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Modules:
Introduction
1. Advance Care Planning
2. Communicating Bad News
3. Whole Patient Assessment
4. Pain Management
5. Assisted Suicide Debate
6. Anxiety, Delirium
7. Goals of Care
8. Sudden Illness
9. Medical Futility
10. Common Symptoms
11. Withholding Treatment
12. Last Hours of Living
13. Cultural Issues
14. Religion, Spirituality
15. Legal Issues
16. Social and Psychological
More About:
Hospice Care
Clergy and Faith Communities
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Click here for a Special Note
Finding Hope
The Search for Meaning
Sustaining Personhood and Community
Coping with Change and Uncertainty
Taking Care of Unfinished Business/The Need for Forgiveness
Fear of Death, Questions About Life After Death & Spiritual Care at the Time of Death
Taking Care of Unfinished Business and the Need for Forgiveness
Facilitating Life Review
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Life review is a natural part of the end of life
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As persons face their own death, they naturally ask questions such as:
- “Was my life well-lived?”
- “How will I be remembered?”
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The process of reviewing one’s life provides the opportunity to affirm the unique contributions and value of the person who is dying
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Physicians, nurses, nursing assistants, volunteers, occupational therapists, and counselors have many opportunities to assist in this developmental task
- Asking the person to share a piece of their story or what they are most proud of are simple ways to begin
- You may also encourage family members and friends to identify what they have learned from the dying person or how that person has made a difference to them
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Attending to Unfinished Business
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Coming to terms with one’s past is an important task at the end of life
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The end of life represents a chance for persons to resolve or come to terms with their mistakes, failures, regrets, and unfinished business
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How the dying person or family feels about or perceives their past matters far more than the judgment or perception of anyone else
Examples
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Religious and spiritual frameworks play a role in this process
- Framework from which to assess life
- Means to “make right” or be released from sins or failures
Examples
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The end of life care team also plays an important role in this process
- All members of the interdisciplinary team may be called upon to help persons gain a sense of peace with the life they have lived, when that is the goal (explicit or implicit) of the dying person and their family
- However, when strong negative or judgmental feelings about a person’s past arise, members of the team with professional expertise in this area should be brought in if possible
- Social workers, chaplains, and psychologists can:
- Use life review, confession, and reframing techniques in addition to an accepting, non-judgmental presence
- Facilitate communication between the dying person and family/friends as needed to bring closure and reconciliation
- Encourage the dying person to take specific actions to make amends for their past actions or complete an unfinished task to attain the peace they desire
- Words of forgiveness and rituals of reconciliation may occur with the assistance of a professional spiritual caregiver or member of the clergy
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Unresolved past issues may manifest themselves in physical or psychological symptoms
- Pain that is not lessened with appropriate medications
- Resistance to taking pain medication
- Even shortness of breath or panic should be regarded as possible indications of spiritual distress
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Unresolved issues from the past or a need for forgiveness may also cause psychological or emotional symptoms such as:
- Concerns about salvation or the after life, and
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