Physical Comfort for Terminally Ill Patients
This part can be fairly straightforward. Terminally ill patients may benefit from switching positions periodically. They’re bedridden, and significant weight loss can also make it uncomfortable to stay in certain positions for an extended period of time.
Many patients require adequate doses of pain medications to keep physical pain from becoming incredibly severe. In palliative care, opioid analgesics are often used to keep a person comfortable, sometimes in combination with adjuvant analgesics like NSAIDs and steroids. Without very strong analgesics like morphine, some terminal patients would be in unspeakable pain. For nurses, it’s important to balance effective analgesia with safe dosing.
Nurses may also find themselves providing mental and emotional support to patients during palliative care. This can be quite challenging. People who are faced with death are sometimes fearful. They may not be afraid of dying itself, but of things like how their families and friends will grieve.
For nurses, having good listening skills is imperative. If you listen carefully, you’ll gain a better understanding of what your patient does or doesn’t need. When the patient asks questions, give honest answers.
Avoid Platitudes, And Avoid Injecting Your Own Beliefs
Everyone approaches death differently, and each person has different beliefs about death, its philosophical significance, and what, if anything, comes after. Chances are, you have beliefs of your own. When it comes to death, and to speaking with those who are in the process of dying, many people end up resorting to platitudes. Such platitudes may be all you can think of to say, a pre-packaged automatic response of sorts. But this isn’t always the best approach, and even the most well-meaning platitude might not be well-received.
Part of why death is such a difficult subject for people is how closely bound it is with ideas about things like the meaningfulness of life, the existence and nature of God and the soul, and the most basic qualities of human experience, like consciousness itself. When you’re caring for a patient in palliative care, you may need to be delicate or careful about bringing up things related to philosophy or faith.
For example, it’s easy to find yourself telling someone something like “Everything happens for a reason,” or “It’s in God’s plan.” The thing is, these reflect certain beliefs and worldviews about things like the nature of God and the purpose of human life, which not everyone shares. “It’s God’s plan” makes perfect sense to a devout Calvinist protestant, and can be very spiritually comforting. But many atheists and agnostics find this turn of phrase incredibly insulting, so it’s important to be careful about this kind of thing.
At the same time, if you’re a dedicated atheist who views spirituality as a deceptive self-delusion, it is absolutely not your place to say anything about it to a dying patient who speaks about how they’re looking forward to reuniting with a deceased spouse.
Bringing Comfort and Compassion to a Patient’s Final Moments
Death is not an easy subject, and coming to terms with its inevitability is a matter of great psychological and philosophical importance and concern. For nurses, taking care of terminal patients can sometimes be very challenging. But the best things you can do are little things that make their last days as comfortable as possible. Whether it’s giving them a back massage, or simply sitting and listening to them talk about their life and memories, nurses have the power to make a real difference in how a person experiences the end of life.