When "That Time" Comes

Often a chaplain is consulted by family and/or an individual facing the reality of declining health and end of life. Some excellent tips are found in the article below:

Have you ever noticed when some people talk about death and dying, they don't really talk about it? For some, it seems safer to dance around the subject to try to avoid upsetting anyone. But it's important to be frank. A time in your senior loved one's life will come when death is very near, and it’s important to prepare for it. Tiptoeing around the subject can actually make it more difficult for everyone, and opportunities for significant exchange of thoughts and feelings can be missed.

So here are a few tips that may help you and your loved one more comfortably confront the end of life whenever that time comes.

Allow your loved one to lead the conversation. Death and dying can seem awkward to talk about. But tiptoeing around death can actually add stress. If you don't know where to start, just follow your loved one's lead. A family caregiver shared the following story.< "Looking back, I regret how much I tiptoed around the fact that my mom was dying. When we moved her into a room at the hospice house she said, 'Well I guess I'll miss Christmas this year.' It was early December and we had brought a small tree to decorate her room. My immediate reaction to her gloomy comment was "Aw, no Mom! We'll bring Christmas to you!' But the look on her face told me she knew just as well as I did that she wouldn't make it to Christmas."

It's okay to express your emotions, even your sadness, in front of your loved one.
You may feel the urge to pretend that everything is all right, but expressing your feelings gives your loved one freedom to be honest about his or her feelings in front of you. Your loved one will likely feel relieved that you understand what's happening.

Your presence matters. Even if hospitals make you uncomfortable or you'd rather remember your loved one fully functional, your presence matters more than your loved one can likely can say.

Create meaningful conversation. People at the end of life usually prefer to recall happy memories with those they love. Many hope to find closure. Try to focus conversation around themes like forgiveness, thankfulness and love between friends or family.

Listen carefully for any messages your senior loved one would like to convey. Sometimes, people approaching death may try to communicate an important message to those around them, even if they're unable to speak clearly. If this happens, don't immediately assume it's nonsensical babble. Try to understand what your loved one is trying to say.

Hopefully these tips will help you feel a little more confident in approaching what can be a scary, upsetting time for the whole family.

Believe it or not, what seniors fear most about the end of life isn't death, it's moving into a nursing home and losing their independence. According to the results of an Reid survey discussed on Alive.com, 97 per cent of Canadians aged 65 to 85 want to remain home for as long as possible, but most also said they avoided discussions with other family members about how to accomplish that for fear it would lead them straight to a nursing home.

My Voice

The provincial government has prepared a document called My Voice—Expressing My Wishes for Future Health Care Treatment found at this link: http://www.health.gov.bc.ca/library/publications/year/2013/MyVoice- AdvanceCarePlanningGuide.pdf

MOST (Medical Orders for Scope of Treatment)

At the time of changing health the nursing team will always consult family concerning their wishes for transfer to hospital or other care and medical interventions. The MOST form (Medical Orders for Scope of Treatment) is a more extensive process and guide signed by the attending physician that has replaced the former instructions regarding CPR (No cardiopulmonary Resuscitation—Medical Order) in some health regions. This form will be discussed during a care conference with the family, usually with the RN and Social Worker.

From time to time the family will ask the chaplain for their thoughts in advance or at the care conference as they work through this process. It is good to be familiar with the form and then drawing on previous conversations with the family you can talk about the values and goals of the loved one in care and how goals can change as health changes.

Written by Rev. Keith Johnson