...Although all people die, everyone's dying process is unique. Many people think of dying as merely a physical process, but dying is an experience of the whole person and is influenced by a combination of physical, psychological, social, cultural, and spiritual factors. There are as many ways to die as there are to live, so in order to better understand how people who are dying experience the process, researchers and clinicians have developed different models or theories that attempt to account for how people cope with dying. THEORIES/MODELS OF DYING Elisabeth Kubler-Ross's Stage Theory of Dying The general public is most likely to be familiar with Kubler-Ross's theory of dying. In 1969, she published a book titled On Death and Dying, which was based on interviews collected from 200 dying patients. In the book, Kubler-Ross discerned five stages that dying people experience. The five stages, which reflect different reactions to dying, are denial, anger, bargaining, depression, and acceptance. Denial is the "No, not me!" stage where the person is in shock or denial and cannot believe that they are going to die. Denial is self-protective and gives the person time to adjust psychologically to the news that he or she is going to die. Anger is the "Why me?" stage and may involve, in addition to anger, resentment, rage, and envy at God, doctors, nurses, family members, or anyone who is not dying. Bargaining is the "Yes me, but. . ." stage and often involves bargaining with God...
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...(Siden, 2008) Home hospice helps the entire family and family members are encouraged to take an active role in providing supportive care to the patient. In doing so, the family experiences fewer feelings of helplessness and the patient is not relying solely on strangers for all of his/her care. The goal of hospice care is to achieve the best quality of life not only for patients, but also for their families. Enabling death at home, if this is the patient's choice, is often seen as part of ensuring the best possible quality of life. There are hospitals which have a hospice program to give terminally ill patients access to support services and other health care professionals. Many hospitals have a special hospice unit. These units provide intensive medical and psychological support to patients who need aggressive symptom management. Home hospice provides end-of-life care in a setting which is familiar to the patient and their family therefore making their final days more comfortable and beneficial to all. Excellent end-of-life support, in the location of choice, is in itself, an essential aim but my goal is to determine which choice provides the best care for the patient and the family. Palliative care It has been noted that the most common answer to the question "How would you like to die?" is "Asleep in my own bed." A home death is considered the ideal when defining a good death. Interest in the development of home-based palliative care and the concept of a home death has recently...
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...Kristin Bachman February 27, 2012 A dying man needs to die, as a sleepy man needs to sleep, and there comes a time when it is wrong, as well as useless, to resist. Stewart Alsop Death, dying and bereavement finds a way of impacting everyday living. Images of real or fictional death are often while watching television or movies. Death can impact people on a personal and a cultural level. This essay will entail how cultural attitudes toward dying, death, and bereavement have changed. While examining hospice, the care obtained, and its role in this shift. Cultural attitudes toward dying, death, and bereavement have changed. There are enormous variations across societies and over time in attitudes toward death. Some societies engage in death avoidance while others celebrate the communion between the living and the dead. In the United States there has been an immense change in the process of dying from past centuries to the present. “This change is partly due to a shift in the average age of death and the association of dying with old age” (Aubrey, 2007). It is also caused by a change in the causes of death. At one time most people died from critical illnesses that struck quickly. Now people are more likely to die from a chronic illness that leads to a slow death. The setting for death has also changed. Most deaths in the past occurred in the home. Now death typically takes place in a medical setting such as a hospital or nursing home. Certain people prepare for death by engaging...
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...My experience of death and dying happened almost seven years ago, when my mother-in-law passed away due to complications of her cancer. I was was there during her last days in the hospital. We admitted her to one of the largest private hospital in the Philippines. In the Philippines, we do not have a palliative wing in that same hospital during the time that she was admitted. She was given morphine thru PCA pump to manage the pain. She had her own private room . We were able to spend time with her and be with her during her last hours. I have observed the same care here in Canada, the difference I have observed is they have a standard palliative program and it is at no cost to the patient. There are spiritual rituals that we observe in the Philippines. During the wake, it is not allowed to sweep the floor, leave the dead all alone in a room- it is said that someone should be there 24/7 to ensure that bad spirits does not take away the soul of the dead. We observe our wake up to 5-7 days. They even hold it as long as 10 days, when they are waiting for a family member going home from abroad. Wakes are held in their own home or funeral home. For the family members, they are not allowed to do recreational activities while the wake is ongoing, or to the point of not getting married in the same year a family member had passed away. Most of the widows would wear black to represent their grieving. For visitors, they are not allowed to bring home food that is served during the wake...
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...End of Life Care Student’s Name Institution End of Life Care The cause for the trend of majority of elderly people not dying in their own homes as their preference is NHS failings, incorporating a scarcity of health visitors, which ensues in the desires of the elderly persons being ignored or not adhered to. Owing to poor co-ordination of social and health care services for the dying, the preferences of the individuals nearing death frequently go unidentified, and in instances where the preference to die at home is clearly stated, it frequently cannot be met (Rensbergen, Nawrot, Hecke, & Nemery, 2006). The social and healthcare providers conventionally offer low priority to end-of-life care as is evident in the lack of adequate training among significant staff. Another reason encompasses social-contextual elements. Gender, living status, and age are predictors of the location of death; however, the implant of a nursing home in a domestic community is the fundamental factor (Rensbergen, Nawrot, Hecke, & Nemery, 2006). As a nurse, to support clients in end-of-life care, and in reinforcing their preferences, one can come up with creative partnerships with healthcare professionals, patients, policy developers, and others to ascertain that care of the dying is prioritized. Moreover, one can record the comprehensive requirements of dying patients and families and taking note of individual, organizational, professional, and societal hindrances to quality end-of-life care...
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...better prepared to handle the death of loved ones. In our society, we tend to shy away from thinking about death. The terminally ill generally die in institutions (hospitals and nursing homes), away from their homes. Therefore, we are seldom exposed to people dying. Many people in our society seek to avoid thinking about death. They avoid going to funerals and avoid conversations about death. Many people live as if they believe they will live indefinitely. Fortunately, the hospice movement has been developing in recent years in an attempt to foster death with dignity. A hospice is a program that is designed to allow the terminally ill to die with dignity—to live their final weeks in a way they want. Hospices originated in the Middle Ages among European religious groups that welcomed travelers who were sick, tired, or hungry (Sullivan et al., 1980). Hospices serve patients in a variety of settings—in hospitals, in nursing homes, in assisted-living facilities, and in the dying person’s home. Hospices provide both medical and social services, Children should not be sheltered from death. Funerals help children learn that death is a natural process. Taboos against talking about death and dying need to be broken in our society. You may find that tactfully initiating discussions about death and dying with friends and relatives will be helpful to you, and to people close to...
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...Summary Paper Hospice Care Description of the Organization Care designed to give supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life, rather than cure. The goal is to enable patients to be comfortable and free of pain, so that they live each day as fully as possible. Aggressive methods of pain control may be used. Hospice programs generally are home-based, but they sometimes provide services away from home in freestanding facilities, in nursing homes, or within hospitals. The philosophy of hospice is to provide support for the patient's emotional, social, and spiritual needs as well as medical symptoms as part of treating the whole person. Hospice programs generally use a multidisciplinary team approach, including the services of a nurse, doctor, social worker and clergy in providing care. Additional services provided include drugs to control pain and manage other symptoms; physical, occupational, and speech therapy; medical supplies and equipment; medical social services; dietary and other counseling; continuous home care at times of crisis; and bereavement services. Although hospice care does not aim for cure of the terminal illness, it may treat potentially curable conditions such as pneumonia and bladder infections, with brief hospital stays if necessary. Hospice programs also offer respite care workers, people who are usually trained volunteers, who take over the patient's care so that the family or other primary...
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...The Miller Family Angel F. Cuble SOC313: Social Implications of Medical Issues Professor Scott Baxter March 10, 2014 The Miller Family In this paper I will be discussing the how Ella Miller should spend her final days. Ella was diagnosed with breast cancer and has been in remission for some time. She went to the doctor and she was told that her cancer has returned. Ella was treating herself through a variety of natural means and her husband John who is of the American Indian origin has been using tradition methods to banish the bad spirits. Mrs. Miller would like to die at home than to die in a hospital. In this paper I will be discussing what will be best for Ella. Ella and her husband John are not into “modern medicine” and they would like to use their methods of natural healing to help her to be comfortable in her final days. First I would explain to them the difference between natural healing vs. modern medicine. In an article by author Thomas Sullivan entitled Modern Medicine vs. Alternative Medicine: Different Levels of Evidence; he mentioned that about 40 percent of Americans have tried some form of alternative medicine at some point but studies clearly show alternative medicine simply does not (Sullivan; 2011). Studies have shown that patients who use alternative treatments have a poorer survival time. Modern medicine was or is made to fight off infectious diseases like cancer, diabetes, cardiovascular diseases, etc. Ella and John have three children...
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...Jewish Culture Although all people experience death, dying and bereavement in all cultures, everyone’s dying process is unique and different. Some people may think of dying as a physical process, but dying is an experience of the whole person and is influenced by a combination of physical, psychological, social, cultural, and spiritual factors. Culture, identity and personal beliefs all have a profound impact on an individual’s choices in the context of dying process. Ethnicity, cultural differences, religion, personal beliefs, individual preferences and choices etc can all affect care needs and social practice at the end of life. People’s experiences of illness and death, as well as beliefs about the appropriate role of healers, are profoundly influenced by patient’s cultural background. This assignment will provide a brief discussion of the beliefs, customs and rituals associated with death, dying and the grieving process in the Jewish culture and discuss the associated theoretical principles of a grief and loss theorist named J. W. Worden. Also while discussing the challenges in applying this theory to the Jewish culture, in an acute care setting. Jewish cultural beliefs have developed a traditional system of mourning concerning death and burial. The Jewish community views deaths as an ending of life, rather than as a beginning of another. Jewish funeral and mourning rituals are centered around respect for the dead. The body is buried within 24-48 hours, so the soul can...
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...The Liverpool Care Pathway: Does it improve the quality of dying? The Liverpool Care Pathway (LCP) is an integrated care pathway developed in the late 1990’s (Ellershaw et al, 1997) as a means of transferring best practice in care of the dying, from the hospice environment to other sectors starting in the acute setting. Currently the LCP is a recognised tool used by clinicians in the United Kingdom as well as over twenty countries, to give appropriate care to patients who have reached the last hours or days of their lives. Described to provide comfort to the dying and also address the needs of the carers (Chapman 2009). During this assignment the author will highlight and explain how a data search was conducted, and will analyse the data retrieved, explaining and evaluating the data to build a discussion based on the chosen topic of end of life care, with a focus on the Liverpool Care Pathway. The author will conclude by producing recommendations for practice. Although described above that the Liverpool Care Pathway is an appropriate tool for providing adequate care for patients, it can also be seen as a controversial pathway, being described as a ‘tick box’ approach rather than a humanistic approach (Chapman 2010). It has been referred to by the UK’s Daily Telegraph as ‘sentenced to death on the National Health Service’ (Devlin 2009). The author has a keen interest in palliative care, after researching is interested in enhancing knowledge surrounding the LCP as there are many...
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...find ways to make herself independent from her sisters (Encyclopedia). During her education as a child, Kübler-Ross found interest and excelled in mathematics and science, which lead her to her career aspirations. Elisabeth Kübler-Ross witnessed and spoke with people who were dying at a young age and soon after realized that death was a natural stage of life and was not something to fear. The reactions and avoidance people had concerning the topic of death motivated her to be the voice of the dying. Elisabeth Kübler-Ross moved out of her family home at the early age of sixteen, where she began working at a war clinic during World War II. She always had a desire to help others so spending...
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...The Hospice Movement What is a hospice? A hospice is a place where people who are fatally ill can find care during their illness and then return home. The word hospice comes from the Latin word “hospes”, a word referring both to guests and hosts. Cicely Saunders She was a British registered nurse who pursued a career in medical social work due to chronic health problems. She fell in love with a dying patient (David Tasma, a Polish refugee), this helped her solidify her ideas that terminally ill patients needed compassionate care to help address their fears and concerns as well as comfort for physical symptoms. One of her most important quotes is: "You matter because you are you, and you matter to the last moment of your life." After the refugee's death she volunteered at St Luke's Home for the Dying Poor where she was told that she could best influence the treatment of a terminally ill person as a physician. She then entered medical school and achieved her degree in 1957. Saunders believed that it is more important to focus on the patient rather than on the disease and introduced the term “total pain”, which included the psychological, spiritual and the physical aspects. She also believed that the needs of the patient's family should not be ignored. She spread her philosophy internationally in a series of tours of the United States that began in 1963. In 1967, Cicely Saunders and her colleagues opened St. Christopher’s Hospice, the world’s first...
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...Ahmad Ibrahim English 103 David Overly, Ph.D. July 23, 2014 Paper #2 The poem “To an Athlete Dying Young” is about a young athlete from a small town who represents for his town and people by winning a footrace. The athlete is being cheered on and praised for the accomplishments he has done for his fans and town but at the end of the race the athlete has no idea what’s in store for him as soon as he reaches the finish line, sudden death. The young athlete is dead and his people are devastated after they have witnessed glory and fame cut short. Ironically A.E Housman doesn’t laminate the athlete’s sad death nor does he acknowledge it in a negative way instead Housman talks about the perks of dying at young age after accomplishing something glorifying. Bob Marley, the first superstar celebrity to sell more than 20 million records throughout his career. In 1963 Bob and his friends have formed the Wailing Wailers and in 1972 the Wailers came up strong by signing a contract with Island Records. Bob Marley has helped introduced the world with reggae music and until this day he remains one of the most beloved artist his fame has not died nor did his music because of the impact he has made to music listeners. Bob was almost assassinated in 1976 back in Jamaica due to his political beliefs; he was attacked while on stage by a group of gun-men luckily he was struck on his biceps but his wife Rita was shot on the head, Bob continued his show but even more motivated. In 1981 Bob...
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...share experiences and also take care of yourself by doing so. It’s a place to blog or unwind about an experience, there are many resources listed for certification for palliative care and how to treat patients. It’s written with a very open and warm way and it’s a safe place to share your experiences, not formal and official like the NCI website. Communities like this are very important for health professionals to have a place to talk openly about experience which have a huge impact personally and learn from the experiences of others. The priority here is really the well being and training of the health professional. Part 1: Definition of the Topics on End of Life: 1. The Clinical Definition of Dying a. Clinical manifestations and complications -Signs of the Preactive phase of dying: * increased...
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...family members, social workers, and others while trying to understand the factors that led to the prevailing practices. She was particularly interested in how hospitals organized dying as a result of acculturated behavior that was regarded as normal and unproblematic by practitioners who did not understand the origins of the behavior. She discovered how hospitals shape medical practices, how shared medical rhetoric frames decision making about dying patients, and how cultural factors determine the way death occurs in the hospital and even which patients are considered to be dying by physicians and nurses. Kaufman was particularly intrigued by patterns of social behavior. She observed that today death usually is orchestrated by professionals in hospitals and no longer is waited for, a transition that has markedly shortened the “waiting time” for dying. She found that hospital procedures and bureaucracy produced the imperative to “move things along,” mandating that health care professionals expedite decision making and produce the conditions for death. She identified “pathways” for moving things along, such as heroic intervention, and discussed how and why patients may stop moving along a pathway. Her ethnographic study features the detailed case histories of 27 patients culled from more than 100 dying patients she observed. In their clinical and social detail, multidisciplinary approach, and poignancy, many of the histories remind me of inpatient ethics consultations I have performed...
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