When a loved one is diagnosed with a terminal illness, it is natural for both patient and family to feel fear and anxiety. During this emotional time, it can be difficult for family members to express their feelings. However, by directly confronting the realities of death, families can communicate effectively and better support one another during a difficult time.
Identify Your Fears
Death-related fears are natural, but individuals vary in the nature of their apprehension. "Death anxiety" is a phrase that describes the unease people experience when thinking about their eventual nonexistence. Fearing the dying process or worrying how one's death will affect family members is also common. Pinpointing your own fears will help reduce anxiety and make it easier to discuss emotional topics with loved ones.
Share Your Feelings
Faking good cheer to avoid breaking down in front of a patient is a common mistake families make, according to Elizabeth Kubler-Ross, M.D. Dying patients may avoid discussing their own fears of death due to concerns that loved ones will not be able to handle it. This situation can leave the patient feeling isolated, lonely and resentful. Sharing your feelings gives the patient permission to be honest and authentic. It also relieves the patient from feeling responsible for the family's emotional well-being.
Discuss Medical Choices
A 2010 study published in the American Journal of Hospice & Palliative Medicine reported that patients surveyed received inadequate information about their end-of-life options. Furthermore, psychiatric nurses and their medical colleagues felt uneasy openly discussing palliative treatment and addressing patient's emotional issues. The primary focus of the American health care system is to preserve life at all costs. Patients need family support to make informed decisions regarding treatment. If a patient opts for palliative care over active treatment, it may be initially difficult for family members to accept. But listening to the patient's medical or spiritual needs is essential to advocate for the treatment the patient wants.
Discuss Plans for the Future
When a loved one dies, the family must continue to deal with a number of issues. Problems can be decreased by discussing arrangements ahead of time. Seeking an outside professional's assistance can be helpful in preparing last wills, arranging for the care of children or finalizing financial matters. Taking care of these details can minimize the patient's guilt and allow family to focus on their emotional health after the patient's death.
Listen to the Patient
Maggie Callanan and Patricia Kelley, authors of the book "Final Gifts," use the term "death awareness" to refer to the special knowledge patients have regarding their own needs during the death process. Callanan and Kelley believe that dying persons seek to share their experience with their loved ones and that patients will request what they need to have peaceful final moments. Being prepared to listen can both ease the patient's mind and avoid misinterpreting the person's final wishes.
References
- Palliative Medicine Journal; Effect of End of Life Education on Medical Students' and Health Care Workers' Death Attitudes; K. Hegedus, A. Zana, G. Szabo; April 2008
- American Journal of Hospice & Palliative Care; Death Anxiety and Death Competency: The Impact of a Palliative Care Volunteer Training Program; Stephen Claxton-Oldfield, Maggie Crain, Jane Claxton-Oldfield; December-January 2007
- "The Complete Adult Psychotherapy Treatment Planner"; Arthur E. Jongsma, Jr., L. Mark Peterson; 2006
- "On Death and Dying: What the Dying Have to Teach Doctors, Nurses, Clergy and Their Own Family"; Elizabeth Kubler-Ross, M.D.; 1997
- "Final Gifts: Understanding the Special Awareness, Needs and Communications of the Dying"; Maggie Callanan, Patricia Kelley; 1997
- American Journal of Hospice & Palliative Medicine; Psychiatric Nurses' Expertise, Interest in End-of-Life-Care and Requests for Continuing Education on End of Life; Sharon Valente, Judith Saunders; February-March 2010
