Learn. Share. Plan.
Facing a Terminal Illness
by Audrey Miller MSW, RSW, CCLCP
Article Posted on
There are some things that we can plan for and others we cannot. Death is a certainty for all of us, yet many of us find ourselves poorly prepared. Caring for and spending time with a loved one who is facing imminent death can be both rewarding and challenging.
For those who love and provide care for the individual, there are helpful ideas that can make a great difference in the quality and experience of the shared time remaining. Central is that dying is a very individualized process. There is no right or wrong way to do it.
Conventional wisdom dictates that most of us will die in the manner in which we have lived: fighting until the end for life; accepting the process quietly; or somewhere in the middle. Acceptance and nonjudgement provides an atmosphere of safety and trust for the dying person and the loved ones to communicate honestly and openly.
It is important to know that denial of the prognosis can be initially helpful, as it protects the individual from having a catastrophic reaction and associated psychological harm. Denial gives the person time to process an overwhelming amount of varied and intensified emotions, clearing the way toward more reasoned understanding of the full meaning of the end of life. It is important for loved ones to provide a space of safety at this time – a touch of the hand, a gentle question such as “how do you feel?” can go a long way. We need to take our cue from our loved one.
Another common occurrence we see in hospice service is “anticipatory mourning”. This is the rehearsal of grief by the person, and by those who love them, in response to the impending death of the loved one. The dying person tries to imagine a world without them, and so do the carers. Research tells us that this rehearsal serves a valuable function: it regulates the experience of grief, again avoiding the risk of emotional collapse.
Maintaining an open line of discussion and communication during this time reassures the loved one of support and reduces feelings of abandonment and isolation. Listening is most important here – having someone to acknowledge the pain of separation and loss is a huge gift.
Certainly, palliative care, which addresses pain management and symptom control in incurable illness with quality of life as its goal, is required. The needs of the whole person – spiritual, psychological, physical, social – are assessed and accounted for in care planning.
Every health discipline has a role to play, and the full value of health care collaboration is implemented in the best interests of the person and his or her family.
This guest article has been contributed by Audrey Miller MSW, RSW, CCLCP, a recognized expert in life care planning, aging and caregiver issues.