Beyond Death and Dying

The Group ◽  
2018 ◽  
Author(s):  
Donald L. Rosenstein ◽  
Justin M. Yopp

In the late 1960s, LIFE magazine was one of the most widely read and influential periodicals in the world. Renowned for its photojournalism, the general-interest magazine covered all aspects of American life. The November 21, 1969, edition was no exception. It included a review of what would be The Beatles’ final studio album, a profile of Ohio State University head football coach Woody Hayes, and an advertisement for a commemorative book on that summer’s moon landing. It also featured an article on a little-known University of Chicago psychiatrist, Dr. Elisabeth Kübler-Ross, and her groundbreaking work with terminally ill patients. In an era when public discourse about death and dying was almost non-existent and when many physicians believed that a patient was better off not knowing his or her prognosis, Kübler-Ross was encouraging candid and open conversations with people about their impending deaths. Her innovative approach and courage to challenge the status quo drew the interest of LIFE editor Loudon Wainwright. His captivating story introducing Kübler-Ross and her new book, On Death and Dying, would forever change the national conversation about end-of-life and grief. The article described Kübler-Ross’s seminar teaching clinicians about the experiences of terminally ill patients. Physicians, nurses, chaplains, and medical students watched through a one-way mirror as she interviewed a twenty-two-year-old woman who had been diagnosed just two weeks earlier with leukemia, which at that time was almost always fatal. Large black-and-white pictures of the patient showed a vibrant and beautiful young woman with long hair and a wide smile. She looked nothing like someone close to death, which in some ways was the point. She talked about her diagnosis and understanding that leukemia would almost certainly kill her. Her willingness to openly discuss the prospect of her own death must have been astounding to those observing the interview. Kübler-Ross theorized that people facing their own mortality proceed through five stages prior to their death. In the first stage, the person is unable or unwilling to accept that he or she is going to die (Denial).

2020 ◽  
Vol 37 (11) ◽  
pp. 897-903
Author(s):  
Hsiao-Ting Chang ◽  
Ming-Hwai Lin ◽  
Chun-Ku Chen ◽  
Tzeng-Ji Chen ◽  
Shinn-Jang Hwang

Objective: The aim of this study was to explore the status of aggressive end-of-life care and symptom relief treatments in terminally ill patients who had discussed the withdrawal of mechanical ventilation. Methods: This research is a retrospective observational study based on a chart review. Terminal patients aged ≥20 years, who were intubated with mechanical ventilation support, who underwent hospice-shared care, and who personally, or whose close relatives, had discussed the withdrawal of mechanical ventilation with hospice-shared care team members in a tertiary hospital in Taiwan during 2012 to 2015 were included. Demographics, medical conditions, and aggressive end-of-life care, including hospitalization, use of vasopressors, artificial nutrition, tube feeding, antibiotics, and symptom relief treatments including the use of opioids, steroids, and sedatives, were identified. The modes of care and treatments of patients by the status of withdrawal of mechanical ventilation were compared. Results: A total of 141 patients had discussed the withdrawal of mechanical ventilation, and 111 (78.7%) had been withdrawn. Aggressive end-of-life care was noted in all patients regardless of mechanical ventilation status. There were no significant differences in the number and pattern of aggressive end-of-life care measures between patients who had or had not been withdrawn. There were significantly higher rates of symptom relief treatments used in patients who had been withdrawn. Conclusions: Aggressive end-of-life care is common for patients who have discussed the withdrawal of mechanical ventilation. There are significantly higher rates of symptom relief medications administered in patients who have been withdrawn from mechanical ventilation.


Author(s):  
Sagrario Pérez-de la Cruz ◽  
Ivonne Ramírez ◽  
César Maldonado

Health Science students in Spain and Bolivia should be trained in the management of the processes of death and dying of patients. The aim of this study was to examine the degree of training, self-perceived safety and preferences in relation to the care of terminal and non-terminal patients. It was a descriptive, cross-sectional, multicenter study with students of Medicine, Nursing and Physiotherapy in Spain and Bolivia. The following variables were evaluated: care preparation and emotional preparation to caring for terminally ill and non-terminally ill patients, the Death Attitude Profile Revised (PAM-R) and the Bugen Scale for Facing Death. The self-perceived preparation of students for caring for terminally ill patients can be considered “fair” (mean 2.15, SD 0.756), and this was also the case for their perceived emotional preparation (mean 2.19, SD 0.827). In contrast, the score obtained for their preparedness for treating non-terminal patients was higher (mean 2.99 and 3.16, respectively). Working with terminally ill patients, including terminal or geriatric cancer patients, was the least preferred option among future health professionals. The results obtained show a limited preference for end-of-life care and treatment, highlighting a lack of preparation and motivation among health science students in Spain and Bolivia for working with these patients.


2006 ◽  
Vol 64 (1-3) ◽  
pp. 378-386 ◽  
Author(s):  
Minke Goldsteen ◽  
Rob Houtepen ◽  
Ireen M. Proot ◽  
Huda Huijer Abu-Saad ◽  
Cor Spreeuwenberg ◽  
...  

1977 ◽  
Vol 7 (2) ◽  
pp. 123-131 ◽  
Author(s):  
Stanley E. Slivkin

The psychiatric Day Hospital offers a forum for working out bereavement issues of terminally ill patients. Through individual and group psychotherapy, patients and their families are assisted in coping with the issues of death and dying. Coordination of medical, surgical, and psychiatric treatment of dying patients is enhanced by Day Hospital educational and treatment programs which afford continuity of care at the interface area between treatment specialties.


2021 ◽  
pp. 003022282110070
Author(s):  
Typhaine Maïko Juvet ◽  
Marc-Antoine Bornet ◽  
Jean-François Desbiens ◽  
Diane Tapp ◽  
Pauline Roos

Positive attitudes and a sense of competence toward end-of-life care are the key to adequately support terminally ill patients. This qualitative study aims to explore healthcare students’ attitudes toward caring for terminally ill patients. Eleven students from the University of Applied Health Sciences in Switzerland participated in focus groups. Attitudes were overall positive. Most participants felt that supporting dying patients was a way to achieve professional fulfillment. However, most students felt not competent in palliative care and lacking experience. They wanted to receive better training, more specifically in good practices and appropriate behaviors. Our study fills a knowledge gap regarding the opinions and pedagogical needs of healthcare students, and highlights the importance of experiencing end-of-life care during the educational process. We recommend early exposure to terminally ill patients and appropriate attitudes toward death and dying as part of the bachelor’s curriculum, accompanied by benevolent guidance from teachers and health professionals.


1986 ◽  
Author(s):  
J. H. Brown ◽  
P. Henteleff ◽  
S. Barakat ◽  
C. J. Rowe

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