Many of us are uncomfortable discussing death. I work in a cancer care setting and at times, after a cancer diagnosis, patients do ask this question. It is a question that can make us feel uneasy because as health care professionals we are trained to heal. We want to make it better, and send our patients home to their families, in optimum physical and mental health. In many circumstances, advances in diagnosis and treatment of disease have made this possible. A few years back a child with leukemia faced certain death. Thankfully this is no longer the case. Diabetes is not as debilitating as it used to be if monitored and controlled successfully. So improvements in the medical field have given us a longer life expectancy. However, one of the only certainties of life is that we will all die sooner or later.
How can we be effective when supporting individuals facing life threatening illness?
- Be comfortable with your own fragility: Supporting someone who is sick can make us face our own fears of death and suffering. It can bring up our own memories of loved ones lost. Moreover, it can make us feel sad, helpless and distressed. Seek assistance. Caring and supporting someone who is very sick can be extremely stressful. Therefore we need a support network of friends and professionals that can help us go through this difficult time.
- Listen: Facing death and life-threatening illness can be very scary. Listen to the patient’s fears, wishes and needs. Focus on ‘being’ not on ‘doing’. Be comfortable with silence and respect the patient’s need for information. Liase with health care professionals if you feel that this will benefit the patient. Be sincere but remember to keep hope alive. Help the patient to be thankful for the present moment.
- Preparing a memory box: Some patients, especially those who are parents, can be afraid that in the future their family and friends will forget how much they loved them. One way to prevent this is to create a memory box. This is usually a box containing photos, recorded messages, music and letters. These objects can help family and friends remember the good times spent and memories made when their loved one passes away. Creating a memory box can be very emotional for the patient, however with the right support it can also be a way on reflecting back on the positive experiences and achievements.
- Helping the families say goodbye: Do not leave ‘goodbye’ until the last moment. Say ‘thank you’, ‘forgive me’, ‘I love you’. These words can help the patients and those they love gain closure. Help the patients settle any unfinished business they might have.
- Touch can speak volumes: When words are no longer necessary or possible, holding a person’s hand can show them that you are still there and that they are not alone.
Working and supporting individuals with life threatening illness can be challenging. However, the truth is that none of us are going to get out of here alive. Sooner or later we will all pass on to another reality. So eat the good food, smell the flowers, spend time with the people you love. May we all remember that what we have is today, now, the present moment…
References:
Koy, M.Y. et al. (2015) Burnout psychological morbidity and use of coping mechanisms amongst palliative care practitioners: A multi-centre cross sectional study. Palliative Medicine, 29(7), 633-642. doi:10.1177/0269216315575850.
Anna Catania is a counsellor with Willingness. She has had a special interest in working with clients facing intimacy and sexual difficulties and runs a service for families going through cancer and chronic illness. She can be contacted on anna@willingness.com.mt