Showing posts with label Dying Patients. Show all posts
Showing posts with label Dying Patients. Show all posts

Friday, April 22, 2011

More senior citizens are dying at home - Miami-Dade - MiamiHerald.com

jdorschner@MiamiHerald.com

After years of experts and patients saying people at the end of life might be more comfortable dying at home, a new study says that may finally be happening: fewer seniors in the United States and South Florida are dying in hospitals.

But the same survey finds that in the last months of life for seniors throughout the United States and especially in Miami, the trend is for more of them to see large numbers of specialists and to spend more time in expensive intensive care units.

Those are the results of the latest study from the Dartmouth Atlas, a project of the Dartmouth Medical School. The project for years has been using Medicare data to expose anomalies in healthcare costs and wide geographic disparities in expenses.

“Miami is practically off the charts,” says David Goodman, a Dartmouth researcher who was the lead author of the study. “It really continues to stand out” for having the highest costs and most extensive treatments in the last months of life, even when adjusted for age, ethnicity, race and severity of illness.

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Sunday, April 17, 2011

A Good Death | What is a Good Death? | Getting Affairs in Order

Practical ways to help to ensure a "good death"

Poets, professors, priests, and plain folks all opine about what makes a "good death." In truth, deaths are nearly as unique as the lives that came before them -- shaped by the attitudes, physical conditions, medical treatments, and mix of people involved.

Still, many have pointed to a few common factors that can help a death seem good -- and even inspiring -- as opposed to frightening, sad, or tortuous. By most standards, a good death is one in which a person dies on his own terms, relatively free from pain, in a supported and dignified setting. Other things to consider:

Having affairs in order

Not everyone has the luxury of planning for death. But those who take the time and make the effort to think about their deaths during life and plan for some of the details of their final care and comfort are more apt to retain some control and say-so in their final months and days of life.

Legal specifics of such planning can include taking steps to get affairs in order by:

Controlling pain and discomfort

Most Americans say they would prefer to die at home, according to recent polls. Yet the reality is that three-quarters of the population dies in some sort of medical institution, many of them after spending time in an intensive care unit.

As life expectancies increase, more people are becoming proactive. A growing number of aging patients are choosing not to have life-prolonging treatments that might ultimately increase pain and suffering -- such as invasive surgery or dialysis -- and deciding instead to have comfort or palliative care through hospice in their final days.

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Andrew Lopez, RN
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Thursday, April 14, 2011

Sarah's Tears by Tony Collins, LVN, Inspirational Nursing Stories

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Late one December night on the cancer ward the halls were quiet and solemn, the patients were asleep and most of the visitors were gone. The nurses were gathered about the nurse's station preparing for shift change. Sarah, one of the nurses, was especially tired, having worked seven straight 12 hour days. The kids had needs, her husband had been laid off, and the house payment was due. What kept her going was that in January she was going to find a new job. After ten years of answering call lights, working short staffed, putting up with constant administrative changes, she had decided that it was not worth the effort anymore.

PING. PING. PING. Sara angrily looked at the call light box, "Good grief!" The patient was a seventy-year-old woman. Sarah had been to her room at the end of the hall at least fifteen times. Angrily she started down the hall.

On her way, she suddenly stopped. She stood motionless as a soft voice wafted out of room 235.

"And then one day I'll cross the river; I'll fight life's final war with pain; And then as death gives way to victory, I'll see the lights of glory and I'll know He lives."

Tears welled up in her eyes as she listened and thought about the young woman in that room -- a thirty-five year old mother of two with cancer, with only a week to live, perhaps days. Sarah stood there, with tears in her eyes, remembering how this young terminal woman had such peace. The patient would speak to everyone who came into her room and she would smile even in her pain and took the time to share her faith and let people know the reason for her peace was a faith in God. All the nurses who had been around her commented on her strength and how they had felt peace and calm after talking with this exceptional young woman..

"Because He lives, I can face tomorrow; Because He lives, all fear is gone Because I know who holds the future, Life is worth all the living, just because He lives."

Unstoppable tears flowed as Sarah stood a few moments more, but the tears had taken on a newness. No longer were they tears of sadness for this young woman but tears of renewal that washed away the disappointment and disillusionment of her job, and the fear about the future.

Sarah started down the hall to answer the call light, but she was no longer going to check on some pestering old woman. She was going to the room of a patient, a person, a fellow human in need. Sarah no longer looked to January so she could quit -- she looked to her next shift when she would again have the opportunity to serve her fellow man. Sarah left work with a new outlook on life. She had a rekindling of the spirit of service that had motivated her to become a nurse. Those fires had almost died, but for a young terminal woman who had the desire to be of service to her fellow man even unto death.

This is a reminder to me that the reason that we are on this earth at all is to be of service to each other. Christ said it best when He said, "Greater love hath no man than this, that he lay down his life for his brother."

-- by Tony Collins

--

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
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Sunday, April 10, 2011

Dealing with Death and Dying | Myths of Coping with Death | Caring.com

hands_held_hospital

People often adhere to a code of conduct about the end of life that's just not rooted in common sense or reality -- especially when it comes to how to talk to someone who's dying, in their final days or hours. Hospice nurse Maggie Callanan, who has attended more than 2,000 deaths, wrote her book Final Journeys: A Practical Guide for Bringing Care and Comfort at the End of Life in order to take on these myths:

Myth: Don't cry in front of the dying.
They know you're sad. Having the courage to bare your emotions gives the dying person permission to be candid about his or her own feelings. Your tears are evidence of your love. And they can also be a relief to the person, telegraphing that you understand what's happening.

Myth: Keep the children away.
People often steer kids away from death so they'll remember the person in a good light and not be frightened. But most kids do well with simple explanations of what's happening; facts are usually less scary than their vivid imaginations. By cordoning off a child from a natural part of life, you also deprive the dying person of a beloved, comforting presence.

Tuesday, March 29, 2011

Quality of Death and Dying in Patients who Request Physician-Assisted Death - Journal of Palliative Medicine

Background: Physician-assisted death (PAD) was legalized in 1997 by Oregon's Death with Dignity Act (ODDA). Through 2009, 460 Oregonians have died by lethal prescription under the ODDA.

Objective: To determine whether there was a difference in the quality of the dying experience, from the perspective of family members, between 52 Oregonians who received lethal prescriptions, 34 who requested but did not receive lethal prescriptions, and 63 who did not pursue PAD.

Design: Cross-sectional survey.

Measurements: Family members retrospectively rated the dying experience of their loved one with the 33 item Quality of Death and Dying Questionnaire (QODD).

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Monday, March 21, 2011

Death, Dying, End of Life, Hospice, Inspirational Poems, Touching Stories

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Faith Friends by Nancy Haygood, Hospice Poems, Stories of Death and Dignity:"I don't want to say goodbye
Don't want you to see me cry
But in the end, that sweet by and by
We will meet again."
http://www.inspirationalnursing.com/faith

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Tribute to a Hospice Nurse by E.V. Stankowski, RN, Inspirational Poems, Touching Stories:"When it comes to death and dying
There's a special gift you share
One that Angels all admire
One that goes beyond just care

http://www.inspirationalnursing.com/hn

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A Trip To The Supermarket, Inspiration Poems, Touching Stories:"I walked into the grocery store not particularly interested in buying groceries. I wasn't hungry. The pain of losing my husband of 37 years was still too raw. And this grocery store held so many sweet memories."
http://www.nursefriendly.com/nursing/inspiration/a.trip.to.the.supermarket.htm

Inspirational Categories: Affection, Caring, Friendship, Angels In Our Lives, Watching Over Us, Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Love, Marriage, Matrimony, Loving Partners

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Always Say I Love You, Inspirational Poems, Touching Stories:"Brittney loved basketball Friends and parties too And when it came to painting That's all she wanted to do."
http://www.nursefriendly.com/nursing/inspiration/always_say_i_love_you.htm

Inspirational Categories: Affection, Caring, Friendship, Babies, Children, Infants, Kids, Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Living Life To The Fullest, Love, Caring, Self Esteem, Self Worth, Parents & Parenting

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Angels of Mercy, Inspirational Poems, Touching Stories:"Sorry if we woke you in the middle of the night But someone in your neighborhood is fighting for his life. Sorry if we block the road and make you turn around, But there's been a bad wreck with dying children on the ground."
http://www.4nursing.com/inspirational-poems-touching-stories-angels-of-mercy.html

Inspirational Categories: Death, Dying, End of Life, Hospice Poems, Emergency Medical Services (EMS)

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Beatitudes For Aging, Inspirational Poems, Touching Stories:"Blessed are they who understand My faltering steps and palsied hand. Blessed are they who know my ears today must strain to catch the words they say."
http://www.nursefriendly.com/nursing/inspiration/beatitudes.for.aging.htm

Inspirational Categories: Affection, Caring, Friendship, Angels In Our Lives, Watching Over Us, Parents & Parenting Death, Dying, End of Life, Hospice Poems, Living Life To The Fullest, Love, Caring, Self Esteem, Self Worth

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Butterfly Courage, by David L. Kuzminski:"Walking down a path through some woods in Georgia in 1977, I saw a water puddle ahead on the path. I angled my direction to go around it on the part of the path that wasn't covered by water and mud. As I reached the puddle, I was suddenly attacked!"
http://www.inspirationalnursing.com/courage

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Death Is Nothing At All, Poems About Death & Dying, Loss:"Death is nothing at all...
I have only slipped away to the next room...
I am I and you are you...
Whatever we were to each, that we are still."
http://www.inspirationalnursing.com/nothing

Inspirational Categories: Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Living Life To The Fullest

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Do Not Stand At My Grave, Inspirational Poems About Death & Dying:"Do not stand at my grave and weep, I am not there, I do not sleep. I am a thousand winds that blow; I am the diamond glints on the snow."
http://www.inspirationalnursing.com/grave

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Earthbound Angel, Inspirational Poems, Touching Stories:"Occasionally, we are graced with the presence of an earth bound Angel. They are unable to stay with us for long, but while they do, they bring unprecedented joy and happiness to all they touch."
http://www.inspirationalnursing.com/earthbound

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Gone From My Sight, Inspirational Poems, Touching Stories:"I am standing upon the seashore. A ship at my side spreads her white sails to the morning breeze and starts for the blue ocean."
http://www.inspirationalnursing.com/sight

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Hummingbird Man, The by Nancy Haygood, Hospice Poems, Stories of Death and Dignity:"He shows me tomatoes – red cherries, neatly hoed,
He naps in the sun, soaks up heat, sky aglow.
"Meet my new pup," proudly, "she's for squirreling."
His pain burns deep, he hides it, buried, gnawing."
http://www.inspirationalnursing.com/hummingbird

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I Found Jesus There, Inspirational Poems, Touching Stories:"The surgeon sat beside the boy's bed; the boy's parents sat across from him. "Tomorrow morning," the surgeon began, "I'll open up your heart..." "You'll find Jesus there," the boy interrupted."
http://www.inspirationalnursing.com/there

Inspirational Categories: Affection, Caring, Friendship, Babies, Children, Infants, Kids, Death, Dying, End of Life, Hospice Poems, Parents & Parenting, Religious Poems, Christian Stories

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If It Should Be, Animal Poems, Pet Stories:"If it be I grow frail and weak, And pain should wake me from my sleep, then you must do what must be done, for this last battle can't be won."
http://www.inspirationalnursing.com/be

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If Roses Grew In Heaven, Inspirational Poems, Touching Stories:"If roses grow in Heaven, Lord please pick a bunch for me, Place them in my daughters arms and tell her they're from me."
http://www.inspirationalnursing.com/roses

Inspirational Categories: Babies, Children, Infants, Kids, Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Motherhood, Mothering, Moms, Parents & Parenting, Prayers, Requests, Praying, Religious Poems, Christian Stories

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If There Were No Tomorrow..., Inspirational Poems, Touching Stories:"I would tell you today
That you are the one that fills my life,
Whose smile I cannot wait to see,
Whose arms I long to have wrapped around me,
Whose lips I live to kiss,
Softly, passionately, in every way."
http://www.inspirationalnursing.com/were

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Inheritance, Inspirational Poems, Touching Stories:"There is a lovely story told about a famous art collector who learned that his son had been killed in the war, killed saving the life of another soldier. Some time past and the soldier who survived and who himself was an amateur painter, gave the art collector a simple portrait he'd sketched of his son. It was nothing like a masterpiece but it became very special to the man in his loneliness."
http://www.inspirationalnursing.com/inheritance

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Life Still Has A Meaning, Inspirational Poems, Touching Stories:"If there is a future there is time for mending- Time to see your troubles coming to an ending."
http://www.inspirationalnursing.com/meaning

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Men Do Cry, Inspirational Poems, Touching Stories:"I heard quite often "men don't cry" though no one ever told me why So when I fell and skinned a knee, no one came by to comfort me."
http://www.inspirationalnursing.com/men

Inspirational Categories: Babies, Children, Infants, Kids, Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Parents & Parenting

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My Brother Has Fallen, Inspirational Poems, Touching Stories:"My Brother has fallen; no, I don't know his name. Have not the same parents still family all the same. He lives in this town, I live in another, It doesn't really matter 'cause this man is my Brother."
http://www.inspirationalnursing.com/fallen

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My First Christmas In Heaven, Inspirational Poems, Touching Stories:"I see the countless Christmas Trees around the world below, with tiny lights, like heaven's stars, reflecting on the snow. The sight is so spectacular, please wipe away that tear, for I am spending Christmas with Jesus Christ this year."
http://www.inspirationalnursing.com/my

Inspirational Categories: Angels In Our Lives, Watching Over Us, Babies, Children, Infants, Kids, Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Holiday Thoughts, Christmas, Easter, Thanksgiving, Etc., Living Life To The Fullest, Love, Caring, Self Esteem, Self Worth, Religious Poems, Christian Stories

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Nothing Is More Important Than Relationships:"I sat next to the bed of old man, a friend for over twenty years, and held his hand. Hal was dying. We both knew these next few days would be his last. We spent time reminiscing about his long and fruitful career as a church pastor. We talked about old friends. We chatted about his family. And I listened as he offered sage wisdom and advice to a member of a "younger generation."
http://www.inspirationalnursing.com/relationships

Categories: Affection, Caring, Friendship, Bereavement, Grief, Sadness, Sorrow, Death, Dying, End of Life, Hospice Poems, Living Life To The Fullest, Love, Caring, Self Esteem, Self Worth, Religious Poems, Christian Stories

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Old Man and His Dog,The, Inspirational Poems, Touching Stories:"An old man and his dog were walking along a country road, enjoying the scenery, when it suddenly occurred to the man that he had died. He remembered dying, and realized, too, that the dog had been dead for many years. He wondered where the road would lead them, and continued onward."
http://www.4nursing.com/inspiration-the-old-man-and-his-dog.html

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Sunday, March 20, 2011

How to Say Goodbye | Saying Goodbye to a Dying Loved One | Caring.com

Here, those who've been through the experience of saying good-bye share what felt right to them -- and what they wish they'd done differently.

Lesson #1: Don't wait until the last minute

It's hard to say good-bye, but putting off meaningful conversations is perhaps the number-one source of regret. Time and again, families ask Massachusetts hospice nurse Maggie Callanan to tell them exactly when the final hour is approaching, so that they can time their good-byes. This is dangerous, she says, because it's impossible to predict the final breath. "Dying people have the uncanny ability to choose the moment of death, and it's not uncommon for them to spare those they love the most or feel protective of by waiting until those people leave the room," says the author of Final Journeys: A Practical Guide for Bringing Care and Comfort at the End of Life, who has witnessed more than 2,000 deaths.

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

Sunday, March 13, 2011

Anticipatory Grief | Alzheimer's, Dementia & the Stages of Grieving

anticipatory_grief_and_alzheimers
What is anticipatory grief?

Anticipatory grief is the emotional pain of losing a loved one, felt in advance of the person's death. It's a common phenomenon among those who care for the terminally ill.

It may be experienced at any time by any one connected to someone with Alzheimer's, but it's especially common at the middle and late stages of the disease.

Why Alzheimer's caregivers are vulnerable to anticipatory grief

Good-byes are always painful, and Alzheimer's is the ultimate "long good-bye." Anticipatory grief is rampant, and perhaps inevitable, among Alzheimer's caregivers because of the slow, progressive, and incurable nature of the disease. University of Indianapolis researchers asked more than 400 caregivers the open-ended question, "What would you say is the biggest barrier you have faced as a caregiver?" The majority -- more than 80 percent -- referred to the loss of the person they used to know.

The friends and family of someone with dementia experience two difficult psychological states at once:

  • Anticipatory grief, coping with the very real feelings of loss for someone who is still alive
  • Ambiguous loss, interacting with someone who's not fully present socially or psychologically

Click on the "via" link to read the full article.

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Sunday, February 27, 2011

Dying is final, but passing on lives forever

by Greg Smith, MD

It is hard to believe that those we love will die.

We can’t bear it. It’s too harsh, too complicated, too fraught with emotional baggage and unfinished business and things never said. It’s too final. Dead is dead, after all. From the moment of our birth, we are dying. Death can be painful, tragic, too soon, too quick, too slow, too easy, or too hard.

So we soften it up a bit.

She is dying, the doctors tell us.

She is passing on, we tell ourselves.

Dying implies finality and the end of the road. We cannot cheat death.

Passing on implies going through, transitioning, skirting the physics and the metaphysics involved and coming out on the other side, changed somehow, better, calmer, whole. Keeping company with the better angels of our nature while shedding the demons like a skin.

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Wednesday, January 5, 2011

Helping patients experience death, PhillyBurbs.com:  

A handful of local hospitals recently started volunteer programs that train ordinary people to sit with those who are alone and dying.

Angelo DeLorenzo spends many nights watching people as they die.

Occasionally, the person wants to talk, sometimes through the night. Often, the patient is unconscious, but DeLorenzo reads to him or her, plays the harp or sits quietly and prays.

Everyone deserves a good death, DeLorenzo believes. No one should die without someone there to hold a hand, whisper reassuring words and make sure the person is comfortable.

So DeLorenzo stays with these dying patients at St. Mary Medical Center, where he frequently takes the overnight shift. The Middletown hospital is one of a handful in the area that have started end-of-life programs, where ordinary people such as DeLorenzo, a chaplain intern, are trained to provide comfort care for people who have no close family available.

"No One Dies Alone" - the name of the program at St. Mary - originated at an Oregon hospital in 2001. It has since spread around the world. More than 1,100 hospitals and hospices have requested copies of the program's manual, said Carleen McCornack, coordinator of the mission center of Sacred Heart Medical Center in Eugene, where the program started.

These types of programs will go along way towards easing patients and family members into accepting the death of a loved one.

To read the complete article click on the above link:
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Any questions, please drop me a line.

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