Please enable JavaScript.
Coggle requires JavaScript to display documents.
End of life transitions - Coggle Diagram
End of life transitions
Definition
Concerned with the preparation for death rather than its actual occurrence
Why do people not talk about processes of dying
An overwhelming taboo against talking about dying
An internal reticence/reservation to engage with the subject, until it is unavoidable
Singaporean Attitudes about death
Only half of singaporeans are aware of hospice palliative care
Of all races, older Chinese Singaporeans above 60 years are the ones with the most need for info on hospice palliative care
For Older chinese Singaporeans, the fears of being a burden to family and friends 93% and medical cost 94%
Nature of the EOL transition
Health and illness
Not necessarily initiated at a time of illness or impending death
Preparing for EOL which can be done in advance
Writing a will
Instituting an advanced directive
Planning the sort of funeral etc
Impact of preparing for death
Dilts 'neurological levels' framework
Environment - What changes may required in their living arrangements
Behaviour - What changes might be required in the actions the takes in their day to day life
Capabilities - how people's talents and abilities are affected
Beliefs - impact on what people believe to be true or important
Identity - impact on how people feel about their role and place in society
1 more item...
Model of personal consciousness
Consist of a series of levels, each of which is constituted from while also constraining the one below
Feelings around EOL
Associated with multitude of strong emotions
Common fears at EOL
The onset of pain that cannot be managed - The loss of bodily control - The loss of function - Growing dependence on others - The unknown - Loss of family and friends -Ultimately, the loss of self
Discussing fears about dying
Discussing one’s fears of dying is the hardest part of the EoL process
Feeling personal fears suggests that death is more imminent and evokes some of the fundamental questions of being human
Causes people to explore sometimes painful emotions and often opens the door to the unknown
Challenges hope and many people believe that hope cures
Patients, families and doctors may each be afraid to begin that exploration; they may also desire to protect others from feeling pain
Other emotions
Most want to know when death is imminent at the terminal phase
Some describe the spiritual richness they experience in their last days, savouring the moments of living with the intensity of knowing that their time is limited
Most have particular tasks to achieve (e.g., Worden’s task-based model) in bringing closure to life as death draws near
Challenges faced
Pain
Need to have control in the dying process
Aloneness / Loss of identity
Integrating life experiences
Finding meaning in life and death
Finding/giving forgiveness
Issues for family members
Anticipating the death of an elderly spouse
Decision-making regarding end-of-life care
Supporting older adults in the dying process
Dealing with caregiver exhaustion / stress
Grieving the death of the older adult