Talking About Choices
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Our last days are an opportunity to learn lifes last and most powerful lesson: That there
is nothing to fear.
life decisions for those suffering from dementia
almost always the decisions fall in the laps of the family since the patient can no longer speak for himself/herself.
This comes as no surprise for caregivers because they may have been making many decisions all along. So we really need to
think about how to make end-of-life decisions on behalf of another.
In this chapter we explore ethical issues related
to hydration and nutrition in patients with advanced chronic illness.
Fact Sheet:At the End of Life Although many people would prefer not to think about the end of their lives, planning
for the inevitable event increases the chances that your wishes will be met.
Links to help support caregivers cope with ethical, moral and legal conflicts
in diagnosis and treatment of patients with terminal health conditions
Keeping the Patients Comfortable - A Hospice article on explaining their role in patient care. With
most terminal illnesses, symptoms arise which can be quite uncomfortable and which cause a lot of fear and confusion for both
patients and families alike. Fortunately, hospice staff are thoroughly trained in how to achieve patient comfort.
Keeping the Terminally Ill Patient Home: Making
It Happen - If your loved one wishes to stay at home up till the very end, then you need to make
that wish clearly known to your RN casemanager, the social worker, your physician and any other hospice staff who inquires
about your wishes. A good article from Hospice.
"On Our Own Terms"
Link to Bill Moyers "On Our Own Terms" series of artcles, including:
Dying As a Spiritual Event
How to Be with a Dying Person
How to Manage Your Pain
Preparing for the Death of a Loved One
Site also has links to articles in PDF format you can download.
Palliative care and pain management
Some Facts About Artificial Nutrition and HydrationWhat is artificial nutrition and hydration? Is artificial nutrition and hydration
different from ordinary eating and drinking? Will the withdrawal of artificial nutrition and hydration lead to a long and
painful death? Is there evidence that avoiding artificial nutrition and hydration contributes to a more comfortable death?
Is it ever appropriate to give artificial nutrition and hydration to patients who are at the end of life?
Swallowing Problems... How
Thickeners Can Help
Things To Consider-Artificial Nutrition and Hydration Some points to think about when making decisions about the use of artificial nutrition and hydration and the importance
of honoring your loved ones wishes.
SAVE - education about suicide prevention and to speak for suicide survivors.
Straight Talk on Suicide-Teenagers:
learn about what puts a teenager at risk for suicide, the warning signs
Suicide-Links for prevention contacts
Suicide isn't painless-Almost
no one kills themselves because they don't want to live. Most people kill themselves because they want to live so much.
Suicide prevention in primary care-written for doctors but helpful to families
Suicide - Web Sites from Excite Health:
. Guides & Directories
. Illness & Injury
. Support & Prevention
Explains the natural way in which the body prepares
itself to stop, and the most appropriate kinds of responses.
When a person enters the final stage of the dying process, two different dynamics are
at work which are closely interrelated and interdependent. On the physical plane, the body begins the final process
of shutting down, which will end when all the physical systems cease to function. Usually this is an orderly and undramatic
progressive series of physical changes which are not medical emergencies requiring invasive interventions. These physical
changes are a normal, natural way in which the body prepares itself to stop, and the most appropriate kinds of responses are
comfort enhancing measures.
Signs and Symptoms
days and hours leading to the moment of death can be rich with meaning and expressions of love. Knowing the normal physical
processes can make this time more peaceful. When a person is close to death, a natural series of changes occurs. These changes
usually are not medical emergencies and the goal at this point is to keep the dying person as comfortable as possible.
A Gentle Death:
Freedom to Choose at Life's End
hope for a cure is gone, a person's individual beliefs and values about end-of-life care should govern every treatment choice.
Choice In Dying has learned that *having a choice* makes all the difference. Patients describe choice as the "key to
the room of suffering [they] have been locked in," and the remedy for despair and hopelessness. Once the knowledge of choices
is gained families describe an uplifted mood and if there had been plans for violent suicide, these disappear.
The Ultimate Emotional Challenge
A dying person is grieving the loss of control over
life, of body image, of normal physical functions, mobility and strength, freedom and independence, security, and the
illusion of immortality. He is also grieving the loss of an earthly future, and reorienting himself to an unknowable destiny.
Comforting A Dying Person
"Comfort" is more than just pain reduction;
the patient will need spiritual and emotional comfort as well. The hospice team attempts to achieve "comfort" in a number
of ways. Describes the steps to making the terminally
ill patient comfortable both psychially and mentally.
Constipation is a common and uncomfortable
problem. During illness, there are many reasons to be constipated These reasons may include less activity, less fluids, general
weakness, and the side effect of a medication (especially strong pain medications).
From Your Hands to God's Arms -Saying Good-bye
There comes a time to say
good-bye. Letting go is one of the most powerful expressions of faith and greatest parting gifts you can offer your dying
loved one. The words uttered allow you to give up control (and many hours of care giving), trusting instead in God's love.
Your words also offer your loved one the comfort of knowing that you trust in God so that he can draw strength from your faith
Keeping Watch - Readings, Prayers and Spiritual Resources for Those Keeping
Vigil and Giving Care
Lack of AppetiteIt is very normal to have little appetite, for foods to lose
or change flavor, and to feel full after a few bites. Here are a few hints that may help:
The basic premise of how massage helps the dying is touch.
The American Massage Therapy Association states that massage has both physical and mental benefits
Some people who are very sad sleep all of the time. They say
that they are not sad when they are sleeping. You may find that it will help to talk about it, even if it can't solve everything.
The Body Speaks-A Modern
Maturity Guide to end of life
People who are sick or elderly may be touched very
little - especially if their family is not near or their spouse has died, or if they live in a caretaker environment such
as a nursing home. These people especially need caring people around them - to hold their hand, rub their back, brush their
hair, or to just hold them when they need someone. Families often feel regretful after a loved one's death if they have not
spent time with the patient to comfort and to demonstrate caring and love..
Respite From Thoughts
The Daily Motivator
Near Death and Other Experiences
Spirituality & Faith in
PDF Format From Finding Our Way In English, Chinese and Spanish
Treating Mind, Body and Spirit