Death and dying

2018 ◽  
pp. 501-516
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
End Of Life ◽  
Nursing Practice ◽  
Death And Dying ◽  
Health Condition ◽  
Clinical Environment ◽  
Grief And Bereavement ◽  
The Uk

An important aspect of nursing practice is caring for people in the last days and hours of their life, whether in a hospice, a clinical environment, or their own homes. Whilst death may be sudden and unexpected, or the anticipated result of an intractable health condition, the effective support of dying people and their families is an important aspect of nursing and care. The UK Leadership Alliance for the Care of Dying People describes key principles to guide nurses who are working with people and families at the end of life. This chapter discusses these principles and considers how they may be translated into general nursing practices. It also discusses the features of loss, grief, and bereavement, and how nurses may continue to support the bereaved after a person has died.

Corresponding about death: Analyzing letters from patients with cancer to medical students.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11021-11021
Author(s):  
Tianyi Zhang ◽  
Mekaleya Tilahun ◽  
Cynthia Perlis ◽  
Sam Brondfield
Keyword(s):  
Medical Students ◽  
End Of Life ◽  
Death And Dying ◽  
Severe Illness ◽  
Clinical Environment ◽  
Patients With Cancer ◽  
Coping Process ◽  
Award Winning ◽  
Multiple Paths ◽  
One Year

11021 Background: Clinicians frequently discuss death and dying with patients who have cancer. However, the doctor-patient hierarchy and the unfamiliar clinical environment may prevent these patients from discussing death and dying authentically. Patients may feel more comfortable expressing themselves when given the time and space to write at home. Firefly, an award-winning program at UCSF, facilitates written correspondence between patients with cancer and medical students over the course of one year. Firefly’s archive contains thousands of patient letters and constitutes a unique resource for analyzing authentic patient expression outside of the clinical context. The aim of the current study is to improve curricula pertaining to severe illness and end-of-life by providing educators with an analysis of authentic patient perspectives about death and dying expressed in these letters. Methods: We (two medical students, an expressive artist, and an oncologist) read all Firefly letters written by patients between 2014 and 2019 and identified 12 patients whose letters meaningfully discussed death or dying. We performed a thematic analysis of these letters using the Buckman three-stage model of dying as a reference. Results: Four themes emerged: turmoil; grief; making peace; and past, present and future. The first three themes aligned with the Buckman stages. The fourth theme—past, present and future—spanned the three stages and also elaborated the Buckman model by describing multiple paths that patients may take after passing through these stages. Conclusions: The authentic ways in which patients with cancer discussed death and dying in their letters provided deep insight into their coping process. The Buckman model appears useful for framing death and dying from the patient perspective but may not fully reflect modern oncologic care in which many patients live for years beyond a severe or terminal diagnosis. Educators can use the identified themes to shape medical school curricula pertaining to severe illness and end-of-life care.

Managing End-of-Life Care

2012 ◽  
Author(s):  
John W. Albarran ◽  
Marika Hills
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Care Delivery ◽  
Symptom Relief ◽  
Death And Dying ◽  
Past Century ◽  
Life Care ◽  
Care Needs ◽  
Definition Of ◽  
The Uk

This chapter addresses the fundamental nursing role of managing end-of-life care. Death is as fundamental a part of life as living, and while caring for a dying patient and their family is demanding, complex, and emotionally exhausting, it can also be a gratifying and privileged experience for nurses. Specifically, nurses have a centre-stage role in leading and informing care delivery at the end of life. Care will typically embrace assessing the needs of the patient and family, providing symptom relief and comfort care, and providing cultural and spiritual support. Additionally, caring functions should also extend following death to caring for the deceased in a dignified manner and supporting the newly bereaved, demonstrating genuine concern, compassion, and effective communication skills (Hills and Albarran, 2010a; Maben et al., 2010). To examine the key themes and challenges of practice, it is important to understand the political, professional and societal influences, and contextual nature of death and dying in the UK. At present, there is neither a clear nor universally accepted definition of end-of-life care, but it is generally understood to be the care of a person who is identified as having failing health and who is in a progressive state of decline (Shipman et al., 2008). Establishing the last phase of a patient’s life can be a difficult and complex process, and this might occur:…● after the diagnosis of a life-limiting condition; ● during the transition or deterioration of a chronic disease illness; ● when there is an increasing frailty combined with greater dependence on care provision, particularly in the older adult; ● following a sudden infective episode, cardiac event, or a life-threatening accident….The last phase of end-of-life care is referred to as the dying phase. Consideration of the end-of-life care needs of people with chronic terminal conditions should begin at diagnosis, and must embrace after-death care and family support. Over the past century, progress and advancement in disease management, together with improvements in living standards, have resulted in changes to the national death profile, with currently two-thirds of the 0.5 million annual deaths in the UK occurring in people over 75 years of age.

scholarly journals End-of-life education in the pre-registration nursing curriculum: Patient, carer, nurse and student perspectives

2010 ◽  
Vol 17 (4) ◽  
pp. 317-326 ◽  
Author(s):  
Joyce Cavaye ◽  
Jacqueline H. Watts
Keyword(s):  
End Of Life ◽  
Quality Care ◽  
Death And Dying ◽  
Nurse Education ◽  
Nursing Curriculum ◽  
Nurse Training ◽  
Dying Patients ◽  
National Priority ◽  
The Uk ◽  
Eol Care

Providing good quality care for dying patients has been highlighted as a national priority in the UK. The Department of Health’s end-of-life (EOL) care strategy outlines how patients should be cared for to ensure that they experience a ‘good death’. Nurses have an important role to play in the delivery of EOL care and need to be knowledgeable about the palliation of symptoms and the social context of death and dying. Traditionally, the pre-registration nursing curriculum has had a limited emphasis on EOL care. While there have been significant developments in nurse education in the last decade, the amount of EOL content in nurse education remains inadequate. Drawing on literature mainly from the UK and USA, this review explores from the perspectives of students, newly qualified nurses, patients and carers the outcomes of EOL education. It reviews the evidence to determine whether newly qualified nurses are adequately prepared to deliver quality care to patients at the end of their lives. The evidence suggests that despite a greater emphasis on EOL care in nurse training, adequately preparing nurses remains a challenge to educators.

scholarly journals Spiritual Care at The End Of Life: Western Views and Islamic Perspectives

2018 ◽  
Vol 2 (2) ◽  
pp. 65
Author(s):  
Wafa ‘a Qasem Ahmad
Keyword(s):  
Patient Care ◽  
End Of Life ◽  
Spiritual Care ◽  
End Of Life Care ◽  
Human Life ◽  
Death And Dying ◽  
The Past ◽  
Education Of Patients ◽  
Core Components ◽  
The Uk

The concept of spiritual and religious care, as core components of palliative care for patients at end of life stages, has achieved significant organized applications and advances in modes of intervention and tools. The past two decades have witnessed waves of secularization with impacts of the concepts of spirituality and chaplaincy that diverged away from religion, more so in the UK and some European countries as compared to US applications. Spirituality became more generic and broad that revealed itself in helping and education of patients and families to earth and think of meaning and purpose of life, suffering death and dying. The issues of spirituality and religiosity in the Islamic culture, teachings and attitudes towards patient care at terminal stages of life, is distinguished by clarity and harmony in view of clarity of Muslim beliefs and interpretations concerning purpose, meaning and mission of human life on this earth, end-of-life care and the afterlife. This paper will address the contemporary western diverse concepts of spirituality, its relationship with religiosity in terminal patient care, and will elaborate on the holistic Islamic views and attitudes towards this stage of human life.International Journal of Human and Health Sciences Vol. 02 No. 02 April’18. Page : 65-70

scholarly journals Conversations About Death and Dying, End-of-Life Care Plans and Preferences Between Aging Parents and Adult Children

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 417-417
Author(s):  
Hyo Jung Lee ◽  
Jacobbina Jin Wen Ng
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Adult Children ◽  
End Of Life Care ◽  
Death And Dying ◽  
Family Members ◽  
Life Care ◽  
Joint Decision ◽  
Aging Parents ◽  
Care Plans

Abstract This study aims to investigate whether attitude and perception on late-life death and dying, end-of-life care plans and preferences could be better understood from current values shared between aging parents and their adult children in the multi-cultural city-bound country, Singapore. We are in the process of interviewing 20 aging parent-adult child dyads. Up to date, six semi-structured interviews were completed and transcribed. We performed Content analysis to analyze the transcripts. Preliminary findings showed that both aging parents and adult children rarely discussed this issue, although parents had their own plans or preferences. The major barriers against open conversations about death and dying of aging parents include: the perception of not-yet time to talk about this issue (without knowing when the right time is) and tendency to have conversations about death in tandem with finances, but not death itself. Although specific end-of-life care plans or arrangements were not thought out thoroughly, aging parents expressed a high level of trust and reliance on close family members’ decisions regarding their end-of-life care. They tended to agree on joint decision-making process within family, even though adult children had no or unmatched ideas about their aging parents’ end-of-life wishes. This did not necessarily align with previous findings in Western countries, underscoring individuals’ control over their own death and dying process. Open conversation within family, family-involved advance care planning, or joint decision-making processes may be warranted to promote quality of life and death in older Singaporeans and well-being of their family members of all ages.

scholarly journals When “Good Enough” Isn’t Good Enough: Interdisciplinary Perspectives on Caring for Adults Using Substances at the End of Life

2021 ◽  
Author(s):  
Lorna Templeton ◽  
Sarah Galvani ◽  
Marian Peacock
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Structured Interview ◽  
Life Care ◽  
Snowball Sampling ◽  
Policy And Practice ◽  
Template Analysis ◽  
Health And Social Care ◽  
The Uk ◽  
Key Terms

AbstractThis paper draws on data from one strand of a six-strand, exploratory study on end of life care for adults using substances (AUS). It presents data from the key informant (KI) strand of the study that aimed to identify models of practice in the UK. Participant recruitment was purposive and used snowball sampling to recruit KIs from a range of health and social care, policy and practice backgrounds. Data were collected in 2016–2017 from 20 KIs using a semi-structured interview approach. The data were analysed using template analysis as discussed by King (2012). This paper focusses on two of seven resulting themes, namely “Definitions and perceptions of key terms” in end of life care and substance use sectors, and “Service commissioning and delivery.” The KIs demonstrated dedicated individual practice, but were critical of the systemic failure to provide adequate direction and resources to support people using substances at the end of their lives.

scholarly journals Before the 2020 Pandemic: an observational study exploring public knowledge, attitudes, plans, and preferences towards death and end of life care in Wales

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ishrat Islam ◽  
Annmarie Nelson ◽  
Mirella Longo ◽  
Anthony Byrne
Keyword(s):  
Social Media ◽  
End Of Life ◽  
Health Professionals ◽  
End Of Life Care ◽  
Public Attitudes ◽  
Death And Dying ◽  
Service Utilisation ◽  
Life Care ◽  
Manner Of Death ◽  
Attitudes Towards Death

Abstract Background Understanding public attitudes towards death and dying is important to inform public policies around End of Life Care (EoLC). We studied the public attitudes towards death and dying in Wales. Methods An online survey was conducted in 2018. Social media and the HealthWiseWales platform were used to recruit participants. Data were analysed using descriptive statistics and thematic analysis. Results 2,210 people participated. Loss of independence (84%), manner of death, and leaving their beloved behind were the biggest fears around death and dying. In terms of EoLC, participants sought timely access to care (84%) and being surrounded by loved ones (62%). Being at home was less of a priority (24%). Only 50% were familiar with Advance Care Planning (ACP). A lack of standard procedures as well as of support for the execution of plans and the ability to revisit those plans hindered uptake. The taboo around death conversations, the lack of opportunities and skills to initiate discussion, and personal fear and discomfort inhibited talking about death and dying. 72% felt that we do not talk enough about death and dying and advocated normalising talking by demystifying death with a positive approach. Health professionals could initiate and support this conversation, but this depended on communication skills and manageable workload pressure. Participants encouraged a public health approach and endorsed the use of: a) social media and other public platforms, b) formal education, c) formal and legal actions, and d) signposting and access to information. Conclusions People are ready to talk about death and dying and COVID-19 has increased awareness. A combination of top-down and bottom-up initiatives across levels and settings can increase awareness, knowledge, and service-utilisation-drivers to support health professionals and people towards shared decisions which align with people’s end of life wishes and preferences.

scholarly journals Resource and waste quantification scenarios for wind turbine decommissioning in the United Kingdom

2020 ◽  
Author(s):  
Kiran Tota-Maharaj ◽  
Alexander McMahon
Keyword(s):  
United Kingdom ◽  
Waste Management ◽  
Wind Turbine ◽  
End Of Life ◽  
Wind Turbines ◽  
Rapid Rise ◽  
The United Kingdom ◽  
Management Procedures ◽  
The Uk ◽  
Over Time

AbstractWind power produces more electricity than any other form of renewable energy in the United Kingdom (UK) and plays a key role in decarbonisation of the grid. Although wind energy is seen as a sustainable alternative to fossil fuels, there are still several environmental impacts associated with all stages of the lifecycle of a wind farm. This study determined the material composition for wind turbines for various sizes and designs and the prevalence of such turbines over time, to accurately quantify waste generation following wind turbine decommissioning in the UK. The end of life stage is becoming increasingly important as a rapid rise in installation rates suggests an equally rapid rise in decommissioning rates can be expected as wind turbines reach the end of their 20–25-year operational lifetime. Waste data analytics were applied in this study for the UK in 5-year intervals, stemming from 2000 to 2039. Current practices for end of life waste management procedures have been analysed to create baseline scenarios. These scenarios have been used to explore potential waste management mitigation options for various materials and components such as reuse, remanufacture, recycling, and heat recovery from incineration. Six scenarios were then developed based on these waste management options, which have demonstrated the significant environmental benefits of such practices through quantification of waste reduction and greenhouse gas (GHG) emissions savings. For the 2015–2019 time period, over 35 kilotonnes of waste are expected to be generated annually. Overall waste is expected to increase over time to more than 1200 kilotonnes annually by 2039. Concrete is expected to account for the majority of waste associated with wind turbine decommissioning initially due to foundations for onshore turbines accounting for approximately 80% of their total weight. By 2035–2039, steel waste is expected to account for almost 50% of overall waste due to the emergence of offshore turbines, the foundations of which are predominantly made of steel.

“Is there no Balm in Gilead?”: Health, Illness, Death, and Dying in the Hebrew Bible and Today

2021 ◽  
Vol 75 (3) ◽  
pp. 196-206
Author(s):  
Joel S. Kaminsky
Keyword(s):  
End Of Life ◽  
Hebrew Bible ◽  
End Of Life Care ◽  
Death And Dying ◽  
Life Care ◽  
The U.S ◽  
Conceptual Resources

This essay argues that the Hebrew Bible contains conceptual resources that can contribute to and enrich the ongoing discussions surrounding healthcare in the U.S. and in other modern Western societies. These biblical ideas may help us reframe our understandings of sickness and health, something urgently needed if we wish individuals and their families to have less medically invasive and less alienating experiences of illness, most especially during end of life care.

Female genital mutilation in the UK: considerations for best nursing practice

2019 ◽  
Vol 28 (12) ◽  
pp. 788-791
Author(s):  
Bethany Rose
Keyword(s):  
Public Health ◽  
Female Genital Mutilation ◽  
Nursing Practice ◽  
Health Concern ◽  
Public Health Concern ◽  
Genital Mutilation ◽  
Health Complications ◽  
The Uk ◽  
Female Genital

Female genital mutilation (FGM) is any process that injures or removes part or all of the external female genital organs for non-medical reasons. FGM is a growing public health concern in the UK because of an increase in migration from countries where it is widely practised. Education on FGM for nurses is key to supporting women who have undergone the practice, as well as safeguarding girls and women who are at risk. Nurses must understand the history and culture of FGM as well as the long-term health complications to be able to support affected women both professionally and sensitively.

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