End-of-life seminar stresses dignity, compassion
by Christine Hurley Deriso
Erin LaCroix wasn’t ready to say goodbye to her father, but she cherishes the quiet dignity that accompanied his death.
“The last day was the sweetest time of all,” said Ms. LaCroix, whose father died March 3 after a month in the MCG Medical Center intensive-care unit. He was moved to a private room the day before his death so his family could gather for a peaceful, uninterrupted goodbye.
Ms. LaCroix shared her story as one of five guest speakers for a seminar held on campus April 24-28 in observance of End-of-Life Care Week. The seminar, “Dying with Dignity: Caring for Patients at the End of Life,” was organized by medical student Aditi Sethi and sponsored by the American Medical Students Association, the MCG chapter of the association and MCG Health, Inc.’s Pastoral Care Services.
Ms. LaCroix shared her story to offer a personal perspective about the topic. She lauded the wonderful care her father received, expressing her family’s gratitude for every display of compassion. She particularly recalls a medical student who took the time to stop by the ICU and say goodbye before beginning a new rotation.
She also emphasized the importance of information, which families consider one of the most valuable commodities in a hospital. “Families are so hungry for information, so desperate for any news about their loved one that they’ll cling to every word you tell them,” she told the audience, which consisted mainly of medical students.
She urged the future physicians to communicate clearly with patients and families, being mindful that loved ones often filter news through a haze of emotions that may cloud their understanding. Respect, she said, should be paramount—for instance, by finding a quiet place to talk and taking the time to answer questions.
“Just remember that the [patient] could be your mom,” she told them.
Wink O’Neal, psychosocial/community coordinator for the St. Joseph’s Center for Hospice and Palliative Care, echoed the sentiment during the seminar’s hospice-care lecture. “Empathy can be achieved in a very short period of time, but it requires listening,” said Ms. O’Neal. “If [health care providers] lack listening skills, we do a U-turn at the bedside.”
Although hospice patients have a poor prognosis, “hospice is not about dying,” Ms. O’Neal said. “It’s about appropriate treatment. Treatment goals include palliative and supportive care. We take two things to our patients: skill and self. We know relationships succeed where medicine fails.”
When dealing with patients and their families, she urged the students to make eye contact, ask open-ended questions and listen attentively. Information should be honest and realistic, yet compassionate and empathetic. “I defy you to ever say to a patient that nothing more can be done,” Ms. O’Neal said. “We can always comfort.”
Health care professionals must establish trust and respect boundaries when discussing death, but the topic shouldn’t be taboo, she said. “Hospice is a matter of letting go, not giving up. Giving up is getting your ticket snatched. Letting go is handing in your ticket. Accepting death as a natural part of life is about moving toward wholeness. I can’t give people the ability to be whole, but I can remove obstacles.”
She urged the students to disavow guilt when dealing with terminally ill patients. “We are not responsible for the patient’s illness or his reaction to it,” she said. “What we are responsible for is competent intervention and compassionate involvement.”
Health care providers also must address the needs of the family. “Death affects loved ones in three ways: actual losses, impending losses and [anticipation of] our own death,” Ms. O’Neal said. Serving families also serves patients, she said, since the well-being of loved ones is often their primary concern.
Patients who feel physically and emotionally supported can embrace the last stage of their lives with peace and dignity, Ms. O’Neal said, noting, “To live well is to die well.”