How
to Talk About Dying[1]
- Begin by being unembarrassed about the fact that, eventually, everyone
dies.
- Acknowledge that the experience is universal and no one can avoid
it.
- Be sensitive to the feelings of the person who is dying.
- Do not push your own agenda during a discussion with a dying individual.
Take cues from their responses to your questions.
- If the dying individual wants to talk about their dying, listen
to what they have to say and respond in an open and honest way. Do
not dismiss their assertions.
- Do not force your opinion of the situation; usw "I" statements
to describe what you are thinking/feeling so as not to suggest it
is how others should feel.
- If the person who is dying lives in a distant location, there are
still things you can do:
- Stay in contact through phone calls, email, mail, etc.
- Take an active interest in both personal and medical needs.
- Contact involved medical personnel/facilities to discuss care
and treatment.
Discussing
Care Options and Treatment
- When looking for a palliative care program for a dying loved
one, look for the following characteristics:
- Competent care by an interdisciplinary team
- Care centered on the patient and family needs
- Coordinated care that provides access to needed services
- Compassionate care
- Care committed to quality
- Communicate openly with involved physicians to ensure that your specific needs are being met.
- Never be afraid to ask for a second opinion.
- Keep asking questions.
- If you're not happy with the care you are receiving, look for
another physician who can
provide what you are looking for.
- Options for assistance in caregiving
- Nursing home
- Personal care homes or other assisted living programs
- Hire in-home care
Tying up Loose Ends - ways dying individuals can achieve completion
and fulfillment within their life:
- Develop the following items to ensure your wishes for care and treatment
are properly carried out:
- An Advance Directive, a document that expresses your health care wishes
and preferences (i.e.: whether you want a feeding tube, respirator, etc).
- A Living Will, a document that describes your care decisions if you
are dying, with little or no hope of recovery.
- A Power of Attorney for Health Affairs, a document naming the person(s)
you wish to make health care decisions for you when you cannot.
- Complete closure and reconciliation within social relationships should occur if at all possible. This includes forgiving past wrongs, expressing and accepting appreciation and gratitude, and saying goodbye.
- Explore what makes your life meaningful and communicate these things (special memories and experiences, etc) to loved ones.
- Allow yourself to let go of any regrets and forgive yourself.
- Accept the finality of your life by permitting yourself to grieve
the personal loss brought on by your death.
Signs that Death is Approaching
- Increased drowsiness caused by changes in the individual’s
metabolism
- Confusion, restlessness, and/or hallucinations
- Decreased socialization and withdrawal
- Loss of appetite and decreased need for fluids
- Incontinence
- Darkened or decreased amount of urine
- Decreased circulation resulting in skin becoming bluish and being
cool to the touch
- Rattling or gurgling sounds while breathing
- Irregular or shallow breathing
- Decreasing vision resulting in the turning of the head toward
a light source
- Increased difficulty in controlling pain
- Involuntary movements
- Changes in heart rate
- Loss of reflexes in legs and arms
It is important to note that not every individual experiences all of
these signs and that the presence of one or more of them does not necessarily
indicate that the person is close to death. This list is meant to be
a guide for what may occur when death is near.
[1] Byock, I. (2009, May). Frequently Asked Questions about End-of-Life
Experience and Care. Retrieved June 1, 2009, from http://www.dyingwell.org/faq.htm.
[2] Hollmer, M. (2009). Guide to End-Of-Life Care. Medical News Today.
Retrieved April 2009. http://www.medicalnewstoday.com.
[3] Lipson, S. (2008). End-of-Life Care A Guide for Seniors and Caregivers.
Retrieved May 2009. http://www.americangeriatrics.org/education/forum/endoflife.shtml.
[4] Byock, I. (2009, May). Working Set of Landmarks and Developmental
Taskwork. Retrieved June 1, 2009, from http://www.dyingwell.org/landmarks.htm.
[5] National Cancer Institute. (2002). End-of-Life Care: Questions and
Answers. Retrieved June 1, 2009, from
http://www.cancer.gov/cancertopics/factsheet/Support/end-of-life-care.
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