A good life to the very end
Atul Gawande’s acclaimed book, “Being Mortal“ opened our eyes to the medical way of death. He showed millions of readers how the quality of life and human interaction while dying trump the number of years gained through questionable painful procedures and dying in an institution.
He tells us that “our ultimate, goal, after, is not a good death but a good life to the very end
Quality of Life Can Be There to the End of Life
GCM Nina Herndon brings you that same quality of life message- about dying –where an elder can still live the end of life with joy. Her chapter “Supporting Clients’ Quality of Life: Drawing on Community, Informal Networks, and Care Manager Creativity” in the Handbook of Geriatric Care Management 4th edition is a geriatric care management Nina has devoted her career to giving elders a care plan for a happy life and a happy life to the very end.
Bringing Joy in the here and now of Dying
Bringing joy in the here and now of dying can be done through using quality of life tools- Spiritual, emotional, intellectual, creative, and physical quality of life. Increasing the spiritual quality of life can mean for a person is dying and wishes to return to a spiritual group she knew before, connecting them to the faith they are familiar with. Even homebound clients can have visits from members of a religious community or a prelate. They can have hymns sung, prayers said or whatever religious ritual their spiritual group follows, like communion, at home. Care providers can be trained to engage them by reading religious texts or playing hymns.
The Power Reminiscence at End of Life
Spirituality can be the environment. I once had a client who was in a nursing home dying of cancer and wanted to go home to die with hospice and 24-hour care. His
spirituality was the environment and he had been a lead volunteer to build a trail in Santa Clara California from Los Gatos up the steep winding highway 17 over the Santa Cruz mountains to the Lexington Reservoir. He had no family so the care manager asked the volunteers he had worked with if they would visit him at his home. They happily agreed and 300 volunteers took shifts, 24 hours a day to sit with him reminisce, tell stories and sing while he died over several weeks. This is what joy that bringing a spiritual quality of life can offer in dying.
Tools for Reminicance at End of Life
Friends emailing short personal videos with good wishes and memories, that a family member can show on a phone or computer- can bring emotional joy at end of life. Sending notes, not of condolences but great memories can be a salve to dying. Volunteering to give respite to family members, if
visiting is allowed during COVID or post the pandemic, can give an opportunity to share old memories or look at old photos and give family respite. You may have thought those old photo albums should be dumped but they can bring the joy of reminiscence if shared at end of life or with seniors at any time.
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celebrated by them as a child.They may be able recall walking back to the first day of school , buying school supplies, or the taste of late summer tomatoes on hamburgers or ice cream at Labor Day barbecues with family.When an elderly person develops Alzheimer’s or other forms of dementia, the short-term memory is frequently affected .But long-term memories , like childhood Labor Day memories ,can remain as intact and as vivid as they have always been during the course of the client’s life. As a result healthcare professionals and family can use a practice called reminiscence therapy to help combat the frustration, confusion, and depression that can often accompany dementia and even bring joy to the older person.
can evoke good recall. This becomes a visual biography of the elder’s life and helps him or her remember who he or she is.Plus actually interacting or spending time and talking to and listening to 
older friends and family , who are often isolated and very lonely, can bring real joy to their lives. 
reminiscence therapy for elders with dementia. If the senior is a BBC fan, like me, the BBC even has an app called 
jobs, and home care. It includes a $400 billion investment to expand access to 
Person program
poorer health outcomes that annually cost billions of excess health care dollars. 
it is important to involve elders who wish to celebrate the holidays. Religious rituals celebrated with family, friends, members of a congregation ( even on zoom in COVID)offer socialization and reminiscence thus the quality of life so many elders and can return joy to their lives especially in the pandemic that was like maggots to the wound of senior isolation.
about”. As we age this question becomes primal, as we face death coming at a rapid pace. We wonder- do I go to heaven, to hell, or just energy or dust. Will I meet angels- my wife in heaven.?
a seder or Easter brunch or dinner, with a small fully vaccinated group from a congregation 0f a local church or synagogue or through a zoom holiday meal event or service.
