Relating to a dying person
Hospice care for the terminally ill emphasizes helping them to die as comfortably as possible and with a sense of control and dignity. The tasks involved in meeting these goals are not always easy. Some persons will tax one's emotional and physical energies, others may have needs and demands that we cannot meet, and still others may lead us through the process with courage and insight. The following are some suggestions for working with your loved one and for remaining healthy as caregivers.
- Explore your own feelings about aging, death, and dying. The person who is uncomfortable with these issues is less likely to be effective in assisting the person who is dying.
- Recognize the individuality of each person's dying and each family member's experience of this. Dying has as many styles as living. Some people will take the opportunity to adapt along the way, while others do not.
- Find a balance between the practical goals of "helping someone in need" and the human goal of "sharing the dying experience."
- Be ready to accept the variety of feelings expressed by the dying person. Allow the person to grieve for his/her own dying and other losses.
- Listen. Be aware of cues and signals individuals send out. Be prepared to discuss the dying person's concerns openly and honestly.
- Be patient and allow time to think and express feelings, concerns, and fears.
- Give the person the opportunity to live as fully and independently as possible up to the moment of death. Help the person to define and clarify the realities of day-to-day existence: What are the things she/he can do? What are the things she/he cannot do?
- Make continued human contact available and rewarding; however, at the same time, recognize when someone needs time alone.
- Spend time together. Families often need support in coping with a dying person and resolving conflicts which may exist between them and the dying person.
- Grant your loved one the right to decision-making and to exercise some control over the situation. The person who is a participant in decision making is often better able to yield control to others as his/her condition deteriorates.
- Help the dying person to retain a sense of dignity and self-worth.
- Use touch. This often relieves the fear of being untouchable and is an effective nonverbal way of communicating solace, care, and comfort.
- Understand that in any dying person regressive behavior may occur. Family and friends may also need help to understand and cope with such behavior.
- Encourage life-review. Reinforce the strengths of the dying person family members. This process aids in the resolution of old as well as recent conflicts, and adds to a sense of accomplishment or completion.
- Reassure the dying person that his/her fears are natural, and that you and others are there to listen and to help whenever possible. There are medications and therapies available which can address and typically alleviate many of the symptoms faced by a dying person.
- Be prepared for normal expressions of anger, despair and hostility, either overt or subtle. If prepared for such reactions, it is easier to accept them and to avoid a similar response.
- Do not expect the dying person to conform to your standards and expectations in regard to dying. Keep in mind what is important to the person.
- Try not to force a dying person through the so-called "stages" of grief or dying.
- Avoid becoming too preoccupied with how you are coming across to the person. Such preoccupation can prevent you from being "human" and natural in your caring.
- Don't force your feelings onto the dying person.
- Try not to exclude the dying person from what's going on in the home or outside.
- Don't desert the dying person. Even the comatose individual is often more aware of his/her surroundings than others realize.
- Avoid treating the dying person as socially dead, or as an unthinking, unfeeling object. An example of treating a person as such is talking about the individual rather than to him/her even though he/she is capable of hearing and understanding what has been said.
- Avoid saying "let me know what I can do". Instead, offer specific things such as bringing a meal or buying groceries.
- Don't judge. There is a strong tendency to criticize an individual or the family for not accepting death, for not being "a good patient or caregiver", or for not responding "appropriately" to the situation. Each person's journey through the process should be respected.