In this blog I'll continue to focus on the text reading from this week. In particular the section about the role of the health care provider in the process of their patients who may be facing death. Often patients and their families express discouragement and disappointment in the way their health care provider has notified them of terminal illnesses, their treatment during the progression of the disease, and even the actual transition to death itself.
There is a necessary balance that health care providers should maintain so that they are able to express to their patients and patents' families that they are connected to them personally, yet not so personally connected that their professional judgement is altered in any way. It is important to keep the focus on the needs of the patient and their family, so that they don't feel responsible for consoling the health care provider.
This concept is presented in the text as intrapersonal death over impersonal death. Impersonal death would be when a health care provider simply goes through the motions of reading a chart, making rounds, or visiting with the patient routinely without expressing or showing any degree of understanding or connection to the person as a whole. Often this is a coping mechanism, yet it is not best for those going through the stages of dying: denial, anger, bargaining, depression, acceptance. As noted on page 82, it is the truly gifted practitioners who is able to attain intrapersonal and impersonal balance when conveying emotional connection without compromising the needs of the patient or his/her own personal judgement.
Saturday, January 31, 2009
Absence of grief
In many cultures the loss of a loved one is followed by a traditional ritual in which family members, friends, and other supportive circles recognize the death of the individual, celebrate their life, and with dignity, provide those close to the deceased with support. These rituals allow family and care givers to grieve without feeling that it is not socially acceptable or that something is pathologic if they don't immediately (within weeks) return to life as usual. Allowance of this process therefore promotes the natural progression of grieving and also through the various stages of mourning. If the process of grief is halted for whatever reason, it is possible that there will not be normal healing and return to optimal functioning. This can become pathologic if not addressed.
Just as customs vary among cultures, as do the end of life ceremonies/rituals. In the Italian/Catholic culture it is acceptable for a person to mourn the loss of a loved one by wearing black garments for one year. This is an indication to others that the person is to be respected and allowed to mourn in his/her own way without judgement from others. In addition the mourner is treated with kindness and compassion above and beyond the norm, without expectation of any return of favors such as meals, financial help, or household assistance during that entire year. It is also unlikely that the widower or widow will date or marry during that time. Mainland tradition has been altered by Americanism, however there are a number of decendents who carry on the tradition of their greatgrandparents and grandparents because they believe that the healing process is essential for optimal growth and health.
At the Hospice house a ritual is practiced with the passing of every one of their patients, which allows the family members to grieve and celebrate their loved one's life. Respect and dignity for the patient is of utmost importance. It begins when the lights of the entire living area are dimmed. All of the staff members; administrative, chaplain, and medical alike, accompany the lost person and their family members to the hurst with a candle lighting their journey. After their loved one is taken from the home, the staff presents them with a hand made prayer shawl and rosemary tied in a ribbon. The prayer shawls are knitted or crochetted by surviving cancer patients, family members of those lost to terminal disease, or others who want to contribute in some way. During the time of the knitting or crochette process the craftperson prays for the family members who might receive the prayer shawl. My sister is one such person. Last week I talked with her about the ritual and she has already begun a shawl and is going to continue making them in memory of our mom. Contributing to others who are experiencing grief or who are mourning will hopefully give back, in some way, what others did for us during our time of loss and will give them freedom to mourn and eventually regain joy again.
Just as customs vary among cultures, as do the end of life ceremonies/rituals. In the Italian/Catholic culture it is acceptable for a person to mourn the loss of a loved one by wearing black garments for one year. This is an indication to others that the person is to be respected and allowed to mourn in his/her own way without judgement from others. In addition the mourner is treated with kindness and compassion above and beyond the norm, without expectation of any return of favors such as meals, financial help, or household assistance during that entire year. It is also unlikely that the widower or widow will date or marry during that time. Mainland tradition has been altered by Americanism, however there are a number of decendents who carry on the tradition of their greatgrandparents and grandparents because they believe that the healing process is essential for optimal growth and health.
At the Hospice house a ritual is practiced with the passing of every one of their patients, which allows the family members to grieve and celebrate their loved one's life. Respect and dignity for the patient is of utmost importance. It begins when the lights of the entire living area are dimmed. All of the staff members; administrative, chaplain, and medical alike, accompany the lost person and their family members to the hurst with a candle lighting their journey. After their loved one is taken from the home, the staff presents them with a hand made prayer shawl and rosemary tied in a ribbon. The prayer shawls are knitted or crochetted by surviving cancer patients, family members of those lost to terminal disease, or others who want to contribute in some way. During the time of the knitting or crochette process the craftperson prays for the family members who might receive the prayer shawl. My sister is one such person. Last week I talked with her about the ritual and she has already begun a shawl and is going to continue making them in memory of our mom. Contributing to others who are experiencing grief or who are mourning will hopefully give back, in some way, what others did for us during our time of loss and will give them freedom to mourn and eventually regain joy again.
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