Facing Challenges at Death's Door - Essay Example

? Facing challenges at death October 9, Contents Contents 2 Facing challenges at death 3 Introduction 3 Challenges for the dying patient and possible measures for addressing the challenges 3 Challenges for the dying patient’s family and possible measures for addressing the challenges 5 Challenges for the caregiver and possible measures for addressing the challenges 6 Conclusion 7 References 8 Facing challenges at death Introduction The process of death is a challenge to the dying person and to people around him or her such as close relatives and friends and caregivers. The dying person, under natural death, may face associated challenges to the cause of death and fear of the dying process while other people may be suffer because of developed fears by the dying. A caregiver however has a responsibility to manage the involved challenges during the process of dying. This paper seeks to discuss some of the challenges that a dying patient, the patient’s family, and caregivers may face during the dying process and measures that I can take, as a caregiver, to address the challenges. Challenges for the dying patient and possible measures for addressing the challenges People who undergo natural death experience a process that precedes their death. The ultimate stage of death is sometimes defined for patients, especially those who suffer from chronic diseases. Lost hope among the patients may also present the perception that death is imminent and the patients begin to await their death. The time towards death and the exact time of death offer many challenges to patients and pain is one of the major challenges that patients face in the dying process. Most of the diseases that cause death destabilizes patient’s biological system and results in discomfort. Some diseases such as cancer are for example reported with extreme level of pain that patients have to endure as they await death. At advanced level of cancer, for example, there is a probability that 90 percent of patients suffer from extreme level of pain. Pain also induces other challenges to the patients and this identifies its significance. It also causes or moderates depression among patients and may even lead to suicide. Depression is another major challenge that dying patients face and majorly results from diseases with extreme levels of pain. At least 60 percent of cancer patients, for example, suffer from depression and a significant percentage of victims of the chronic disease, almost half, report cases of psychological disorder. Depression is common among dying patients because of its diverse causes that may range from pain, anxiety, neglect, and loss of control of life. Identified effects of depression, in healthy an unhealthy people, also identifies its significance as a challenge to dying patients. A study of diabetes mellitus patients, which can be inferred to patients with other terminal illnesses and especially in their dying stages, established that depression has adverse effects on patients’ quality of life but dying patients needs a high quality of life as a measure to overcoming their pain and the reality of death. The high incidence of pain, depression and their dependence on other conditions that the patients face, and their effects on the patients’ condition identify pain and depression as the major challenges that dying patients face (Woo, Maytal and Stern, 2006; Eren, Erdi and Sahin, 2008). Maintaining hope in the patient’s life is the most suitable way for addressing the pain and depression issues. Treating the dying patient as though they do not suffer from terminal conditions, managing their pain, and offering emotional support is likely to develop the patients’ positive attitude and reduce their psychological pain. Effective care and strong relations with the patients can achieve such optimism. Some level of pain, such as in advanced stages of cancer my however fail to respond to such measures and a patient’s poor attitude towards the dying process may also undermine the proposed efforts to quality of care. I would however remain optimistic and care for the patients’ needs for a quality dying process. Challenges for the dying patient’s family and possible measures for addressing the challenges People play different but significant roles in their families. Some may offer financial support while others may be a source of love, unity, and inspiration in their families. The dying process exposes the family to the need for transition as the family faces the reality that the patient will no longer perform his or her roles that either will be assumed by another person or may not be performed any more. This is because death imposes change in family structure from the family’s normalcy and identifies lapses and setbacks. The change in structure is particularly a major challenge as a family may fail to unite and recover from the loss, especially if the dying patient was the pillar of the family such as a sole breadwinner, a parent, or an elder member of the family. Setbacks may also emerge through financial instability if the patient was the main provider and provision of care demands significant resources from the remaining members of the family. Failure to manage the loss, or anticipated loss, towards a positive transition is further a major challenge because it can lead to stress and its consequences, especially after knowledge that the patient is in the dying process, induces distress and leads to emotional instability that requires proper management. While other challenges such as loneliness may face family members of a dying patient, the need for effective transition is a major challenge because of its wider scope and the degree of suffering that poor transition can cause to family members during and after the dying process (Helpguide, n.d.). As a caregiver, I would engage family members in a counselling session and inform them of the stages of grief and the need to embrace each stage for effective management of the anticipated loss, the ultimate loss, and its effects. I would focus on the five-stage grief model that outlines denial, anger, bargaining, depression, and acceptance with the aim of attaining unity by the end of the grief process. Core to my counselling would be the reality about denial and anger and the need to embrace the grieving stages towards ability to accept the situation and reconstruct life for a better future. Counselling, based on the model is likely to unite affected families during the dying and grieving process because of its ability to inform the family members that the grieving process is a normal phenomenon, especially if the families have not been bereaved in the recent past. This is because such families are more susceptible to emotional strain and instability. The proposed solution is however a subjective approach and does not guarantee success in all members of the families. It anticipates possible rebellion as family members experience pain (Prieto, 2008). Challenges for the caregiver and possible measures for addressing the challenges Witnessing pain that dying people go though and their ultimate death is a difficult experience that requires potentials to endure. Caregivers should receive training towards such potentials but this is not the case. Lack of sufficient training therefore remain a challenge and the dying process may overwhelm caregivers. Empirical studies on caregivers’ formal training regarding the dying process reveal that most training institutions do not train caregivers on related competence to the dying process. A study of 1455 medical trainees revealed that less than 20 percent of the students received training on how to deal with the dying process. The study also showed that a significant percentage of caregivers are never prepared for the experience with dying process. This occurs when the caregivers are expected to support the dying patient, family, and friends of the patient but unmanaged grief by the caregiver may have detrimental effects on the professional’s roles. Like family and friends, caregivers develop an attachment to their patients and should be equipped with necessity skills for managing anticipatory grief to provide care even in the terminal stages. The lack of training however limits the caregivers’ ability to manage their loss and anticipated loss and this may cause more damage to either patients or their friends and relatives (Lloyd, 2008). Caregivers’ personal attitude towards the dying process is another major challenge. Some individuals are highly sensitive to death and cannot handle it. Feelings of failure to care for the patients and anxiety over death also influences caregivers’ attitudes towards death and may affect their emotional stability and competence as they experience the dying process (Woo, Maytal and Stern, 2006). In order to manage the lack of training and poor attitude towards the dying process, I would register for trainings on management of the dying process and attend seminars for competence. I would also seek to appreciate patients through their dying process and restrain from emotional reactions. These strategies are likely to equip me for competent management of the dying process that can support both the dying patient and affected family members. Training is effective in ensuring ability to cope with the dying process because it follows established and tested curricula but may fail to change psychological perspectives towards dying and may therefore not be a perfect solution. Conclusion The dying process is a trying moment that presents challenges to the patient, the patient’s family and involved caregivers. Major challenges to the patient are involved pain and depression that are wide spread and have adverse effects. Family members however face the challenge of ensuring a positive transition while caregivers’ lack of training on the dying process is their major challenge. I would promote hope in my care provision and ensure quality care to manage pain and depression among dying patients, counsel family members of dying patients, and attend training for effective management of the dying process. References Eren, I., Erdi, O. and Sahin, M. (2008). The effect of depression on quality of life of patients with type II diabetes mellitus. Depression & Anxiety 25(2), 98-106. Helpguide. (n.d.). Terminal illnesses and prolonged grieving process. retrieved from: http://www.helpguide.org/harvard/saying_goodbye.htm. Lloyd, 2008). Spirituality, meaning making, and grief in alzheimer’s caregivers. Ann Arbor, MI: ProQuest. Prieto, E. (2008). Home health care provider: A guide to essential skills. New York, NY: Springer Publishing Company. Woo, J., Maytal, G. and Stern, T. (2006). Clinical challenges to the delivery of end-of-life-care. The Primary Care Companion to The Journal of Clinical Psychiatry 8(6): 367-372. Read More