Death and Dying in Long-Term Care

Most people don’t feel comfortable talking about death or dying. This is one of the more sobering and sometimes necessary topics to discuss. If you’re a healthcare professional, and are used to dealing with death, you may still be unsettled by it. Some handle it well, and others, not so well. My experience in long-term care has provided insight into how healthcare professionals may suffer emotionally after caring for a senior for many years. I often hear statements like “He was like family to us”, and “It is so strange to not have her around”. There are many people and issues involved in the dying process and eventual death of a resident.

The Many Aspects of Death and Dying

As I think about death and dying, so many ideas emerge in my mind. Comfort and pain management are some of the first things I think of, as well as being with family and friends. Dignity is an issue to always consider. Another important concepts is spirituality. I also think about where I may die, either at home, in a hospital, or maybe a senior care center sometime in the future. The cause of death is something that also comes to mind. Being able to communicate my wishes is important and I also would want to experience a “Good Death”.

What is A “Good Death”?

I know this tends to be an awkward question for many people, but how would you like to die? I ask this during live presentations and always get a variety of answers. Where would you prefer to die? Doing what? With whom? How does death look or sound? The “Good Death” is what most people hope for. It involves being home, surrounded by loved ones, and without pain. Having a great sense of accomplishment and completion in life can provide a sense of calm. A “Good Death” also means that we have the opportunity to say goodbye to those we love. Some people say they want to die in their sleep without suffering while having no fear or anxiety about dying.

The Realities of Death

While most of us would prefer a good death, we don’t always get to decide where and with whom we will die. Dying involves many people that we don’t know. We may also die alone. Statistically, most of us will die in a hospital or long-term care facility. Once we are admitted to the hospital or SNF, we become part of the health care system. Our physician and nursing staff have a good amount of control and power over us. How we die is influenced by many outside factors that we may no power over. It is therefore critical for healthcare professionals to do everything they can to provide a peaceful and dignified death.

Quality at the End of Life

So many variables become important during the dying process and eventual death. We should protect the individual’s autonomy as much as we can and honor their wishes. Pain should be well-managed and comfort should become the main focus. It is important to listen to the resident as well as their family and keep communication open and supportive. Our team should work in harmony to provide the necessary care at the end of life. Other aspects to remember during end of life care include physical touch, respect, privacy and emotional support.

Final Words

Death is inescapable. Eventually we will all experience the death of a loved one as well as our own. It may be hard to think about what we might want in the future considering our own death. Our wishes may change between now and then. Regardless, I bet we all know how we don’t want to die – alone, scared, and in pain. Today, death can be managed better than in the past. As healthcare professionals, it is our calling to provide the highest quality of life while the resident is alive, and a good death and the end of life.

More About Hospice

• Pain Management
• On Grief, Mourning and Bereavement
• Hospice 101