Dylan’s Thomas warns us in his poem
Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Give a good death – not a cold terrifying dying of the light.
But today a care manager or geriatric social worker can help an older client go gentle into that good night, they do not have to burn and rage at the close of their day because you will be giving them as Atul Gawande suggests – a good death – not a cold terrifying dying of the light.
The terminal phase of any life-threatening illness is the time between diagnosis and the final decline when no cure or extension of life is in the offing. The individual confronts progressive decline and deterioration. Death is imminent. The care manager has a role.
The focus of doctors and patients now changes from attempting to cure the illness or prolong life to trying to provide relief from pain and to comfort the sufferer. Religious concerns such as what happens after someone passes away or how to handle the
suffering at the end of life or how to give comfort to family members are the focus during this time as well as trying to tie up any loose ends.
Death to Rage About- Alone in the Hospital
But in the time of the plague, when 95.5 % of souls still die in the hospital and not at
home the care manager has a critical role with the family. High tech introduced by the care manager and at times the hospital with the care manager coordinating the family outsides and unable to touch their dying loved one – can make this death full of rage more gentle as the person passes into the night.
Care Manager tasks:
Make a referral to hospice if the family has not already reached out
Partner with hospice and work under them
Monitor anticipatory grief needs
Communicate that this is the end (and time to say goodbye)
Assess spiritual needs and contact the appropriate religious-spiritual counselors to provide comfort and healing.
Encourage family members to say The Four Things That Matter Most “Please forgive me”, “I forgive you”, “Thank you”, and “I love you”.
Assess the need for paid caregivers to help the family or help family members share round the clock care among family and friends
Support the family members in their need to grieve and have respite by continuing to assess for overload and burn out with a caregiver assessment tool
Prepare family for the active phase of dying which can be loud and disturbing to someone who is not aware of what will occur
Bring in technology if death is alone in the hospital
Join me Thursday, March 11, and learn why End of Life Services Are a perfect new service for care managers
Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency
Serve Your Client Until Death Do You Part
In this 1 ½ -hour webinar you will learn how to
1.Transition the patient/family through the five stages of death
2. Help clients be active participants in their care
3.Give the family/caregiver tools to manage care
4 Provide family center care to caregiver and family
5 Choose the right support services through all stages of death
6.Introduce Hospice and Palliative care and work with their team
7 Use ALCA End of Life Benefits During COVID
8.Use COVID -19 Family Coaching for GCM
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If you really want to add End of Life to your care management business sign up for this webinar now
Gwendolyn LAZO Harris MA, CT, Seniors at Home, San Francisco and Diane LeVan MA both highly expert care managers, created a seminal chapter “Palliative Care and End of Life Care Manager ” in my book Care Manager’s Working With the Aging Family
for the parent, and thus will find it difficult to provide the practical and emotional care that their aging parent needs. The challenge to the adult child of the dysfunctional family is how to meet the dependency needs of the here and now old-old parent when the parent did not meet them dependency needs as a child. That is why they need a highly experienced 
