Pastoral Thanatology

Dying With Dignity At Home: Checklist and Needs for the Home

Posted on by Dominick Flarey

Pastoral Care for the Dying at Home

Pastoral Care for the dying and Dying With Dignity at home is a sad but good choice if the loved one is capable of doing so.  It ensures comfort, dignity and peace for the dying person.

Susan Seliger of the NY Time writes about the important things needed when preparing one’s home for a loved one’s final days in her article “Preparing For A Loved One To Die At Home”
To read the article, please click here

If you would like to learn more about Pastoral Care certifications, please review our site and click here.

AIHCP

Hospice and Palliative Care For Mesothelioma

Posted on by Dominick Flarey

Why Mesothelioma Patients Benefit from Palliative Care and Hospice Care

hospice and palliative care are two different – but beneficial – forms of medical attention for mesothelioma patients. Although they both focus on making the patient as comfortable as possible, they are given with different intent.
Palliative therapies refer to treatments that do not have the potential to cure the cancer but still provide symptom control benefits.  For mesothelioma patients, these therapies may reduce chest pain or dyspnea and dispel anxiety. Palliative care may even be able to help patients respond more positively to traditional mesothelioma treatments, such as surgeries or Alimta chemotherapy. Patients can obtain these benefits from palliative care at any stage of their disease, regardless of the expected time to progression.
Hospice care, on the other hand, provides benefits that are more appropriate for patients with a later stage of mesothelioma. Typically, patients enter hospice when they have six months left to live. Since most mesothelioma patients survive about a year after diagnosis, they may not need to consider hospice care right away.
Benefits of Palliative Care for Mesothelioma Patients
Palliative care for mesothelioma can include minor surgery, radiation therapy and several alternative procedures. These therapies can help reduce the pressure on the lungs, improve breathing and relieve pain.
Patients may undergo surgery to drain fluid from the chest or abdomen (known respectively as a pleurodesis or a paracentesis). These operations can have significant pain reduction benefits until the fluid accumulates, at which point the patient may need to repeat the procedure.
Mesothelioma patients can also benefit from palliative radiation therapy. Although it does relieve pain by shrinking the tumor, it is still considered a palliative therapy as long as the doctor does not expect it to cure the cancer.
Oxygen therapy and respiratory therapy can also provide palliative benefits to mesothelioma patients. Both of these therapies can make it easier to breathe, and respiratory therapies can improve lung function over an extended period of time.
Doctors may prescribe these therapies alongside potentially curative treatments, or they may be the patient’s sole cancer management system. This depends on whether or not the patient is a candidate for more aggressive therapies. When combined with curative care, palliative treatments can also help patients manage the side effects of traditional therapy. Alternative therapies such as yoga, therapeutic massage and acupuncture are especially useful for this purpose.
Benefits of Hospice Care for Mesothelioma Patients
Hospice care takes palliative care to the next level. It strives to make the patient as comfortable as possible in the face of a late-stage disease. Hospice workers can administer medications that reduce pain caused by the mesothelioma tumors, and they can position the patient in a way that encourages smoother breathing. Hospice nurses can also address the patient’s hygiene needs, making it ideal for patients who need extra personal assistance.
Hospice also provides spiritual or emotional care for mesothelioma patients who are coming to terms with a terminal diagnosis. While certain palliative therapies can relieve stress and anxiety, hospice organizations often employ mental health professionals and clergy members who are trained to provide these additional benefits.
Author bio: Faith Franz researches and writes about health-related issues for The Mesothelioma Center. One of her focuses is living with cancer.

If you are interested in Pastoral Care Certifications, please review our program at AIHCP.

Pastoral Care for the Dying

Posted on by Dominick Flarey

Pastoral Care and Compassion for the Dying

More and more people are recognizing the need for pastoral care of the dying.  The fear of dying alone or without compassion is one of the biggest concerns of the dying.

Colette Douglas Home of the HearldScotland writes about the need of pastoral care and love for the dying to ease the transition from life to death in her article “We Need a Human Touch on the Pathway to Dying”.

“ASK anyone if they fear death and nine times out of 10 they’ll tell you: “I’m not afraid of being dead but I’m nervous about dying.” Death really is the last frontier, the great unknown.”

If you would like to read the entire article, please click here

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AIHCP

Palliative Care and the Dying

Posted on by Dominick Flarey

Palliative Care and Death

Pastoral Care givers are thrilled that more options are becoming more available for dying patients to live their remaining lives at home and in decency.  Federal laws are looming that may help families afford this option and give their loved ones some peace in their final days.

Irma Faith Pal of Inquirer News writes about the growing need of good and affordable Palliative Care in her article, “Palliative Care: Helping the Dying “To Live Until He Dies”

“For any family, it is devastating to hear doctors say there is nothing more they can do for the patient.
But with palliative care, patients and their families can face the prospect of death more courageously. It offers well-thought-out “goals of care” that ease suffering and give the patient the opportunity to die with dignity and in comfort.”

To read the full article, please click here

If you are interested in learning more about Pastoral Thanatology, then please review the program and click here

AIHCP

Pastoral Care Givers – Denial: Is it Dangerous?

Posted on by Dominick Flarey

Pastoral Care Counselors and Dealing with Denial of Patients

Elizabeth Kubler Ross identifies denial as the first response to grief.  She considers it to be a natural reaction to sudden and horrible news.  In her seminar on the dying, she hoped to share with pastoral care counselors, health care professionals and ministers the necessity of denial in the progress through grief.
While not everyone follows the same pattern of grieving, pastoral care givers can be assured to witness many cases of denial.  The looming question, however, is when can denial become dangerous, if it ever even can be?
Kubler Ross experienced one case of a woman who was diagnosed with cancer.  She attended a faith healing service and proclaimed she was healed despite everything medical science proved otherwise.  Her behavior was consistent till the very end insisting she was healed.  Nevertheless, she continued her treaments, medications and visits to the hospital.  During that time, she would joke of the foolishness of these treatments only till her body finally broke down and she had to come to the heart breaking conclusion of her dire situation.
Kubler Ross never contradicted her denial explicitly.  Instead, she would never confront the woman on the issue of the supposed healing or say otherwise.  Her primary concern was that the woman continued to take the prescribed medications necessary.  Through simple requests to continue to take one’s medication, Kubler Ross implicitly resisted the denial.
This type of denial was far from dangerous but critical to the woman’s coping of her physical situation.  It allowed her to carry on day by day.  As long as the woman did not resist the medications or therapies, then the denial was not dangerous.
Cases where denial become dangerous are when the person refuses treatment or carries on doing activities that are harmful to their health.  Some people and their denial will even lead them to insane adventures and spending sprees.
The primary lesson for pastoral care givers to learn from Kubler Ross is to react to most denial in an implicit way that does not damage a person’s coping.  Merely ensure the denial does not damage them health wise.
If you are interested in Pastoral Care Certifications, please review the program.

Mark Moran, MA

Pastoral Care and Dealing with the Angry Patient

Posted on by Dominick Flarey

Pastoral Care Giving Is Love and Understanding

Elizabeth Kubler Ross in her writings spoke of the five stages of grief.  In particular, her studies dealt with the reactions of terminally ill patients and the phases they went through.  Pastoral Care Giving involves an intimate connection of communication between care giver and patient.  In many cases, the care provider supplies the horrible news that someone will soon die.  Within this there will be a multitude of reactions.  One such reaction is anger.
So how does a nurse or pastoral care giver deal with the angry patient.  Ultimately with love and understanding!  The care of a terminally ill patient is more than just caring for his or her physical needs but is a caring for the totality of the human person.  In this regard, emotional symptoms must be treated as if physical symptoms.
Kubler Ross asked the question, why is the patient angry?  The only way to know is through communication and care.  Avoidance and frustration with a patient’s anger will not endear him or her to you nor will it make matters better.
Many patients may be upset over a variety of reasons.  Is their death premature or expected?  Is the death blamed on God or another doctor or treatment?  Is the anger a source of regret of how a person lived his or her life?  Is the anger due to the fact you never notice any family members coming to say “goodbye”.  Is the anger over a loss of control?  Is the anger over how the patient was treated the previous night by a different nurse?  Is the anger over the fact the person cannot die at home?
The realm of possibilities is endless and this is again why Kubler Ross insisted one cannot ignore the patient who is angry.  Instead, one must discover why the person is angry.
In one case study, Kubler Ross noted that an elderly man simply wished to have his side gate of his bed down so as to move his legs.  He feared the casket like formation he had to endure and it reminded him of death.  His nurse instead refused for fear of him falling.  She was more interested in reading her book by the bedside chair.  Maybe it was due to her own fear of facing death that she distanced himself from this poor man.  Regardless, the man would be frequently angry.
Another case study was of a man who always controlled his life, whether in his successful business or his command of his family.  His anger was a result of the loss of control to the nurses and other health related decisions.  Simply by identifying this and giving him options, he became less angry.  In fact, he always had a say or input in the course of action directed, but under the guise he had a “control” in the matter.
So as one can see, pastoral care is more than just taking one’s blood pressure or taking checking various readings, but it is also understanding the emotional dynamics that take place within the human mind.  Anger is merely a manifestation of something that is deeply wrong;  it shoud not affect health care professionals to the extent they ignore the angry patient, but instead push them to finding out why and alleviating it.
If you are interested in Pastoral Thanatology Certifications, please review the program.

Mark Moran, MA

Patient Assisted Suicide Possibly in Massachusetts

Posted on by Dominick Flarey

Pastoral Care Givers and Assisted Suicide in Massachusetts

The issue of Patient Assisted Suicide became a national controversy when Oregon first passed a bill that allowed it in the late 90s.  Now Massachusetts is proposing a similar bill.  Many people may support this idea but there are many Pastoral Care Givers who oppose it.  In the article below from Lifenews.com, the concerns regarding this bill are analyzed.

Dr. Jacqueline Harvery writes on Patient Assisted Suicide in her article “Massachusetts’ Assisted Suicide Proposal: Concerns on Question 2” and how it may not be beneficial to those of the state.

“The 2012 “Act Relative to Death with Dignity” goes before Massachusetts voters on November 6. Question 2 asks voters directly whether to legalize physician-assisted suicide (PAS) or uphold existing state statutes. “

If you would like to read the entire article, please click here

If your interested in pastoral care certification, please click here 
Mark Moran, MA

Are Pastoral Counselors Effected By Your Own Fears of Death?

Posted on by Dominick Flarey

Medical Caregivers and Their Own Preconceived Notions About Death

In counseling it is always taught to keep one’s own preconceived notions or past out of the objective judgement during a session with a patient.  The same should hold true for medical caregivers.  This represents a large portion of doctors, nurses, social workers and even pastoral counselors.
While counselors and social workers recognize the psychology behind death, many doctors are not trained in emotional caregiving.  They tend to not treat the emotional symptoms but only the physical ones.  Treating the disease overtakes treating the wholeness of the human person.
With these things in mind, doctors need to also look at themselves–and this goes for nurses and counselors as well.  What ideas do you have on death or the terminally ill?  Do patients suffering in a cancer ward remind you of a lost loved one, or does the scent of death terrify you to such an extent, you cannot face them?
Maybe you feel if you avoid the issue of death with patients, you will not have to discuss it in length with them.  Kubler Ross in many of her studies noticed such behaviors from doctors and nurses who confidently felt the patient did not demand long and detailed accounts of their condition.  However,  upon review, Kubler Ross discovered that the  patients sensed the discomfort of the doctors and nurses and decided not to discuss death because of these attitudes.
So the reality was that many patients played off the emotional indifference or fear of the doctors and nurses.  These terminally ill patients then lost a critical element of treatment for their own emotional well being.  Instead of dealing with their own fears, these doctors and nurses avoided these fears by avoiding the patients they swore to help.
With such lack of pastoral training and difficult fears of their own, many medical caregivers are unable to treat emotional symptoms of grief or simply talk to the patient.
This can only be overcome via education but also facing one’s own fears of death and understanding patients and why they react or do not react to certain things.  Anger, indifference, compromise and denial are all reactions or better yet symptoms of grief when someone learns of impending death.  Doctors and nurses need to overcome their own fears so they can treat these emotions as well as they treat physical symptoms of a disease.
If you are interested in Pastoral Thanatology Certifications, please review the program.

Mark Moran, MA

Pastoral Help For the Entire Family During Terminal Illness

Posted on by Dominick Flarey

Pastoral Care for the Whole Family

Pastoral Help sometimes does not touch upon the needs of every family member or various feelings that identify the family as a whole.  It is important to meet the needs of the patient’s family while the patient approaches death.
One of the first steps a pastoral caregiver can do is normalize any feelings within the family.  Some family members may be experiencing secondary losses.  They may feel angry at the dying person.  It is important to let them know that this does not make them bad or that this does not mean they do not love their family.  Instead, such emotions should be faced and dealt with in order to prevent guilt and other ambiguous feelings when death does occur for their family member.  There should also be care in preparing the family for death.  The family should be prepared and taught what anticipatory grief is and how they may feel when the death does actually occur.
Second, it is imperative that the pastoral provider ensure that all family members are recognized in their grief.  Too many times, other people and groups that are affected by a death are ignored and left disenfranchised in their grief.
Third, the family needs to have a healthy balance between denial and acceptance.  The pastoral counselor must help certain family members who may experience denial and begin to slowly guide them to acceptance.

Fourth, a pastoral caregiver needs to guide the family into open dialogue with each other.  Better communicating families experience better resilience after a loss than closed and quiet families.  This open communication should also include children.  Children should be told the truth but in accordance with their maturity and understanding of death.
Fifth, the family may need help learning and preparing to say good bye.  Throughout the process of death, the family may be experiencing anticipatory grief.  Through this, thoughts of the final good bye are already forming in their minds.  As a counselor, one can help them better articulate how to express those feelings when the moment of death comes.
Finally, in some cases, the pastoral caregiver also assists with the after death rituals.  It is important to ensure that the whole family has a chance to say farewell and commemorate the death of a loved one at the funeral.  It is important to encourage the attendance of children.
If you are interested in Pastoral Care for families facing death, please review the program.
(Information for this article is from “Helping Grieving People-When Tears Are Not Enough” by J. Shep Jeffreys)
Mark Moran, MA, GC-C, SCC-C

Pastoral Care and the Rights of the Dying

Posted on by Dominick Flarey

Caring for the Dying and Their Rights

It is so common to speak about the dying and the  rights of the dying instead of to them.  They almost become the giant elephant in the room.  However, from a spiritual and ethical prism, the dying have rights that must be preserved and respected.  As people they have human rights and their needs, concerns and issues need to be met with compassion and professionalism.  In caring for the dying, we must remember these five rights.
The first rights of the dying is that they have a right to know as much of the truth that they can handle.  To purposely leave the dying patient out of the light of what is happening to their body is unethical and wrong.  Only when such knowledge can cause harm to a  patient should some information be disclosed with discretion and in possible dosages.  In some cases, as with children, every single detail is sometimes not needed in one’s discourse with the dying, while in other cases, the dying patient may well need or be able to handle the information.
The second right of the dying is they have a right to be free from suffering, pain and have hope for the future.  It is the duty of providers to provide the maximum comfort for the sick and dying as possible.  The dignity and spiritual nature of the person must be preserved in this final stages, even if for a simple hour.  Whatever can be done to alleviate suffering and provide comfort should be offered to the dying patient.
The third right of the dying that must be adhered to by pastoral care givers is the autonomy of the patient.  The patient has a right within his or her capabilities to participate in decisions.  This is even more helpful when one has a Advance Medical Directive, but even without, the patient’s right to engage in dialogue regarding procedures is imperative to his or her dignity as a human person.
The fourth right is a patient can talk about death when ready.  Many families like to ignore the ominous signs of death but if a dying patient wishes to discuss this important event in his/her life, then the family and providers should take the time to hear the concerns of the dying.
The final right of the dying patient is the right to express emotional feelings, complete unfinished business and the presence of any religious figures.  A dying patient may want to express regret, or forgive a friend, or call upon a priest.  These are imperative to the spiritual and emotional well being of the person and his/her journey to the next phase of human existence.  To deny these things is a gross case of spiritual neglect.
If you are interested in pastoral care, please review the program.
(Some of the information found in this article was from “Helping Grieving People-When Tears Are Not Enough” by J. Shep Jeffreys)
Mark Moran, MA, GC-C, SCC-C