Spiritual, Emotional and Medical Needs at the End of Life

"Dying is one of the most important moments in our lives. Like all important moments, it deserves thoughtful preparation.” (Fr. Lawrence Reilly, Ethicist and Theologian)

The end of life can be a time of spiritual and emotional growth. But with the onset of technological advances, patients and families may find themselves dealing with complicated treatment plans instead of addressing those spiritual questions.

Fortunately, new options on the care and comfort of people near the end of life have paralleled the emergence of technical advances.

Today, the conversation is emerging over how we can “die well.” What can the medical community do to make sure a patient has the best possible care without becoming intrusive at the end of life? Proper care is complex and will vary among patients and physicians.

As physician-ethicist, Daniel Sulmasy points out in a recent article in Christian Century, the medical profession “can accept (your) death but we do not have to cause it.”

Options for End-of-Life Care: Palliative and Hospice

The best way to fully understand end-of-life care is to “visualize two concentric circles,” describes Terri Warren of Providence Healthcare. The large, encompassing circle is palliative care and the smaller circle within the larger one is hospice care.

Palliative care is a key service that creates a comfort level for the patient who may or may not be terminally ill but is in severe pain. Hospice works with the patient who has been diagnosed as terminally ill with six to 12 months to live.

The goal of both levels of care is to address the physical, emotional, spiritual and existential needs of not only the patient, but the whole person and his or her family. Experts in palliative care are working to broaden the reach and understanding of the specialty.

According to Dr. Glen Komatsu of Providence Health, the field was just recognized in 2006. It is currently the only specialty in the healthcare field that does not require a fellowship. All specialties require a fellowship and a board certification while palliative care is the only specialty that requires only the latter.

Families and patients now need to proactively ask for palliative care and also undertake some research on leading facilities and providers. Physicians like Dr. Komatsu are working to change this.

There is no one size fits all when it comes to palliative care. It is up to family and loved ones. Conversations concerning end of life care should happen early. Health care providers repeatedly described how they hear from patients and their families wishing that “they had more time” to think about these issues before the time of crisis presents itself.

Groups such as The Conversation Project are encouraging innovative, creative ways to talk about a very tough subject such as “Death Over Dinner.” The earlier these conversations happen, the easier it will be to manage the complexities and grief of serious and life threatening illness.

End of Life Teachings

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What can we do now to prepare ourselves for the end of life?

It is the simplest things that will enable us to prepare for death. The pragmatic and mundane items such as settling legal and fiscal issues are important first steps. People who also have a sense of connection to something larger than themselves find the process of dying more peaceful.

Being well while dying is the focus of all palliative care.

“Every person has the ability to be healed even if they are dying and when they cannot be cured,” states Dr. Komatsu.

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