How To Proceed When Your Patient Wants To Talk About Dying
Pegasus skilled in-home caregivers in Atwater Village and elsewhere assist individuals of all ages and medical conditions. Some of their clients have terminal illnesses. Career home health care nurses offer these tips on how to proceed when a patient wants to talk about dying.
It’s a fact of life that people die. Nevertheless, talking about death is taboo for many individuals. That makes having a conversation about it difficult.
If you haven’t already, you need to prepare yourself to talk about dying. If necessary, seek spiritual or professional counseling before offering caregiving. It’s essential that your feelings about death don’t interfere with your ability to communicate with your patient and their family.
Your patient must always come first, but communication with families is also essential. You may be the only person to whom they can express their feelings. Listening is the key skill required in conversations about dying.
Always respect your patient’s privacy. Often, families are part of end-of-life discussions. But your patient may want conversations with you kept confidential.
It’s Important To Listen To Their End-Of-Life Feelings
A physician may have explained to your patient that they aren’t expected to recover from their illness. However, it’s probable that as their home care nurse, you will be dealing with their end-of-life feelings. They may be afraid of:
- Abandonment
- Loss of dignity
- Pain
- The unknown
Listening and expressing empathy can help alleviate these fears.
Talking about dying is helpful for most people. Depending on their culture and beliefs, some individuals choose not to discuss death. If appropriate, just let your patient know you’re available if they want to talk.
Knowing When Patients Want To Talk About Dying
Some individuals who need to discuss their end-of-life feelings don’t know how to start. As their in-home nurse, you may recognize clues that they want to talk. Examples include:
- Acknowledging that they aren’t getting better
- Asking direct questions about their condition
- Contemplating the existence of God and their afterlife
- Expressing worry about family members they’ll “leave behind”
- Mentioning death, often indirectly
- Inquiring about what death is actually like
- Wanting to see friends for “the last time”
- Wondering about how their spouse or partner will manage without them
If needed, you might use prompts, such as asking their thoughts about what they’ve mentioned. But the most important thing you can do is validate their feelings by listening well.
Make sure you understand the individual’s illness. Knowing the details will help you answer any questions accurately. Sometimes you won’t know the correct answer.
If so, be honest. Avoid making something up. Tell your patient you’ll find the answer and get back to them with it.
Euphemisms are rarely advisable. Patients and their families usually want the truth. Euphemisms may seem kind, but they can obscure factual information.
Not using direct words can lead to misunderstandings of the person’s condition. Patients or families may experience false hopes. That can hinder individuals in making appropriate end-of-life decisions.
Talking About Dying Includes Honoring The Patient’s Feelings
Sometimes a patient is fully aware of their condition but prefers denial. That’s their choice, and you must respect their decision. Simply offer the care that’s needed at that moment.
It’s important to honor the individual’s dignity. That means avoiding giving them false hopes about recovering. It’s a fine line, but you can be positive while avoiding false optimism.
Consider that while your patient accepts their death today, tomorrow may be different. They may be angry because they’re dying. Or they feel hopeful that a miracle will occur and they’ll have more time.
As a nurse, asking “how are you?” is a natural greeting. That’s not always a good idea. Instead, try asking your patient how they’re feeling.
That will give you clues as to whether they want to talk and what they want to talk about. Conversations and subject matter are one of the few things over which they have control. Follow their lead.
Tips To Help Families Talk To A Dying Loved One
Suggest to the family that they also follow the lead of their loved one when talking about death. Offer them the following tips as well:
- Ask their loved one if there is anything they want to have done.
- Offer forgiveness for past hurts if appropriate.
- Listen attentively to what their loved one says. Give them all the time they require to express themselves.
- Remember that silence is golden. Their loved one may only want someone to sit with them.
- Reminisce about happier times.
- Say thank you for being allowed to share time with them.
- Tell their loved one how much they care about them.
Explain to the family that their loved one may still be able to hear even when unconscious. You, and they, need to be careful of what is said when near the patient.
Pegasus is a licensed Home Care Organization and a Joint Commission Accredited Home Health Care organization. Our professional in-home caregivers in Atwater Village and our other locations assist individuals at all stages of life. Our career home health care nurses treat patients with respect and dignity regardless of their medical condition.
