End of Life Transition
preparation for death rather than its actual occurrence.
why is it not talked about
overwhelming taboo.
internal reticence/reservation.
myths about death/dying in older adults
not as difficult to face.
less pain than younger adults.
death of parent is not difficult.
singaporean attitudes about death
no financial burdens behind
well-trained medical professionals guide them
platform to talk about death in community
want to die at home & affordably
wanting more involvement from medical professionals
Nature of the transition
not initiated at a time of illness or impending death
preparation to be done in advance:
health & illness takes precedence
writing a will
instituting an advanced directive
planning funeral
Dilts 'neurological levels' framework (model of personal consciousness)
Environment: changes in living arrangements and where they carry out their day to day activities
Sense of purpose: people's motivation and meaning in life
Behavior: changes in actions
Identity: how people feel abut their role and place in society
capabilities: talents and abilities are affected
Beliefs: what people believe to be true or important
associated with a multitude of strong emotions
fears during the end of life transitions
Discussing fears of dying is the hardest part of the End of Life process
evokes some of the fundamental questions of being human
explore painful emotions
patients, families and doctors may each be afraid to begin that exploration; protect others from feeling pain
other emotions
have particular tasks to achieve
want to know when death is imminent at the terminal phase
describe the spiritual richness they experience in their last days
challenges faced while facing death
pain, control in the dying process
aloneless & loss of identity
life experiences
finding meaning in life & death
finding & giving forgiveness
issues for family members
supporting older adults in the dying process
dealing with caregiver exhaustion / stress
decision-making regarding end-of-life care
grieving the death of the older adult
anticipating death of an elder spouse