When we have a very ill loved one, it occupies our thoughts constantly. Our mind has a way of sifting through the information that we hear from their medical providers, rejecting the negative and holding tight to the positive. Even when confronted with the information that our loved one’s situation is dire, we may continue to refuse to see death as a possibility.
Fear of Nonexistence
The thing that everybody knows but nobody really talks about. But though how much we evade this unavoidable conclusion, time forces us to think about what death really means to us. Since we all know that we will have to face it, when time comes.
Reading about this may even start to frighten you off, but all of us must be able to understand that in order to live our life to the fullest, we must discern how little time is given to us.
Our denial is an important mechanism that we use to protect ourselves from feeling overwhelmed by our emotions. For a time, it can help us to get through the demands of the day. If used for too long a time,however,it can rob us of living what time remains with our loved one. We may miss the opportunity to make plans that assure their comfort. Even worse than that, it can result in the loss of many important shared moments that may sustain us long after they are gone.
The participants in this research study identified six components of a good death. The first wish voiced by the patients was that their pain and symptoms be controlled. They feared dying in pain and experiencing shortness of breath. The participants were assured that pain and shortness of breath can be easily controlled with medication. Their second wish was to have the communication that allows them to participate in decision making. The participants said that unexpected medical situations had occurred with their illness previously causing decisions to be made in a crisis situation. The patients felt very empowered when they were informed that their condition was changing and they were able to participate in treatment decisions. It can be helpful for children to have conversations with their elderly parent helping the child to understand what the parent’s wish may be when their condition worsens. For example, would they want to receive artificial feeding or fluids if they were imminently terminal? Where would they want to be in their final days of life? The third wish of the patients in the study was to be better prepared for death.
Another sign that they are in the final months of life is that they develop infections. Elderly patients tend to get infections in the bladder and lung. As swallowing becomes difficult, they may cough and inhale liquids into their lungs causing bronchitis or pneumonia. This is called aspiration and is often seen in patients in the final months of life. Antibiotics will work initially but will have less power with repeated infections. Aspiration, once started, often reoccurs. Recovery depends on the strength of their cough but because their lungs are weakened, their cough is ineffective. For this reason, pneumonia is the number one cause of hospitalization and death in patients who are in nursing homes.
Losing someone is painful. We never feel prepared for the loss. But research shows that those of us who do confront the reality of a loved one’s impending death will emotionally do better after they are gone. We will have the opportunity to share in their journey and assure that they are comfortable. In our care giving, we will have the chance to thank them for the gifts that they have given us in this life. Finally, we will have time to say goodbye and to let them go with love.
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