Photo taken in Zurich, Switzerland
What to expect when dying...
Only in the last 100 years or so has care for the dying become the primary responsibility of the health care system, particularly in western cultures. Though there are pros and cons to this reality, the fact is, one of the major problems many of us face when a loved one, or we ourselves are dying, is fear because we have not had face to face experience with death. The medical system has essentially sterilized death and though there are certainly exceptions to this statement as it varies in degree, country to country, community to community, knowing what to expect certainly can be a stepping stone in the alleviation of fears...
Knowledge is PowerKnowing the specific terminology can really help with navigating this delicate, often complicated but potentially beautiful season in the life of your loved one...
hospice philosophy: hospice provides care to meet the physical, emotional, social and spiritual needs of the patient and family facing life-threatening illness. The focus of care provided is palliative palliative care: the focus of palliative care is to assist the patient in the management of symptoms of disease such as pain, nausea, loss of appetite and emotional distress. Hospice does not provide life-prolonging treatments, but aims to achieve the best quality of life for the patient. primary care giver role: the hospice team is not intended to take the place of the family, but rather support the primary care giver in caring for the patient. **definitions from the Hospice Association of the Witwatersrand; Johannesburg, South Africa |
Common Signs and SymptomsThe following are some common signs and symptoms which occur when dying. Note that each person is unique, some people may experience all of these while others experience none. The point, however, is to not be frightened and worried if these signs occur. By allowing these symptoms without resorting to unnecessary aggressive treatments (though pain management can of course be provided), you are allowing a person to naturally experience this universal reality of death.
-Sleepiness, periods of being awake may reduce and eventually the person may be deeply asleep all of the time -Difficulty swallowing, loss of appetite -Loss of bowel and bladder control -Signs of distress or restlessness -Changes in breathing, can become noisy, this can be due to chest secretions which naturally increase when a person is approaching death, usually this is not distressing at all for the patient, though it can be for the family who is listening -Hands, feet, legs and arms may feel cold to touch. -Person may become confused, disoriented -Mood swings -Beliefs, faith or religion may become particularly important at this time -Lose interest in surroundings, withdrawal from people *This part of the natural dying process does not necessarily mean they are uncomfortable or are in distress (Information from the "Care and Support in the last days of life" pamphlet from the Royal Wolverhamption NHS Trust (UK)) |
When a Loved One Dies: A Practical Guide
Source: Pamphlet from University of Pittsburgh Medical Center (2011) www.upmc.com
This list is particular to the USA and more specifically Pennsylvania, however, it can still serve as a practical guide in many other areas of the world.
What to do first
Arranging funeral or memorial service
After funeral or memorial service:
This list is particular to the USA and more specifically Pennsylvania, however, it can still serve as a practical guide in many other areas of the world.
What to do first
- Contact family members, close friends
- Discuss choice of a funeral home
- Contact clergy to assist with funeral arrangements
- Notify loved one's employer
- Notify employers of other household members
- Notify schools your children are attending
- Contact attorney, if have one, to assist with legal matters
- Ask someone to keep a list of all telephone calls, flowers and donations so that you may acknowledge them at a later date
- Decide who will take care of pets
Arranging funeral or memorial service
- Decide if you would like donations made to a specific organization or charity in memory of your loved one and discuss with funeral director
- Having the following information ready will help with the process:
- full name of loved one, nicknames and other names he/she might have used
- date of birth
- place of birth
- Social Security Number
- Occupation
- Father's name
- Mother's maiden name
- proof of military service, if a veteran
- list of family members and relationships
- list of religious, professional, or civic organizations and any other clubs in which membership was held
- name and address of any organization you would like to have donations made to memory of your loved one
After funeral or memorial service:
- Have 5-10 extra copies of death certificate. You will need these to process Social Security and insurance policy or other claims
- Contact any companies with which your loved one held a life insurance policy and/or accidental death insurance policy
- Contact Social Security Administration office if you think you are eligible for benefits
- Contact bank or financial institutions, may need to close accounts or transfer control of accounts. Discuss states of certificates of deposit, bonds, individual retirement accounts or similar savings accounts
- Notify health insurance company of loved one
- Contact loved one's employer about pension benefits
- Notify loved one's creditors, financial institutions and companies or department stores that issued loans or credit cards in your loved one's name. You may wish to cancel or have your name replace your loved one's name
- Notify clubs or organizations in which your loved one was a volunteer or dues-paying member
- Contact companies regarding changing your loved one's name on any certificates of title, including titles to a home, a motor vehicle, real estate, or a recreational vehicle.
- Notify your state's Department of Motor Vehicles if your loved one had a valid driver's license
Bereavement
Dear families and friends who have experienced a loss,
Grief and mourning are a natural part of your journey and will be experienced differently by each individual. It is so important to acknowledge that bereavement is a reality. Truly, a human being, another soul, has been taken from you. This is indeed a real loss and one that it is only right that you should feel a sense emptiness. The importance of recognizing the reality of grief and normalizing bereavement can allow you to better cope with loss and be there for others around you who have experienced loss as well.
Different cultures deal differently with grief. In some areas of the world, support systems are simply part of the community, while in others, external services such as counseling or support groups are predominant. Still in others, individualism prevails and grief may not be acknowledged, for better or for worse. One way or another, learning about grief, its various symptoms, which are often unique to each individual, can help us to cope with death, recognize its significance, and build better systems or create more aware and caring communities in the future.
Course of Grief: "The intensity of grief or mourning will fluctuate over time. The process does not follow a predictable orderly pattern. Rarely will it be static. Grief is composed of many ups and downs, twists and turns, which can temporarily intensify the grief for minutes, hours, days or longer. Grief can often flare up for years after a particular death. Certain experiences later in life, e.g. other losses, memorial anniversary dates, birthdays, times of crisis or joy can temporarily resurrect intense feelings of grief" (Source: Calvary Bereavement Counseling Service, Sydney, Australia)
Grief and mourning are a natural part of your journey and will be experienced differently by each individual. It is so important to acknowledge that bereavement is a reality. Truly, a human being, another soul, has been taken from you. This is indeed a real loss and one that it is only right that you should feel a sense emptiness. The importance of recognizing the reality of grief and normalizing bereavement can allow you to better cope with loss and be there for others around you who have experienced loss as well.
Different cultures deal differently with grief. In some areas of the world, support systems are simply part of the community, while in others, external services such as counseling or support groups are predominant. Still in others, individualism prevails and grief may not be acknowledged, for better or for worse. One way or another, learning about grief, its various symptoms, which are often unique to each individual, can help us to cope with death, recognize its significance, and build better systems or create more aware and caring communities in the future.
Course of Grief: "The intensity of grief or mourning will fluctuate over time. The process does not follow a predictable orderly pattern. Rarely will it be static. Grief is composed of many ups and downs, twists and turns, which can temporarily intensify the grief for minutes, hours, days or longer. Grief can often flare up for years after a particular death. Certain experiences later in life, e.g. other losses, memorial anniversary dates, birthdays, times of crisis or joy can temporarily resurrect intense feelings of grief" (Source: Calvary Bereavement Counseling Service, Sydney, Australia)
Grief
Grieving is normal and many intense emotions can surface during this time. You are not going crazy.
Some feelings that are common:
shame, guilt, anger, sadness, panic, shock, abandonment, confusion, rejection
Some people have physical problems:
numbness, chest pain, upset stomach, low energy, headaches, lack of sleep, no appetite
While dealing with death, it is helpful to:
talk with others, express your feelings, connect with your faith community, draw on your personal strengths, spend time with people who support you, learn more about the grieving process, seek help without hesitating
(Source: Grief and Support Programs 2008, UPMC Pittsburgh USA)
Some feelings that are common:
shame, guilt, anger, sadness, panic, shock, abandonment, confusion, rejection
Some people have physical problems:
numbness, chest pain, upset stomach, low energy, headaches, lack of sleep, no appetite
While dealing with death, it is helpful to:
talk with others, express your feelings, connect with your faith community, draw on your personal strengths, spend time with people who support you, learn more about the grieving process, seek help without hesitating
(Source: Grief and Support Programs 2008, UPMC Pittsburgh USA)