What do we know about the process of dying? Not much. | Ability 4 Life

Posted in Decisions Fearful Topics Many things I didn't know Planning for the future on May 25, 2011 by kathy

Everybody knows about death.? That is, we all know we?re going to die. But what do we know about dying? Enough to meaningfully let our loved ones know ? though an Advance Directive ? what we do and don?t want to happen en route to that final journey? Myself, I?d like to go gentle into that good night preferably in my sleep but if not, like getting general anesthesia, I want to count backwards from 10 and by 6 be gone. Rarely does it seem to work like that, even in the movies. As the complexity of dying is dawning on me, I want to know more: the preparation, the process, and the reality.

My first stop is always #hpm ? Hospice and Palliative Medicine ? a tweet chat for professionals whose chosen career is to make comfortable our end of days. Through their insights,? links to research, articles and articulate? bloggers, I?m coming to understand how much there is to consider when thinking and re-thinking end-of-life decisions.

• There?s often a disconnect between specialists whose job it is to preserve life, and the families (and? palliative care team) who have a different perspective on definition of ?life?.
• ?Aggressive? treatment is often interpreted differently by family and health-care professionals
• DNR means: ?Do Not Resuscitate/Revive? but is often wrongly presumed to mean ?do not treat?
• Dr Lauren Jody Van Scoy?s book, DNR: real stories of life and death and somewhere in-between reminds that family members may have their own agenda driven by their own needs rather than the dying person?s
• New terminology, such as Physician Ordered Life Sustaining Treatment (POLST) and A Natural Death? (AND) are coming into use. AND meaning: no heroic, extraordinary or interventionist efforts to prolong life. This flies in the face of Emergency Medical Team?s (EMT) mandate, as eloquently described by Niamh van Meines a Nurse Practitioner and volunteer member of her community?s EMT:

I struggle with the discomfort that emergency medicine brings for the patient:? an endotracheal tube against your will; getting tied down because you are flailing too much.

I learned from A Hospice Doctor who shares personal experiences:

• The dying person often needs and wants to hear:? ?It?s ok to go. We?ll be ok.?
• When the family takes a break from the death-bed vigil and their loved one dies ? they?ve often shared with the health care professional that they?d rather spare their family witnessing the last breath.

A plastic surgeon puts her 5 wishes in her blog inspired by her mother?s willingness to talk about death and dying

As for the process of dying, I found the various stages eloquently described by Stacey Burling, whose intention is to make the first time witnessing death less frightening and disturbing. There?s Canadian Virtual Hospice offering perspective on the challenges (and rewards) of dying at home

And, where assisted dying is legal, Death with Dignity and Compassion and Choices offer invaluable support for those making that choice.

Presumably we?d each like to be as at peace as possible with the process. I feel that the way to go (pun intended) is to put it all in writing. But first: learn, consider, discuss. Repeat as often as necessary.

?Kathy Kastner

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Source: http://www.ability4life.com/2011/05/everybody-knows-about-death-what-do-we-know-about-dying/

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