A Team Approach

We’ve all read it: “He died peacefully at home surrounded by his family”. Certainly most of us have expressed it: “I want to go quietly, in my sleep, at home…”. It is a desire for all: to die at home, with family. This is a choice we can make; but not all of us know how to make this happen. A hundred years ago, Grandmother died upstairs on the ranch with all the kids running around and care being given by family. Death was a part of life and was accepted as normal. Now, the trend is to die in the hospital, often after futile efforts to stave off the inevitable. Surrounded by strangers who have the skills to provide needed compassionate care, many of our loved ones die in an unfamiliar environment following uncomfortable or painful procedures.

My job is to change this. My job is to help people, at the end of their life, die comfortably, and at home. My job it to normalize this inevitable process and teach the necessary skills to families and caregivers. My job is to help people attain this final wish. Providing care for the dying is not easy. Because it is no longer something we routinely do, most of us don’t know the nursing techniques to provide physical comfort. We don’t recognize the changes at life’s end. Not only may there be symptoms of pain or nausea, there may also be confusion, shortness of breath, or constipation. Appetite will decrease. Weakness will usually be progressive, followed by incontinence of bowel and bladder. Agitation and restlessness may lead to a risk of falls, and finally, the physical needs of a bed bound patient will need to be addressed 24 hours each day. My job is to educate, guide, and support. I assess and address symptoms, as well as instruct families. Together, our goal is to keep the patient comfortable and to keep them at home.

At Cascade Hospice we utilize a team approach to care. Nurses provide education and medical therapeutics supervised by the patient’s personal doctor or our Hospice Medical Director. A medical social worker provides emotional and psychological counseling, and also can assist with coordination of any needed community resources or care giving options. Our chaplain is available for spiritual support, whether it is religiously based or not. Certified Nursing Assistants give baths and personal care and demonstrate care procedures. Massage therapists address patients’ physical and emotional needs with comforting, healing touch. Trained hospice volunteers provide breaks for caregiver respite or welcome companionship to patients by just being present. Music is available for serenity; therapy dogs share unconditional acceptance and love. Whatever the need, we try to make these final days or weeks comfortable and positive.

So if you find yourself facing a chronic or potentially terminal illness, talk to your doctor. Get all the facts - frankly, honestly, and realistically. Then talk to your family. The choice on how you want to spend this time is yours. You choose if your final days will be cloistered away in a cold hospital room or at home surrounded by the warmth and love of family. We are here to help make your choice happen. For more information, contact Cascade Hospice. A low stress, informational consultation is available at any time.

By: Dale Mostkoff, RN