Introduction
Terminal conditions are malignant diseases that cannot possibly be treated. The aftermath of these diseases is normally early death. Some of the diseases under this category are heart diseases in the advanced stages and to some extent cancer. “In popular use, terminal conditions indicate diseases which will end the life of the sufferers in a relatively short time. Individuals are said to be terminally ill when they are not expected to live more than half a year.” (Jones, 2002). These conditions have become widespread of late necessitating measures to be put in place for caregiving and comforting purposes.
Main body
“For the person with a terminal illness, life does not abruptly stop, and comforting is regularly needed” (Jones, 2002). Terminally ill patients are often seen to lose all hope as they feel useless and a burden to the family. This kind of situation together with the feeling of death in a short period makes it difficult to discuss the illness at family levels. Many patients who have these complications believe in handling the situations their way. This encompasses choosing caregivers allocated to them, how they want the disease managed, and the kind of treatment they prefer. Some of these patients do keep to themselves not opening up to other people for comfort, sharing issues, and discussing the way forward. Patients with these characters complicate situations even more as the discussion on medical preferences and other matters in the event of a medical crisis won’t be possible. Therefore this paper is going to focus on death and terminal illness, show family discussions on preferences regarding medical treatment and other matters in the event of a medical crisis and then highlight some of the methods employed in helping loved ones communicate their wishes regarding this issue. This paper will then conclude by giving measures to be embraced in tackling the whole issue of terminal illness and death from the same.
Individuals diagnosed with terminal diseases respond differently upon diagnosis. “In general, almost all patients go through various stages of acceptance when a terminal disease is diagnosed. The initial reaction to this diagnosis is always shocking. Most people are shocked that it could happen to them, this generates extreme anxiety especially about the unknown” (Jones, 2002). After this stage, patients often become hopeless and distressed making it difficult to discuss the issue with the family. The situation yet again gets worse because of the obvious aftermath (death). As much as it is hard to discuss this issue research has it that after discussion and proper management the patients readily accept the illness and prepare for the aftermath. Another importance of family discussions is for chatting a way forward as most patients find themselves in situations where they cannot think for themselves. “In some cases, patients could reject conventional medical treatment and pursue unproven treatments such as radical dietary modifications. Patients’ choices about different treatments are also seen to change over time showing the kind of despair they go through” (Jones, 2002). These are some of the reasons necessitating family discussions.
Many other reasons make it hard to discuss this topic. Some of these are; the patient might feel he or she is a burden to the family or he/she is hopeless and is only destined for death. On the other hand, some family members might wish to skip the topic because of escape from possible caregiving responsibilities. As said by Grumman (2007) some members of the family evade these responsibilities because giving care to a person who is dying can change someone’s life completely. Another reason is that one takes up the role of a nurse the only difference is that he/she does not have an off duty. Conversely, discussions concerning these issues are important as they embrace contagious issues concerning the welfare of the whole family. Some of the important issues for discussion are “the patient’s preferences regarding medical treatment and other matters in the event of a medical crisis, daily living, personal care, hygiene, healthy eating, home safety, making decisions, social and family issues, stress, depression, grief and preparing for death” (Whiteman, 2000).
In discussing these issues the patient’s wishes should always be respected. As much as the family would wish to suggest how the patient should be properly managed he or she is the one to decide how management is to be carried out. Whiteman supports this by stating that:
Each patient is bound to have strong opinions about the way his/her illness is managed, deciding on the type of care to be employed, the location of treatment, and if or when to discontinue treatment. These are regarded to be very personal decisions that can only be made by the patients themselves. Friends, family members, and health care professionals can all offer opinions and advice, but ultimately, the responsibility for decisions regarding the management of a serious terminal illness must lie with the patient (Whiteman, 2000).
This argument is also discussed by Hales who says, “Individuals can use a living will (also called health-care directive or physician’s directive) to indicate whether they want or don’t want all possible medical treatments and technology used to prolong their lives” (Hales, 2010).
“Those helping people with terminal illness often hope to offer more than love and support; they also want to understand the person’s last wishes to grant him/her happy moments. There’s always feelings of urgency when time is short” (Grumman, 2007), so satisfying these wishes becomes the main concern.
There are several methods of helping parents and loved ones communicate their wishes regarding terminal illness and death. “Some of these are taking them for holidays, plane rides and even family reunions. Before doing this though the patient has to be asked what he/she likes most of what he or she wants to be done” (Grumman, 2007). During such events communication with the patient turns out to be simpler as he/she feels more at ease.
Therefore it is important to note that death does not come abruptly to patients with terminal diseases; consequently, a caregiver is highly required to take care of the patient. It is necessary to employ a nurse or any responsible family member to give these services. Caregivers are required to aid in the day-to-day activities of the patient, feeding, and to some extent psychological support. Again different patients have different necessities so caregivers must work closely with doctors and call them when; the patient experiences a lot of pain, “when he/she is having difficulties breathing, has difficulty passing urine or is constipated, is depressed and wants to harm him/herself, when he/she will not take the medications prescribed and when the caregiver does not know how to handle a situation” (Whiteman, 2000).
Conclusion
Another importance of caregivers is that they turn out to be the patient’s best friend allowing the patients to pass across their concerns. It is again vital for the patient to be close to the caregiver as this is one method of helping communicate his/her wishes. “Besides this, the caregiver is required to comfort the patient without being judgmental. Additionally, the caregiver holds the patient in high esteem, in the event he/she does not disclose any information concerning the patient’s secrets.” (Whiteman, 2000). Therefore as shown in this paper, terminally ill patients are part of the family and should be given proper medical care because their lives do not stop suddenly upon diagnosis. The families and caregivers of these patients are supposed to ensure that there is an efficient pain and depression management, there are enough discussions regarding the aftermath of the illness, the patient’s wishes are honored, all decisions made are in the favor of the patient and lastly, the patients’ family should make sure that all-important goals are completed. When this is done the patient and the family at large would not feel the harsh effects of terminal illness and its aftermath (death).
References
- Grumman, J. (2007). Handling terminally ill patients. South Melbourne, VIC: Oxford University Press.
- Hales, D. (2010). An Invitation to Health. Belmont CA: Wadsworth publishers
- Jones, K. (2002). Terminal illness. Journal on coping with terminal diseases 26 (1), 12-14.
- Whiteman, B. (2000). Caring for the terminally ill. International journal on terminal illness 14 (4), 172- 191.