The Word "Now"
11/10/2014
One of the most important words used in end of life communication is "now". By putting "now" on the end of a sentence one can manage to cope with what is happening in the present. Fear can easily replace calm when facing the vast unknown. Asking one how they feel now is manageable. Asking how one feels in general is open-ended and leads to projection of the future which is uncertain. Inevitably we are okay now. Even if tied to the tracks with a train coming we are okay "now".
What are your thoughts about and experiences with keeping the dialog in the present?
11/10/2014
One of the most important words used in end of life communication is "now". By putting "now" on the end of a sentence one can manage to cope with what is happening in the present. Fear can easily replace calm when facing the vast unknown. Asking one how they feel now is manageable. Asking how one feels in general is open-ended and leads to projection of the future which is uncertain. Inevitably we are okay now. Even if tied to the tracks with a train coming we are okay "now".
What are your thoughts about and experiences with keeping the dialog in the present?
Hopeless and Helpless
11/03/2014
11/03/2014
I have recently received letters from people who were feeling hopeless and helpless as they witnessed their loved ones decline. These are common feelings that come with a sense of loss. With change comes opportunity. At end of life there are many opportunities that can change helplessness and hopelessness into compassionate service.
Hope is desire, expectation, goals, that sometimes involve a plan and or a design and almost always about things in the future. Staying in the present and being present for someone is a great gift. There is much uncertainty at end of life. Hope for a prognosis or diagnosis to change is usually futile however hope for "dying well" (Ira Byock, MD coined the phrase) is often achievable. One can still hope that the time that is left is peaceful and without suffering.
We think we are helpful when we are useful, constructive, and informative. All of those things are invaluable although they may take a different form. One feels helpless when one cannot change the outcome or control the situation. One thing friends and family can do is to allow someone to die in their own way. The following are other "helpful" actions that can be taken:
1. Investigate that the decline is not caused by a treatable medical condition or depression.
2. Validate what the person is feeling without trying to talk them out of their feelings.
3. Explore the person's end of life wishes and make certain they are known and documented.
4. Be present for and with the person. Often being present and being able to sit with the silence is most challenging and healing.
5. Engage the person in life review.
Feelings of helplessness and hopelessness are real. How one responds to them are the key to compassionate service to another.
Hope is desire, expectation, goals, that sometimes involve a plan and or a design and almost always about things in the future. Staying in the present and being present for someone is a great gift. There is much uncertainty at end of life. Hope for a prognosis or diagnosis to change is usually futile however hope for "dying well" (Ira Byock, MD coined the phrase) is often achievable. One can still hope that the time that is left is peaceful and without suffering.
We think we are helpful when we are useful, constructive, and informative. All of those things are invaluable although they may take a different form. One feels helpless when one cannot change the outcome or control the situation. One thing friends and family can do is to allow someone to die in their own way. The following are other "helpful" actions that can be taken:
1. Investigate that the decline is not caused by a treatable medical condition or depression.
2. Validate what the person is feeling without trying to talk them out of their feelings.
3. Explore the person's end of life wishes and make certain they are known and documented.
4. Be present for and with the person. Often being present and being able to sit with the silence is most challenging and healing.
5. Engage the person in life review.
Feelings of helplessness and hopelessness are real. How one responds to them are the key to compassionate service to another.