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Palliative Care and Facing Death
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Pallative care affirms life. I tprovides support and care for people who are in the last phases of incurable illness. It recognises dying as a normal process whether or not resulting from a disease. It exists in the hope and belief that through appropriate care and the promotion of a caring community sensitive to their needs, patients and their families may be free to attain a degree of mental ang spiritual preparation to death.

- Extract from the United Nations definition of palliative care.

Many people prefer to die at home in familiar surroundings and in the company of their families. Palliative care makes this possible. Supportive services are provided by a multi-disciplinary team of professionals and trained volunteers both in the home and the hospital or hospice. Although caring for someone who is dying can be stressful and upsetting, it can give people a chance to say goodbye. It may also reunite a family and forge friendships. Close relationships between the carer, family and friends are likely to continue after the death, and can be a great source of comfort and support to those who are grieving.

Facing Death

Finding out that someone is soon to die brings with it a wide range of emotions. Your dying patient, relative or friend may fear death, pain or simply the unknown. You may fear deeing someone who is close to you suffer and worry being left alone when the person has died. These fears are very common and many people have found that talking about them openly can help.

The Do's and Dont's

The quality of care you provide will improve if also look after your own needs.

1. Do acknowledge your own grief. It is a sign of human strength, not human failing.

2. Do turn to healthcare professionals for their support, and take advantage of their experience and expertise.

3. Do seek the help of volunteer carers.

4. Don't feel guilty if you are angry or frightened that your patient is dying. These emotions are natural, but try confiding in others tather than depressing your patient.

5. Don't bottle up your emotions as this may create even more stress.

6. Don't regard yourself as useless. You are providing essential support in a difficult time of need.

When The News is Broken

You may be one of the first people to be informed that your patient is terminally ill.

Be informed. Try to be present when your patient receives the news: by listening and learning about her condition, you may be able to provide comfort later.

Be honest. If your patient asks you to expand on any detail, try to tell the truth as sensitively as possible. If there are any questions you cannot answer, seek the advice of a healthcare professional.

Be discreet. Your patient may not wish to discuss death, or maybe even refuse to believe she is dying. If you need to talk about it, discuss the issue with the rest of the family or with an outsider, such as the doctor.

The Importance of Communication

As death approaches, it is important that the dying person is encouraged to share her feelings.

Talking. Don't be put off is she is unable to speak. Watch for non-verbal signs of communicating feelings.

Listening. If she is able to express her wishes and sentiments, listen patiently and carefully; this is one of the most important things you can do for her.

Writing. If she finds it difficult to talk, suggest that she writes down her feelings.

Touching. Hold her hand; this can soothe anxieties and communicate reassurance and affection.

Counselling. Your patient may benefit from talking to someone outside her family and close friends, such as a professional counsellor.

Pastoral Care. You may want to talk to a pastoral care worker. These people are trained to listen and provide spiritual comfort and guidance for the dying person and their relatives and friends.

Source: A Dorling Kindersly Book

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