Acceptance Phase of Death Archives ⋆ Cathy Cress

Do You Do Cultural Assessment With an End Of Life Client?

February 13, 2021

Each Culture Has Different Customs and Beliefs in End of Life

There may be cultural differences in end-of-life decision making as a result of underlying cultural values with disclosure of a terminal illness and very critically -use of life-sustaining medical treatment. With the widespread availability of advanced medical technology in the United States, people are encouraged to do everything possible to seek a cure for a life-threatening medical condition or sustain life. However, there are many other cultures for whom quality of life is more important than the length of life.

Other Cultures Do Not Follow US Medical Model

There are some societies, such as Japan, where a terminal illness may not be disclosed to a patient and it is culturally inappropriate to discuss impending or imminent death. For instance, among some Chinese, it is considered bad luck to discuss death because such talk may cause death to occur. Sometimes the ethnic elder is not expected to make healthcare decisions and the responsibility may be based on a traditional family hierarchy. For instance, in many Filipino families, there may be a designated decision-maker who is not the patient (e.g., the oldest son or a daughter or son who is a health professional) and who articulates the wishes of the elder or family.

Some Cultures Follow Religious Customs and Beliefs in Death & Dying

Other end-of-life decisions are based on religious tenets. In many Catholic immigrant communities, there may be strong resistance to an advance directive because the document would signify a “loss of hope” or be interpreted as suicide, which is against church doctrine. These beliefs may also influence the use of hospice services.

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Serve Your Client until Death Do You Part

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1.Transition the patient/family through the five stages of death

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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

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Can a Geriatric Care Manager or Social Worker Be a Midwife for a Good Death ?

June 24, 2017

Atul Gawande’s breakthrough book, Being Mortal tells us the ultimate goal, after all, is not a good death but a good life to the very end. Elizabeth Kubla- Ross tells us the death is really in parts called five stages.

A Care Manager or Geriatric Social worker can be a midwife through these five stages to a good death, reaching towards joining the ultimate midwife team, hospice.

The Acceptance phase of death occurs when people finally are able to cope with the mental, social, physical, religious and financial effects of their disease, a heavy load In the disease process and acceptance process, this is the period of time after a medical procedure such as chemotherapy, radiation or surgery. The client’s response to treatment is being monitored. Recovery does not always mean remission, but instead, it is the ability to accept and deal with the struggles of their illness.

A Story About the acceptance phase Mr. Murphy

William accepted his coming death while in the hospital. He had 4 physicians’ who were treating him aggressively for renal failure with dialysis. He was 93 and refused to sign a DNR. The doctors discovered what they thought might be a tumor. However, they were afraid the biopsy procedure would be too radical for his age. So they kept up the dialysis.

The care manager appealed to the nurses for help when the physicians would not intervene. A nun appeared – it was a Catholic hospital- and said, ” the nurses called me to go around this problem. Talk to the head Dr. about ordering palliative care.” The Care Manager did.

Sure enough, after the care manager talked to him that physician ordered palliative care. Then one by one one the 4 physicians came to Bill’s bedside and talked softly, asking him to accept that he may have cancer and the biopsy could not be done. The last, a gentle urologist, held his hand and talked of letting go and accepting he would die. He agreed to stop the dialysis.

Bill accepted his death reluctantly wanted to live to watch his 3 great grandchildren grow. The urologist ordered palliative care and Bill changed the DNR with the help of his son. Hospice met with the family and all agreed to move William to the son’s home with 24-hour care and hospice to die.

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

How Care Manager Helps with The Acceptance Phase of Death

February 27, 2016

The Acceptance phase of death and dying occurs when people finally are able to cope with the mental, social, physical, religious and financial effects of their disease, a heavy load In the disease process and acceptance process, this is the period of time after a medical procedure such as chemotherapy, radiation or surgery. The client’s response to treatment is being monitored. Recovery does not always mean remission, but instead it is the ability to accept and deal with the struggles of their illness.

A Story About the acceptance phase Mr. Murphy

If you want to add an End of Life service and other services, plus all the forms necessary, go to my web site Cathy Cress. Com and check out GCM Operation Manual with a new service Death and Dying

How Care Manager Helps with The Acceptance Phase of Death

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