Category: Philosophy of Living

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Dia de los Muertos (Day Of The Dead) 2018

More than 500 years ago, when the Spanish Conquistadors landed in what is now Mexico, they encountered natives practicing a ritual that seemed to mock death.

It was a ritual the indigenous people had been practicing at least 3,000 years. A ritual the Spaniards would try unsuccessfully to eradicate.

A ritual known today as Dia de los Muertos, or Day of the Dead.

The ritual is celebrated in Mexico and certain parts of the United States. Although the ritual has since been merged with Catholic theology, it still maintains the basic principles of the Aztec ritual, such as the use of skulls.

Today, people don wooden skull masks called calacas and dance in honor of their deceased relatives. The wooden skulls are also placed on altars that are dedicated to the dead. Sugar skulls, made with the names of the dead person on the forehead, are eaten by a relative or friend, according to Mary J. Adrade, who has written three books on the ritual.

The Aztecs and other Meso-American civilizations kept skulls as trophies and displayed them during the ritual. The skulls were used to symbolize death and rebirth.

The skulls were used to honor the dead, whom the Aztecs and other Meso-American civilizations believed came back to visit during the monthlong ritual.

Unlike the Spaniards, who viewed death as the end of life, the natives viewed it as the continuation of life. Instead of fearing death, they embraced it. To them, life was a dream and only in death did they become truly awake.

“The pre-Hispanic people honored duality as being dynamic,” said Christina Gonzalez, senior lecturer on Hispanic issues at Arizona State University. “They didn’t separate death from pain, wealth from poverty like they did in Western cultures.”

However, the Spaniards considered the ritual to be sacrilegious. They perceived the indigenous people to be barbaric and pagan.

In their attempts to convert them to Catholicism, the Spaniards tried to kill the ritual.

But like the old Aztec spirits, the ritual refused to die.

To make the ritual more Christian, the Spaniards moved it so it coincided with All Saints’ Day and All Souls’ Day (Nov. 1 and 2), which is when it is celebrated today.

Previously it fell on the ninth month of the Aztec Solar Calendar, approximately the beginning of August, and was celebrated for the entire month. Festivities were presided over by the goddess Mictecacihuatl. The goddess, known as “Lady of the Dead,” was believed to have died at birth, Andrade said.

Today, Day of the Dead is celebrated in Mexico and in certain parts of the United States and Central America.

“It’s celebrated different depending on where you go,” Gonzalez said.

In rural Mexico, people visit the cemetery where their loved ones are buried. They decorate gravesites with marigold flowers and candles. They bring toys for dead children and bottles of tequila to adults. They sit on picnic blankets next to gravesites and eat the favorite food of their loved ones.

In Guadalupe, the ritual is celebrated much like it is in rural Mexico.

“Here the people spend the day in the cemetery,” said Esther Cota, the parish secretary at the Our Lady of Guadalupe Church. “The graves are decorated real pretty by the people.”

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Talking about death with those who are ill is sometimes the kindest thing we can do

If it is true that death and taxes are the only two certainties in life, it is astonishing how much we readily discuss the latter, but often shy away from the former

There are also many patients who simply want to know what will happen to them as their final days approach

By Jonathan Romain

It is the ultimate question that many of us will have to face one day: do we want to be told that we are dying, or would we prefer to be kept in ignorance?

If it is true that death and taxes are the only two certainties in life, it is astonishing how much we readily discuss the latter, but often shy away from the former.

Perhaps even more surprising is that those professionally qualified to deal with death are equally tongue-tied. This has just been revealed in a Royal College of Physicians’s report, which says that doctors are reluctant to talk about death with patients.

This is a dereliction of duty. As a congregational minister who regularly has to visit those who are seriously ill, it is very clear that some patients would benefit from knowing they are nearing the end of their life

It might be that they wish to sort out their affairs – like Derek, who had never written a will but was prompted to do so by the thought of his demise; or Sandra, who had written one, but it was over 30 years old and needed radical changes.

Alternatively, thoughts of imminent departure can lead to important conversations, whether telling loved ones how much they mean to the person, or, as with Beatrice, contacting the sister with whom she had not spoken for 12 years, and effecting a reconciliation.

There are also many patients who simply want to know what will happen to them as their final days approach. They may be fearful, but it is often not so much of death itself, but of dying and the process that they will experience. Talking about it, and the pain relief on offer, can be very reassuring. It can also allow them time to contact organisations such as Compassion in Dying, which provides support for both them and their families.

Of course, doctors also need to know when not to discuss death, for there are patients who prefer not to be informed. If they wish to take the attitude that “ignorance is bliss” and clearly mean it, then why disturb that bliss?

One of my own relatives had a phobia about death. Whilst a long period of therapy might have uncovered his reasons and allayed his fears, telling him he was going to die a few days before the event, was not appropriate.

How do you know if a person really does or does not want to know the truth about their condition? It can be hard, as long-held views can change when confronted with the reality of death. Asking the patient directly but obliquely is one option, such as: “Is there anything you’d like to discuss or talk about?”, and letting them give a signal either way.

The new report begs the question of why many doctors have been so unwilling to tackle the issue until now. It could be lack of training – which should be rectified as a matter of urgency. It might be their own personal anxieties about death, which should also be addressed before qualifying.

Perhaps it is a worry that, if they do open up the subject with patients, then, unlike mentioning a prescription, it is a conversation that could take half an hour – time they do not have, yet which should be considered an important part of patient care.

There may also be the feeling that death is a failure on their part, seeing their job as to keep patients alive, and a reluctance to admit they cannot help any further. Although admirable, this is misguided, for death can be a natural outcome of a life long lived, or the inevitable consequence of the way it was lived.

It is good that doctors do not want to let patients down, but they may be inadvertently doing so by not talking about death.

Complete Article ↪HERE↩!

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Death doula says opioid epidemic means more end-of-life services needed in the Downtown Eastside

Amanda Page Brown completed her training to become an end-of-life doula last November and now is trying to secure funding to work full time as a death doula in the area of Vancouver hit hardest by Canada’s overdose crisis

The stretch of East Hastings Street that runs through Vancouver’s Downtown Eastside sees emergency authorities respond to thousands of overdose calls every year.

by Travis Lupick

Last fall, Amanda Page Brown visited a friend in the hospital.

“As I was leaving, I saw their roommate laying in bed, skin and bones, and very little life in him,” she told the Straight. In a telephone interview, Brown explained that she recognized the man through her job as a support worker in Vancouver’s Downtown Eastside.

“He was completely alone and no one knew he was there, dying,” she continued. “I asked him if it would be okay if I visited again. He said yes.”

Brown sat with the man once more before he passed away a few days later. “I realized I was the only person who knew,” she said. “I was it.”

The experience affected Brown deeply. “He taught me much over those three final days,” she said. “He taught me the path I’m meant to walk.”

Brown learned that she wanted to help people in the Downtown Eastside make the transition from life to death. Especially those residents who might not have anyone else to be with them during that time. She began researching how she might be able to do that, and found a certificate course at Douglas College.

“End-of-Life Doulas are advocates for their clients and complement the work of the medical community and hospice-palliative care workers and volunteers,” the program’s website reads. “End-of-Life Doulas assist clients in creating and carrying out their health-care treatment decisions, as well as providing support to clients and their family and friends.”

Brown completed her training to become an end-of-life doula (also known as a death doula) last November. Now she’s trying to secure funding to work full time as a death doula in Vancouver’s Downtown Eastside.

Brown said that her plan is to collect support via her Facebook page and an accompanying fundraiser, but hopefully not for more than one year. Then, with a little experience under her belt (plus the previous seven years she’s spent employed in the Downtown Eastside), she’s hoping she can secure a staff position or reliable and sustainable funding from one or several of the many government agencies, private organizations, and nonprofits that operate in the neighbourhood.

“As a doula, you can walk in as a trusted friend. That’s what is needed here,” Brown said. “I want to be able to offer things like bedside vigils. If somebody is going to be taken off of life…and if that person doesn’t want to die alone, then somebody should be sitting with them.”

There are typical scenarios where it’s easy to understand why a death doula might be needed. For example, an elderly Downtown Eastside hotel tenant with an alcohol problem who doesn’t have any family. But Brown described other situations where it might be less obvious how someone could benefit from the presence of a death doula.

“I’ve asked drug users who have had quite a few overdoses, ‘Has anybody ever asked you if you are trying to kill yourself?'” she recounted. Brown said that with folks in that type of situation, she could befriend them and, once a bond is established, offer to help them draft an advance-care plan.

“Hey, I hear that your overdosing a lot,” Brown explained she could say to them. “Does anybody know your wishes in case something does happen to you?…Because we can do this on a legal piece of paper. Why don’t we do this?”

Brown added that these types of conversations can have unintended benefits.

“That might actually open up another conversation about maybe treatment or detox,” she said. “Maybe, maybe not. But it might be another way to open another very important conversation down here.”

There were 367 illicit-drug overdose deaths in Vancouver last year, up from 235 in 2016 and 138 the year before that. For every fatal overdose that occurs in the city, there are many more that are reversed.

Coco Culbertson is a senior programs manager with PHS Community Services Society (PHS), a nonprofit that manages more than a dozen supportive-housing buildings in Vancouver. She also happens to have the same end-of-life doula certificate that Brown has.

Amanda Page Brown is employed as a support worker and wants to become a full-time death doula in Vancouver’s Downtown Eastside.

“There are volunteer networks that provide this service for free, but maybe not necessarily for the population that we support,” Culbertson told the Straight. “There are so many people in the Downtown Eastside who are living with a chronic illness and comorbidity and who become palliative or require some level of hospice. And there are very limited resources for those folks.

“Having someone who has the expertise and the empathy—professionalized empathy—to sit with them as they live out the last few days, weeks, or months of their life, would be an incredibly meaningful thing,” she said.

Culbertson noted that PHS staff often spend time with tenants who have been transferred to a hospital and are nearing the end of their life. But everyone is spread thin, especially since the dangerous synthetic-opioid fentanyl arrived and overdoses skyrocketed, she added.

“Someone who is able to provide more support for people who don’t have a family…that would be an incredibly important thing,” Culbertson said. ” I think it is just as important to offer dignity and humanity in death as it is in life.”

Complete Article ↪HERE↩!

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‘I’m a friend at the end – why I became a death doula’

Hilary Pepiette is an end-of-life doula

When a loved one dies, it is often medical staff, a hospice and an undertaker who deal with the final moments.

But families can now bring them back into the home, engaging an end-of-life doula to take care of the last wishes and arrangements for their loved ones.

Hilary Pepiette, a solicitor, is one of Scotland’s first end-of-life doulas.

She thinks there is a great need for her role as a “friend at the end”.

Hilary told BBC Radio Scotland’s Kaye Adams programme: “An end of life doula is someone who supports and walks alongside a dying person, the family and people close to that person, through the dying process, through the death and sometimes after that.

“The doula is your consistent flexible presence to fill in the gaps and give support emotionally, spiritually and practically in whatever way it is needed for each individual person and your family.”

Hilary believes we have handed over control to the professionals.

She said: “I have seen family members who have died and I think there is a feeling for me that I would love to do more and make sure that people can have the best possible death they can have, and to celebrate life.

“It is about making sure people live their life to the absolute fullest potential as long as they possibly can, and celebrate that, and then help them have the death that they want to have, give them come control over that.

“My mum died at home and while we did the best we could and it was a good death.”

Death is a taboo

But she added: “I wish I knew then what I do now about what was going on for her at that time.

“It’s only in the past 100 years or so that people have stopped caring for their dying family members at home and it all became about hospitals and the medical profession.

“Death has become a taboo and something that people have stopped talking about. But the more we are open about it the better. Being with someone and having those final conversations is so rewarding.”

Hilary thinks people can talk about their end of life wishes more easily with someone who is not family

As a solicitor in Edinburgh, Hilary processed wills and personal business. She decided to take her end-of-life services one step further.

She said: “It felt natural. I have been a private client solicitor for more than 20 years, and through that I have worked with a lot of people planning wills, powers of attorney and advanced medical directives to help them think about and plan for the end of their life.

“It seemed like a natural progression to me to take that one step further and think about what happens after the legal documents have been put in place.”

Hilary’s firm BTO, is the first to offer an end-of-life doula as part of its services.

What does an end-of-life doula do?

A doula will talk and listen to the patient’s wishes and hopes for the way they will die

According to Hilary: “I do things from washing dishes or making their dinner or cutting someone’s nails or feeding them at the end of their life. Also providing the personal care that might be provided in a hospice.

“Also talking. There is a big role for conversation here where it can be really hard within a family to have the difficult conversations about what you want the very end of your life to be like, where do you want to be when you die, who do you want to be there. Do you want music playing?

“It is establishing what the biggest hopes and fears are. What are you most afraid of? Is it pain or losing control of autonomy, of making decisions. Having those conversations is a big part a doula can play.

“Some people are never comfortable talking about it. But most people who are given that opportunity and a safe place to do that are happy to do that and have those conversations.”

Someone who agrees with Hilary is Prof Dame Sue Black, forensic anthropologist and vice chancellor for engagement at Lancaster University, wants death to be celebrated more.

She told Kaye Adams: “It is an inevitability, it is going to happen. What we can’t control is how it happens.

“In the past that would have often been done by family. I think we have become scared of death, we don’t want to admit it exists.”

Prof Black was awarded a Damehood in 2016

Prof Black thinks people have been conditioned to believe in a certain way of doing things.

She said: “People tend to accept there are rules we have to abide by but generally there aren’t. It’s important those left behind feel they have the autonomy to respect the person they have lost in a way that helps them with their grief.

“We think a funeral has to be very specific in that it has to have hymns and speaking, and it doesn’t. We need to have a confidence that those who are left behind have control over the celebration of the person who has been lost.”

She also thinks people should not be afraid of the last moments and to make the most of them.

She said: “I think we forget sometimes when patients are advancing towards the end of life that we think they are not listening and don’t communicate.

“There is some research that suggests the last sense to go may well be hearing so that’s the time we need to tell them how much we love them, how much we care, what a difference they’ve made.

“One of the last things we can do is communicate.”

Complete Article ↪HERE↩!

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Death Is Not An Emergency: How Recompose Is Redesigning The End of Life

Katrina Spade envisions more options for the end of life that draw on nature as a model. Spade was named a 2018 Ashoka Fellow for her groundbreaking work.

Ashoka Contributor

Katrina Spade wants to transform the U.S. funeral industry, making way for many more options for those facing death and for their families. She founded Recompose in 2017 to champion a dramatically new approach that reconnects death to natural cycles of life and engages people through meaningful participation. Ashoka’s Michael Zakaras caught up with Spade to learn more.

Michael Zakaras: What inspired your interest in the rituals and practices around death?  

Katrina Spade: I had a moment around age 30 when I realized I was mortal, and I became curious about what would happen to my physical body when I died. Because my family is not religious and most of my friends aren’t either, I thought, what will they do? And I discovered that there are really just two options in the U.S.: cremation and conventional burial. Both practices poison the planet — this struck me as the wrong punctuation for lives lived in harmony with nature.

Zakaras: Why do we have just these two options?

Spade: Much of it is convention, it’s just the way things have been done. Take modern embalming. Many people think of it as a centuries-old tradition — but it became popular in the U.S. only during the Civil War. A couple of enterprising young people invented and marketed it to soldiers on the battlefield as a way to get their bodies home to their families — for advance payment. They used arsenic instead of formaldehyde back then. Today’s funeral practices, and many of our laws, are based on the dual practices of selling caskets and embalming bodies from 150 years ago.

Zakaras: How big is the funeral industry today?

Spade: About $20 billion dollars, and it’s an interesting industry, with many funeral homes passed down generation to generation and a few large corporations that own a lot of funeral homes. One of the things that’s so interesting is the idea that every person can “own” a piece of land for eternity, in the form of a cemetery plot. This is not a sustainable model, especially for cities with space constraints.

Zakaras: That’s a good point. How much land would you need to bury everyone in, say, New York City?

Spade: We’d need over 200 million square feet of land, or 7.5 square miles! And besides the land use, cemeteries are filled with metal, wood, concrete, and embalming fluid, a known carcinogen.

Many people consider cremation to be a more sustainable choice, and its popularity is rising: by 2035 an estimated 80% of Americans will be cremated. But actually, cremation is an energy-intensive process that releases greenhouse gases and particulates, emitting more than 600 million lbs of CO2 annually.

Zakaras: So what’s the alternative?

Spade: With Recompose, we asked ourselves how we could use nature — which has totally perfected the life/death cycle — as a model for human death care. We developed a way to transform bodies into soil, so that with our last gesture we can give back to the earth and reconnect with the natural cycles. We’re also aiming to provide ritual, to help people have a more direct and conscious experience around this really important event. As hard as it can be, the end of one’s life is a profound moment — for ourselves and for the friends and families we leave behind.

Zakaras: If you are successful, what will look different in 10 years?

Spade: I’m hopeful that we will have many options for the end of life — from hospice care all the way through disposition. It won’t be the odd family who says, “Maybe we should have a home funeral” — it’ll be every family that says, “Okay, how are we approaching this? What feels right to us?” And it will be normal to ask: “What do I want my end of life to look like? What will happen to my body? Where do I want to be when I die?” These are things that should be up to us, but we’ve never really felt that we had the agency or the cultural support to decide them.

The funeral industry would like us to think that it’s difficult or impossible for us to care for our own after a death, but humans have been doing that for millennia. There are a lot of reasons to take back some of that work, the work of caring for the dead, because there’s so much beauty inherent in it and it’s such a personal thing.

Zakaras: Why is this a particularly important moment for this work?

Spade: There’s a growing realization of climate change, coupled with this incredible cohort of baby boomers — 10,000 Americans turn 65 every day — who are approaching the end of their life or seeing someone go through death and thinking, “Is this really the best we can do?” This is a generation that’s really good at saying “Wait a minute, we can do better than this.”

Zakaras: Do you ever get tired of talking about death?

Spade: I never do! We have such a long way to go, but a new relationship with death is totally possible. One of my favorite sayings is “Death is not an emergency.” This is a wonderful reminder that the very first thing we should do when someone dies is pause and take a deep breath and just be in the moment.

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Author’s new book looks at dying at home

‘It’s my passion to demystify hospice’ — Karen J. Clayton

 

by

With more Americans living longer and aging in place, more also want to die at home.

Few, however, actually do.

Karen Clayton of Oak Harbor believes more terminally-ill individuals and their caregivers might choose home end-of-life care if they knew more about the physical and emotional support provided by hospice services.

“It’s my passion to demystify hospice so patients and families will use this truly extraordinary care,” she said. “I believe most people think hospice is a really good thing—for someone else. They do not realize they can have six months of quality end-of-life care wherever they live.”

Clayton’s just-released book, Demystifying Hospice: Inside the Stories of Patients and Caregivers, is based on years of experience working as a social worker in public and private hospitals, a hospice, and with the American Cancer Society. She plans to discuss her book and the topic of hospice care at a series of presentations and workshops around Whidbey Island this fall.

Clayton describes herself as a hospice social worker, sociologist, author and a story catcher.

Studies have shown that approximately 80% of Americans would prefer to die at home, if possible. Despite this, 60% of Americans die in acute care hospitals, 20% in nursing homes and only 20% at home.

According to the National Hospice Foundation, many people at the end-of-life are being referred to hospice care too late or not at all.

Many Americans don’t realize hospice care is a benefit of Medicare, Medicaid, VA benefits, and many other insurance plans, Clayton said. Additionally, hospice organizations can help those with no insurance.

“Hospice offers at least six months of care for terminally ill patients and their caregivers,” she added. “So, it’s stunning that, in 2015, half of the U. S. hospice patients had this truly extraordinary care for 17.4 days or less and one-third for seven days or less.”

Home hospice services consist of a team of professionals who regularly visit patients at home and are available 24 hours a day. Nurses, social workers, chaplains and nurse aides comprise the main team and some services also provide massage therapists, even instrumentalists, such as harpists, to play soothing music.

Hospice services also supplies medication and delivers equipment, such as hospital beds, wheelchairs and personal hygiene items.

Clayton’s book doesn’t focus on medical problems but rather the emotional and practical help given by socials workers to patients, caregivers and families.

“The caregiver receives training and support from the team, and it is difficult,” Clayton said. “It helps to have someone to talk with about the types of feelings involved; fear, grief, anger, curiosity about how to help in the best way.”

She also provides caregiving tips and suggests ways to connect with people in their final days.

“It’s good when families spend time with photo albums, old family films, games, movies, playing checkers or chess, remembering the good times in their lives, the things they have contributed through their job or service,” Clayton said. “Quality of life can be maintained when patients are offered activities, food, family interactions within the limits they have.”

Clayton’s book describes the hope, healing and support that home hospice care offers.

Each story addresses some aspect of helping families through the caregiving and grieving process and it offers comfort and understanding to readers who may be going through similar experiences.

“These stories will lift your spirits and touch your heart,” Clayton said. “It’s a joyful thing to learn how to provide good physical and emotional care for the person you love.”

Karen Clayton will discuss hospice care and her book at the following free events open to the public:

Three Journeys: Writing, Caregiving, Publishing; 3 p.m., Thursday, Oct. 18, Friends of the Library, Oak Harbor Library

“Demystifying Hospice” workshop: 1:30 p.m. Monday, Oct. 22, Coupeville Library

“Demystifying Hospice” workshop: 2 p.m. Wednesday, Dec. 5, , Freeland Library

“Demystifying Hospice” workshop: 10 a.m., Saturday, Dec. 8, Langley Library

• More information  HERE!

Complete Article ↪HERE↩!

Demystifying Hospice: Inside the Stories of Patients and Caregivers
Rowman & Littlefield, 2018 Hardcover, 2020 Paperback

Whidbey author, social worker and sociologist, Karen Clayton’s book is listed as one of the “20 Best Hospice Care Books” by Book Authority which creates lists of the most recommended books on business, technology and science. The book is  in 719 libraries, several outside the US, according to WorldCat operated by OCLC (Online Community Library Center). Locally you can find it in the Anacortes, Burlington, Mt. Vernon libraries and the Sno-Isle Library System. Several independent bookstores in the NW carry the book and it’s available online.

“My purpose is to help folk–patients, family members, and medical personnel–understand the services provided by hospice and the value of seeking hospice care when the decision is made to do no more treatment for cure. About 50% of Medicare patients do use hospice; however, about 40% wait until the last 2-3 weeks when they could have this unique comfort care for 6 months!”
                                                                      –Karen Clayton, social worker and sociologist

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The cost of not talking about death to dying patients

By Colleen Chierici

Will you know when it is your time to die? It is a question that has permeated my mind since July 14, 2017. This was the day my mother died. It was a sad day, but it pales in comparison to the months preceding it. A breast cancer that had returned aggressively, a hasty port placement to receive chemotherapy that was too late  and an ICU admission that began many futile interventions that never saved her life, but prolonged my mother’s suffering.

As a registered nurse, I watched a scene unfold that I swore to myself I would never let happen to anyone I loved. Yet, there I was listening to an oncologist discuss a 30 percent chance she would respond to chemo (which did not mean she would be cured) and choosing this inappropriate treatment for my critically-ill mother. I was party to these decisions when my mother couldn’t make them and when she made some recovery in her mental status, she also chose to continue treatments.

Were these decisions well founded? They were missing a key piece of information, that even with my training, I failed to see. My mother was dying. She was dying and none of my mother’s care providers were able to say those words.

Would my family have chosen a different path for my mother, if there had been a more explicit conversation? Resoundingly, yes. If my mother’s health-care providers would have had a deliberate discussion about her impending death my family would never have chosen chemotherapy and instead chose to initiate hospice care.

As a nurse, I have a duty to advocate for patients. Advocating can take many forms, but most often, it is helping patients navigate the complexities of the health-care system as well as explaining the meaning of test results, procedures, and diagnoses. Often, answering the question “What does this mean for me?” In my own practice, I have helped many patients understand the life changes needed to manage, diabetes, heart failure, and coronary artery disease.

But, like the nurses who provided care for my mother, I struggle having explicit conversations about dying with my patients. This does not appear to be an isolated phenomenon. In a 2018 study, researchers in Australia surveyed acute care and critical care nurses to assess their understanding and utilization of end-of-life discussions and care planning. They found that nurses’ own knowledge and rates of participation are low when it comes to end-of-life care.

On the other side of this, is a patient who may not be making a well-informed decision, because they don’t understand their disease is life-limiting or that they are dying. When the focus is shifted from “fighting to live” to “death is imminent,” other care decisions can be made by these patients. They can choose hospice care. Patients who have a prognosis of 6 months or less are eligible.

In hospice, care is shifted from procedures, tests and medications that can cause discomfort or pain for the patient, to comfort measures that improve the quality of one’s last days. Medicare, who pays for this benefit, found that only 12-25 percent of beneficiaries’ days during the last year of life are being spent in hospice. Are we having these conversations with our patients too late? I have coordinated and provided care for patients who only hours before their death have been enrolled in hospice, even though their diagnosis had been terminal and had been known by the patient’s providers for months.

To be sure, there are nurses who are adept at having these difficult discussions about death with patients and their families. But it is not a skill that comes easy to the majority of the profession. Fortunately, there are resources available to help nurses facilitate these conversations in an effective way.

The End-of-Life Nursing Education Consortium (ELNEC) project, for example, is a national education initiative that seeks to educate nurses on better end-of-life care. Their curriculum includes coursework on how to lead effective communication during end-of-life care.  

Perhaps, we need to re-evaluate how we train our nurses to have conversations about death and dying. Have those who are experts at these discussions share their wisdom and teach nurses how to have these conversations in an empathetic and impactful way so that patients can receive the comfort and dignity of hospice care in a timely manner. If we can make these changes in our communication with patients and their families, perhaps, one day we will all know when it is our time to die.

Complete Article ↪HERE↩!