2.
Anger- not directed at actual persons but at what they
represent
3.
Bargaining- doe not last that long
4.
Depression – two (2) types, quite different and calling for
a different response from those who wish to help!
a. Reactive Depression- looking to the past and losses
already incurred, losses that are physical and social.
b. Anticipatory or Preparatory Depression – looking to the
future and the impending loss of EVERYTHING and EVERYONE.
5.
Acceptance
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Learn
from those facing death what others can do to help them.
Alternative Forms of Caring
Home
Care
Palliative
Care
Palliative
Care Web Sites
http://www.ejpc.co.uk
http://highlander.cbnet.ns.ca/cbnet/health/pallit.html
http://www.stoppain.org/palliative_care
http://www.mdanderson.org/departments/palliative
http://meltingpot.fortunecity.com/trinity/832
http://www.ircm.qc.ca/bioethique/english/publications/journal_of_palliative_care.html
Hospice
Program
Provide
comfort with care on the journey toward death!
Hostels
are places to rest on a journey
Hospitals
are places for a person on a journey towards health
HOSPICES
are:
Programs not places
80% in Home
Diversified Team supporting FAMILY
Pain Control- variety of chemical Agents
Drugs are effective 99.5% of the time
Intractable pain exists only .5% of all cases
COMBINATIONS-
e.g. Morphine, cocaine and
potentiators
Hospice
Program Web Sites
http://www.hospiceweb.com/states/ny/abraham/abraham.htm
http://www.cabrininy.org/hospiceMain.html
http://www.catskillareahospice.org
http://www.eeh.org
http://www.hospicecarenetwork.org
http://www.hospicecareinc.org
http://www.sunyit.edu/~burlinc
http://www.hospicecny.org
http://www.americanhospice.com/hony/honyfrm1.htmhttp://web.northnet.org/hospiceslv
http://www.cayuga-cc.edu/hospice
http://www.hospiceofwestchester.com
http://www.hospiceinc.org
http://www.brooklynhospice.org
http://www.palliativecare.org
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