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Caring for the Dying

"He may cry for rest, peace and dignity, but he will get infusions, transfusions, a heart machine, or tracheotomy if necessary. He may want one single person to stop for one single minute so that he can ask one single question-but he will get a dozen people around the clock, all busily preoccupied with his heart rate, pulse, electrocardiogram or pulmonary functions, his secretions or excretions but not with him as a human being. He may wish to fight it all but it is going to be useless fight since all this is done in the fight for his life, and if they can save his life they can consider the person afterwards. Those who consider the person first may lose precious time to save his life!" ("On Death and Dying", by Elizabeth Kubler-Ross, M.D.)

It seems that even when a person is facing great suffering and the inevitability of their own death, there is one thing that hasn't changed. More than anything, they long for and need human connection and compassion. Most people are not as afraid of death itself as they are of pain, debilitation and dying alone. Perhaps this will help those of us in health care to understand the deeper needs of the patient. What the dying want, more than having their life prolonged, is to be relieved of physical suffering, emotional anguish and abandonment. So, how can we meet the needs of those we care for in a way that meets their physical needs as well as emotional and spiritual? There are at least four components to a compassionate response to the dying.

One gift that we can offer to those facing their last days is the reassurance that we will do what we can to minimize their suffering, both physical and emotional. Some obvious ways of doing this are making sure medication is dispensed in a timely manner, closely monitoring the patient's level of pain, and giving extra attention to the person's positioning so they can be as comfortable as possible. Another way to provide pain relief is to give the patient a massage. Not only does this reduce local pain, but is also helps the person to relax. As far as emotional suffering goes, slowing down to listen and truly hear from one who is dying is a very compassionate thing that we can do for them.

When death is eminent, people need to be provided with the opportunity for restitution. We can help to accomplish this by doing what we can to help the patient contact those with whom they wish to make amends. Most people who are facing their final days have a desire to be totally

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