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Recognizing and Responding to Nearing Death Awareness: For Hospice Volunteers

Recognizing and Responding to Nearing Death Awareness: For Hospice Volunteers. C. Andrew Martin, MSN, RN, CHPN Seasons Hospice & Palliative Care candrewmartin@comcast.net NHHPCO 16 th Annual Fall Conference 10 November 2011. Nearing Death Awareness (NDA).

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Recognizing and Responding to Nearing Death Awareness: For Hospice Volunteers

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  1. Recognizing and Responding to Nearing Death Awareness: For Hospice Volunteers C. Andrew Martin, MSN, RN, CHPN Seasons Hospice & Palliative Care candrewmartin@comcast.net NHHPCO 16th Annual Fall Conference 10 November 2011

  2. Nearing Death Awareness (NDA) • Medical research has attempted to place physiological factors as the root cause of Nearing Death Awareness phenomena • metabolic imbalances • hypoxic events • medication induced reactions • general confusion

  3. Understanding NDA • Hospice professionals relate these experiences to be the preludes to the final journey and the final gifts we witness our loved ones experiencing • Non-professionals, such as our volunteers and family members, often misunderstand these experiences

  4. Final Gifts • Callanan and Kelley first described Nearing Death Awareness in their book, Final Gifts, close to fifteen years ago • Where are we now with understanding and having open discussions about this common occurrence?

  5. Final Gifts • “It’s Time to Get in Line” • Laura & Joe met when travelling in India, as widow and widower • Traveled the world together, under Laura’s organizational skills • Daughter, Susan, died of breast cancer the year prior • Dysentry>colon cancer>6 month prognosis

  6. Permission to Go • “I hate that this is happening, but I know you have to go.” • “I’ll bet you’re worried about me, but I promise I’ll be all right.” • Let me tell you about my plans, so you can rest easy.”

  7. Domains • Physical pain • Emotional pain (psychosocial) • Spiritual pain

  8. Visions, Trips, and Crowded Rooms • Kessler guides the reader to: • Share stories • Start conversations • “In life, we’re more connected to others than we ever imagined. What if we’re even more connected in death?”

  9. Visions, Trips, and Crowded Rooms • Who or what we see • Preparing for a journey • Room filled with other people

  10. Visions, Trips, and Crowded Rooms • “Maybe They Were Right” by Sonia • “These incidents happen so often that they can no longer be dismissed.”

  11. Reflections of a Loving Partner: Caregiving at the End of Life

  12. Reflections of a Loving Partner: Caregiving at the End of Life • “…when we are open to its possibilities, [being] with someone who is at the end of life can teach us just as much about living as about dying.”

  13. “Nantucket” • “I’m going. I’m going now. I’m going to that beautiful place.” • A journey • Preparing the caregiver for the phenomenon

  14. Nearing Death Awareness • Identify nearing death awareness experiences • Respond appropriately and compassionately

  15. Responding to Nearing Death Awareness • Being present • Acknowledging the dying person’s experience • Engaging family in the phenomenon

  16. Teaching Methods • When the dying is speaking to a person not present • When the dying is talking about taking a trip • When the dying is referring to a room filled with people

  17. Teaching Methods • Journaling what is being said by the dying, as it may provide comfort at a later time • Providing resources for family

  18. Being Present with the Dying • Listen • Ears • Hearts • Minds

  19. NDAs • 1. Calling out for someone who has previously died • 2. Referring to a room filled with people • 3. Talking about taking a trip • 4. Losing sight of this world and looking into the world to come • 5. Indicating/choosing the time when death will occur

  20. Sharing your Experiences • Ability to talk openly about the experience • Colleagues • Family • Community

  21. Question & Answer • Thank you for attending and participating in this session!

  22. Resources • Final Gifts. (1992). Callanan, M., & Kelley, P. Bantam Books: New York, NY. • Reflections of a Loving Partner: Caregiving at the End of Life. (2010). Martin, C. A. Quality of Life Publishing Company: Naples, FL • Visions, Trips, and Crowded Rooms. (2010). Kessler, D. Hay House, Inc.: Carlsbad, CA.

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