Time of Death: Some Patients Prefer to Die Alone

This article is the fourth in a series of articles where I will take each assumption from the original article and explore the concept in greater depth to include implications and possible interventions.  In my last article, I wrote about the assumption Family will want to be with their loved one when they are dying.Here is our next assumption: People don’t want to be alone when they die.This may be an unpopular assertion within my own hospice industry for me to advocate for leaving a patient alone sometimes. Hospices have entire programs devoted to assuring patients and families that they will not ever be alone. Many of them are actually called, “No one dies alone” or NODA. The perhaps unintended consequences of the marketing of these programs is the programs may perpetuate the myth for the public that nobody ever wants to die alone.For the family member who has minimal prior direct experience of being with a loved one as they die, this assumption that dying patients shouldn’t ever have to be alone can create intense anxiety. Family members will sit vigil for days without eating or sleeping. Hospice professionals may inform the family they can take a break, but this can be a confusing mixed message. Hospice has a program that says that no one should have to die alone, and yet this hospice nurse is telling me to take a break?Some patients want to die when no one else is there.Hospice professionals know that companionship while dying is a personal ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: assumptions hospice lizzy miles NODA social work social worker time of death Source Type: blogs

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J Palliat Care. 2021 Oct 21:8258597211045780. doi: 10.1177/08258597211045780. Online ahead of print.ABSTRACTHospitalization is a stressful experience both for primary caregivers (PCs) and cancer patients alike. Although there is significant evidence that PCs of cancer patients can experience significant caregiver burden (CB), less is known about the relationships between PCs and patient symptom severity that influence CB. Methods: In this cross-sectional study, measures of the symptom severity were obtained from cancer patients. The PCs were assessed for CB. Associations between patients' symptoms and demographic character...
Source: Journal of Palliative Care - Category: Palliative Care Authors: Source Type: research
ConclusionsPalliative care has received considerable socio-political support in recent years, due primarily to epidemiological developments. Depending on severity, life expectancy and the patients' personal circumstances, it can be delivered in a variety of settings, including private residences, assisted living facilities, acute and long-term care hospitals, hospice residences, correctional facilities, and homeless shelters. As a result, access barriers might be particularly complex to identify and overcome. Cross-country learning can be an important catalyst for future improvements.
Source: The European Journal of Public Health - Category: General Medicine Source Type: research
CONCLUSION: The study provides rich insights into the nature of challenges, uncertainty and lost opportunities resulting from the COVID-19 pandemic for patients and carers living with cancer that is treatable but not curable, which has wider resonance for people living with other life-limiting conditions.PMID:34664537 | DOI:10.1177/02692163211049497
Source: Palliative Medicine - Category: Palliative Care Authors: Source Type: research
From Wall Street to Hollywood, psychedelics are having a cultural moment. For those of us who grew up in the “this is your brain on drugs” era, it’s hard to let go of stigma—and the mental image of an egg sizzling on a hot pan. But as a growing number of states and cities move to decriminalize drugs, and investors flock to an emerging market for psychedelic health care, substances like psilocybin, ketamine and LSD are edging into mainstream culture—and setting the stage for a paradigm shift in modern medicine. Within the next few years, we could see psychedelic therapies prescribed for refract...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: news
Br J Community Nurs. 2021 Oct 2;26(10):494-497. doi: 10.12968/bjcn.2021.26.10.494.ABSTRACTIn the community there are about 200 000 people with a stoma. Some of these may have been performed as a palliative procedure to relieve a bowel obstruction, for example. Alternatively, the condition of the patient may have altered. A person with a stoma may, for many reasons, be approaching the end of life. There are a number of stoma-related issues that can occur at the end of life as a result of cancer treatment, such as skin around the stoma being damaged as a result of chemotherapy or changes in weight. In the palliative setting,...
Source: British Journal of Community Nursing - Category: Nursing Authors: Source Type: research
AbstractPurpose of ReviewThe goal of this review is to highlight recent literature that addresses the role of rehabilitation for managing symptoms for patients with cancer near the end of life.Recent FindingsCurrent literature supports the integration of rehabilitation interventions as part of comprehensive symptom management in patients with advanced cancer near end of life. Research is needed to clarify the impact and timing of specific rehabilitation techniques. There is also a need for robust education for both palliative and rehabilitation clinicians about the role for rehabilitation.SummaryIn this article, we review ...
Source: Current Physical Medicine and Rehabilitation Reports - Category: Rehabilitation Source Type: research
The number of people over the age of 65 years living with chronic diseases is exponentially rising worldwide. In 2008, the World Health Organization estimated physicians diagnosed approximately 210 million people worldwide with COPD and millions of others with another respiratory disease (e.g. asthma or interstitial lung disease) [1]. Many among these millions of patients with advanced, chronic non-malignant respiratory diseases often experience disabling (intractable) dyspnoea, cough and pain. Dyspnoea (breathlessness) is an "air hunger" comprising a multifaceted, subjective symptom with significant impact ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Editorials Source Type: research
Am J Hosp Palliat Care. 2021 Oct 4:10499091211049798. doi: 10.1177/10499091211049798. Online ahead of print.ABSTRACTDecline in executive functioning, before frank dementia occurs, has been reported in patients with a history of stroke and malignant brain tumors. This may also be true in patients with advanced Parkinson's disease (PD). In this paper, we summarize the limited research on the motor and cognitive predictors of mortality in advanced PD. We then provide 2 case vignettes of patients with end of life advanced PD who demonstrated a substantial decline in working memory and speech festination. We contrast these pati...
Source: The American Journal of Hospice and Palliative Care - Category: Palliative Care Authors: Source Type: research
CONCLUSIONS: This pilot study suggests that the MCP-EC has feasibility, acceptability, and preliminary efficacy reducing the emotional distress in advanced cancer patients. Larger studies are warranted to clarify the strengths and limitations of this psychotherapy.PMID:34581266 | DOI:10.1017/S1478951521001486
Source: Palliative and Supportive Care - Category: Palliative Care Authors: Source Type: research
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