Facing the end of life is something everyone has to go through themselves and with family members. It is one of the most difficult times a human will face, and talking to someone about end of life issues is never easy. Many people in different situations are placed in the position to talk to someone else about end of life, this includes medical staff, hospice care staff, social workers and family members. Having compassion and concern during such a difficult time will help make it easier to address.
Step 1
Recognize the signs of approaching death. The Hospice Patients Alliance explains some of the stages of approaching death such as a decrease in fluid intake, apnea, coma like state, increased respiratory congestion and inability to swallow. A medical caregiver will explain to the family that these signs are part of the normal process of death and the patient is not in pain. A hospice nurse or physician will prescribe medication to help him relax to make the transition more comfortable. Keep in mind that only a registered nurse or physician can pronounce a death.
Step 2
Acknowledge who is to be contacted at the time of death. It is important if you are a caregiver or medical personal that you contact the right person before or at the time of the patient's death. This information, regarding advance directives should be in the social worker's notes inside the patient chart, if the patient is under hospice or hospital care. Refrain from discussing the patient's condition or their death over the phone. Ask them to come to the home, hospital or care center where the patient is located to discuss the condition with an RN or physician.
Step 3
Understand a durable power of attorney or DPOA. Lectric Law states that a durable power of attorney or health care power of attorney generally has decision making capabilities pertaining to end of life care of another individual, even if they are not immediate family. This person should be contacted and consulted with first by medical personal before anyone else. He will make end of life care decisions for the patient if she is unable to do so. Part of a durable power of attorney is a DNR or Do Not Resuscitate Order. This specifically states whether or not the patient is to be resuscitated or not after the heart stops. The DNR plays a factor in talking to the family about end of life care and what to do when death occurs if the patient is at home.
Step 4
Contact next of kin. Unless the patient has a different DPOA than their next of kin, this person needs to be contacted and brought to light on impending death or the death of their loved one. If the death is unexpected, make sure that medical personal is on hand to explain exactly how the patient died to the family.
Step 5
Offer time for the family to spend with the patient or the deceased. Once the patient dies, explain to the family that they can take as much time as they want to spend with the deceased before the medical examiner or funeral home removes the body. This is part of the grieving process and offers the family a chance to say goodbye in private.
Tips and Warnings
- Use compassion in your tone when discussing a loved ones passing or soon to be passing. Provide support and guidance, never answer medical questions or relay information if you are not a nurse or physician.
- In a medical setting, the primary care team such as an RN, social worker and physician are generally only allowed to discuss end of life care issues pertaining to a particular patient.
