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Communication need to begin in all forms. Written understanding of end of life needs to be posted, spoken, written, copied and reviewed several times with the patient and family members. Too much is left unsaid today. The patient’s life is number one. The doctors orders often are less then certain. These practises must be changed today.
My mother recently passed away with metastatic breast cancer and spent her last two weeks in palliative care. I felt that communication among the health professionals was excellent. Most of her care was managed by the RN and LPNs. There was no formal “palliative care physician” available in the facility, re:rural area, however she was seen by a physician/resident team every 2-3 days or as needed. At this stage of the dying process, what would have helped us most was an initial family consultation about what to expect, key players in her care and their roles and responsibilities. There was a lot of family conflict at this stage of my mother’s illness because of differing perspectives on the use of injection dilaudid and versed. One of my family members felt that heavy sedation was harmful. Communication about potential benefits/harms needs to take place with as many staff and family members present as possible. Communication about stopping IVs and not giving water needs to be communicated as a team – the language needs to be the same, and a family consult is a must.
I cannot remember a single instance where comments from other health care providers regarding one of my palliative patients has been unhelpful – on the contrary! I welcome comments, and I always do my best to communicate with the patient and his/her family about their condition, to their satisfaction.
When my husband passed away there was no one there to communicate with us in regards to what was to come. We were totally in the dark. I had to ask the nurse if he was in a coma because I didn`t have a clue. We walked out of the hospital like zombies with no one but one nurse to speak to. I was approached minutes after my husband passed away to ask if I would like to have an autopsy done. That is not the time to ask someone such a question. That is something that needs to be thought through. Looking back now, I wish I did have it done. Communication with the family is key. We had to rely on google for our information. That`s not right.
80 College Street,
Toronto, Ontario, M5G 2E2