Cathy Cress

Expert in Aging Life and Geriatric Care Management

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Can You Give a Good Death without” Rage, Rage Against the Dying of the Light”?

March 9, 2021

slide-worried-manjpg.jpg

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

SIGN UP

 

 

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  

 

 

Filed Under: 5 Stages of Dying, 5 stages of End of Life, Aging, Aging Family, aging family crisis, aging life business, Aging Life Care, Aging Life Care Assocaition, aging life care manager, ALCA Role Death and Dying, Blog, care manager, case manager, Death & Dying, Death and Dying Care Management, death and dying care manager, elder care manager, End of Life, End of Life Care manager, End of life documents, Families, Five Stages of Death, Geriatric Care Manager, geriatric care manager, geriatric social worker, Good Death, nurse advocate, nurse care manager, Palliative care manager, Webinar, Webinar ALCA GCM Tagged With: 5 stages of death, adding geriatric care management, aging life care manager, ALCA &end of life, ALCA Death and Dying, Atul Gawande nurse care manager eldercare manager, Benefits Care Managers, Benefits of Care Managers To Hospice, care manager, case manager, death and dying, eldercare manager, end of life care, free webinar, geriatric care manager, Hospice at end of life, Hospice Care, Palliative Care, terminal phase of dying, US medicaization of Death

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

February 13, 2021

 

 

 Each Culture Has Different Customs and Beliefs in End of LifeiStock_000063346301_Medium-1.jpg

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 ChiCheng_hmpgHdr.jpg

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.

 

Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency

Serve Your Client until Death Do You Part

 

Join me Thursday March 11 and learn why End of Life Services Are a perfect new service for care managers

 

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

Sign Up

If you really want to add End of Life to your care management business sign up for this webinar now

 

 

 

 

 

 

 

 

 

Filed Under: Advanced Directives, advanced directives& COVID-19, Aging, Aging Life Care, aging life care manager, ALCA Role Death and Dying, Benefits of ALCA to Hospice, Cultural Assessment, Cultural Assessment Death, Cultural Beliefs in Death, Death & Dying, Death and Dying, Death and Dying Care Management, death and dying care manager, End of Life, End of Life Care manager, End of Life Cultural Assessment, End of life documents, Families, FREE WEBINAR, GCM role Death and Dying, Geriatric Care Management Business, Geriatric Care Manager, Geriatric Care Manager Cultural Assessment, geriatric social worker, Good Death, Hospice, Hospice Care, nurse advocate, nurse care manager, Palliative Care, Palliative care manager, SNF death COVID-19, US Medicalization of Death Tagged With: 5 stages of death, Acceptance Phase of Death, adding end of life services, Aging Life Care Association, care manager cultural assessment, chronic phase of death, COVID-19 Deaths, cultural assessment, Cultural Beliefs in Death, Cultural Customs in Death, cultural diversity, death and dying in COVID-19, geriatric care manager, Hospice at end of life, Palliative Care at end of life, US medicaization of Death

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