Death and dying – End of life care

Talking about death and dying is the first step towards reality, planning for life, and supporting ourselves and our loved ones. Usually, it is not until something ‘significant’ happens in our lives that we begin talking about death and dying. It’s a reality that many of us feel anxious and unsure. End of life care, when people are dying of diseases.

There is a scenario with advanced breast cancer and hospice: Female 62 years old, noticed a mass in left breast accidently and told about this to her doctor. Doctor examined her and sent for some tests. Tests showed that she had Breast cancer with spread to her bones. She underwent treatment with surgery, chemotherapy, radiotherapy. Over the years she had repeated infections and cancer spread all her body. She became extremely weak. The doctor informed her and family that cancer is not curable at this stage and recommended hospice care for comforting her and pain management.

Hospice services are provided at home, in hospice centers, nursing homes or hospitals depending on the patient’s situation and preferences. Hospice care emphasizes comfort, respect patient’s choices and support for families during a challenging time.

Another scenario with Living will advanced directives: Male 75, had breathing problems with 45 years of smoking history. After undergoing many tests, he was diagnosed with lung cancer spread to brain, bones, liver. He was admitted to ICU with severe breathing problems. Kidney, liver were not working. He was put on breathing machine for 2 weeks with hole in the neck. He has living will stating he wants any aggressive treatments like ventilator, if his condition worsens.

Advanced directives allow individuals to know their preferences regarding medical treatment and care if they are unable to communicate in future due to their illnesses.

Family discussions with spiritual practices: One of the family members who had not seen his father suffering from terminal illness, suddenly comes and wants to make decision about treatment. There is no rule that one family member should decide end of lifecare goals. Majority of family members should make the decisions.

A combined approach with emotional and spiritual support from chaplains is provided. Traditional rituals are done. They ensure that culturally sensitive and aligned with patient’s values and beliefs.

Take care of people when alive. A book called Tuesday with Morris is a great book which explains honor family members when they are alive. Author of the book is Mitch Album.

Talking to the family doctor can help in decisions in patients interest because they know and care utmost about the patients. Some hospitals make decisions not to do CPR by medical ethics committee.

General Health Recommendations:

Every person is unique and you are special. Stay social, don’t hold grudges, don’t feel guilty. Sleep well for 7-8 hours and cut down on stress. Exercise 30-40 mins 4-5 times a week , maintaining healthy weight Balanced diet including fruits, vegetables, whole grains, lean protein and healthy fats Avoid smoking, alcohol and other drugs . Spirituality helps in giving meaning and purpose to person’s life, building hope, strength and sense of peace.