Raising A Parent: Recommendation #55 Quiet, Passive, and Respectful Observer

Recommendation #55: Be a Quiet, Passive, and Respectful Observer

This recommendation brings back the topic of a “good death” and what constitutes as a good death. The definition of a good death many take different meaning for different people based on religious, ethnic, race, or cultural background. We must learn to respect these values and provide care based on these beliefs in order to facilitate a measureable amount of what may constitute as a good death. A general consensus is that many suffer a painful death, thus a death lack of pain may be viewed as a good death. However, studies have shown severe pain is not a common phenomena of death, and is not the primary concern of the dying individual. Loneliness, by far poses as the greatest fear for patients experiencing their final days.  It is imperative for family members to spend quality time with a loved one during this disconcerting time, as the author and his family did ‘till the very end. More than any other time, the individual needs to know that he/she is not alone; there is a need to know that a friend or family member’s hand is nearby. There is also a need for soothing, quiet and compassionate communication. Despite the lack of exchange of communication between the author and his mother near her final hour, the author did not give up instead he came up with an alternate way of communicating with his mother. Expressions are often the best form of communication, rather than words. Although unresponsive with words, the author’s mother communicated by squeezing his hand to indicate acknowledgment of his presence. This would also prove that hearing is still intact until the individual’s last breath, providing there is no deficit. To surmise, providing compassionate communication should never end until the final hour. Further, this act of kindness brings closure to all involved, without excluding the healthcare workers. Finally, respecting and preserving the individuals self-dignity can be considered as a “good death.” (Word count 322)

Author: Kerline Leonard

Raising A Parent: Recommendation #40 Protect your Charge

Recommendation # 40: Be prepared to do what’s necessary to protect your charge

Safety above all else takes priority when caring for a loved one. Due to safety concerns and for the welfare of his mother, the author made the conscious decision to place her in a secure and safe environment. After seeking out the most appropriate environment, consulting the advice of the administrator of the dwelling, and collecting additional resources, the author had enough detailed information to present the matter to his mother in a respectable fashion. Worth noting is the consideration of what is valuable to the person, whether it is religion, spiritual, culture, or ethnicity these values must be part of the decision making component to assure compliance. On that note, the author searched for the environment best suited for his mother, a Jewish senior residence to promote compliance and self-preservation of what is most valuable to her beliefs. Another pertinent point to consider is who the final decision maker is. Given the fact of the high level of competence the author’s mother still possess, the final decision regarding relocation to a congregated dwelling is left up to her. This is exemplary on respecting one’s autonomy with decision making in the later years. If the author had taken the final decision regarding placing his mother in a congregate housing without her consent, the end result would have be devastating to her pride, self-efficacy, health, and their relationship. Although his mother was in disbelief with the thought of moving into a senior living residence, I believe, the manner in which the author presented the information opened the door for a review of the present situation with her finances and compliance. The author did not choose to minimize the situation of her financial predicament but instead presented the information for review and consideration which as stated was the overall determinant of her decision. In sum, honesty with the person is vital towards promoting compliance. (Word count 312)

Author: Kerline Leonard

Raising A Parent: Recommendation #22 Create a Plan

Recommendation #22: Be prepared for the ‘ups’ and ‘downs’ and create a plan

Planning is of the utmost importance when preparing for the inevitable of end. Conversely, no matter how well planned or organized one’s expecting death is orchestrated, it should not be considered a “good death,” because no death is good. And I agree on this key point made by the author, we (surviving family members) cannot categorized death as “good” rather  it should be remembered as a well-organized or peaceful death. The same can also be said for a “bad death” or unplanned death, when things are chaotic and disorganized which many times result in a complicated grieving process. Not to go off tracks, the author’s meaning of “good death” is used in the context that no matter how prepared the family may be to handle the death of a loved one, death is never good.

With planning some of the disconcerting issues of death can be alleviated and the author provides a formula for assistance with planning at the end of life. First, it is crucial to be present during the decision making if you are not the primary decision maker or be available as the decision-maker. Second, be prepared to the ever changing moods of a loved one. Third, continual connect with other in the family is also a vital component in the planning process; this will help others cope and provide additional support to the decision-maker. Fourth, be prepared to answer questions from concerned individuals who may or may not be part of the extended family. Fifth, assess the situation and evaluate the true of the condition. Sixth, be prepared for criticism from others regarding your judgment calls. As the decision-maker not everyone will agree with some of your decision, but the loved one who elected you as the decision maker did so because of confidence and reliance on your decision making that would be in his/her best interest. Seventh, be compassionate towards others feelings and ways of grieving.

I would add another point to the formula, as the eighth point:  be prepared to educate others on mood changes the person may exhibit, as a result of impeding death. The reason why I point this out is because the author expressed how others were taken aback by his mother’s behavior and change in character, had the primary person who is accustom to the individual daily, I would suggest making others know of the changes in mood that are common with this process.  Overall, preparation lessens the impact of death and provides a lasting memory of a peaceful death. (Word count 416)

Author: Kerline Leonard

Raising A Parent: Recommendation #14 Unconditional acceptance

Recommendation #14- Project an air of unconditional acceptance

Dylan Thomas expressed the final hours of death in his poem: “rage, rage against the dying of the light.” As the person experiences the deeming of the light of life, all efforts are put forth to hold on to those memories and most of the time it is this emotional pain many suffer during the end of life. Perhaps the best thing is to come to terms with the problem and learn how to accept and recognize the condition of your loved one, learn about the condition by seeking out additional resources (the internet is a great tool), and talk about the condition with the loved one, but most of all allow the person to “rage.”

It is by the process of acceptance we learn how to deal with reality. This is essential for the sufferer and the caregiver. Many times the caregiver may feel a need for emotion distance from the agonizing torment of seeing a loved one suffering, but must also learn how to separate self from sympathy from empathy. While distancing yourself from the ongoing suffering the individual in subjected to, it is important not to distance yourself from the person (in this case the author’s mother).  Embracing the commitment of support no matter the degree of emotional difficulty is vital in helping the person who is suffering during the transitional acceptance of end of life experience. The author incorporates the event of his father’s shooting, which took place 43 years ago, as an example of a reoccurring flashbuld memory his mother keeps revisiting and is highly emotional about, and remembers quite vividly.  Even though the author’s perception of the event is somewhat different from his mother’s, out of respect he allows her the freedom and distance needed by not interfering with her recollection of what she perceives to be true; instead the author quietly, patiently, and gently listens to her perception of the events of 1966. 

As time passed, the author expressed the suppression of the event by his mother or perhaps she had forgotten the episodic component of 1966. I don’t believe it was forgotten, may be suppressed or had been acceptable to her as a disconcerting matter that cannot be undone. Studies have indicated that episodic memories are part of a person’s autobiographical memory, although those memories are connected with emotional details and difficult to remember they are not forgotten. Dylan Thomas expresses this feeling best in his famous poem: “Old age should burn and rave at close of day.” (Word count 416)

Author: Kerline Leonard

Raising A Parent

 LESSONS LEARNED IN DEALING WITH AN AGING PARENT: recommendation 1 and 2

I believe communication is a key factor when dealing with anyone during the end-of-life cycle, particularly loved ones. The author outlined several recommendations but I would combine recommendation number one and two into a more specific point such as (Effective Therapeutic Communication) and then outline the subheading of empathy versus sympathy. 

More often than we would like to admit, when someone is dying (in this case the author’s mother) we tend to show sympathy which I believe complicates the matter. As the author stated he utilized empathy instead of sympathy to deal with his mother’s frustration and anger. Perhaps, the author is correct in stating, information learned through education or higher level learning is essential in helping us cope with the inevitable taker of life “death.” Based on this understanding, I will make the presumption that the author was able to use effective communicate due to his level of knowledge.

Effective therapeutic communication is also illustrated in recommendation #2. No communication can be effective if it’s one sided, therefore listening to what is being said is an important and vital component of therapeutic communication. If the author made no attempt to listen to his mother, I can image the frustration and rollercoaster of emotions he would have to endure on a daily basis. But allowing his mother to express herself even when she was mumbling or rambling is commendable. Interestingly, the author’s mother expressed no reason for being upset and made it a point to open the door for communication about her feelings by stating “I need to understand why I feel so angry.” This part of the reading exemplified how effective communication can be if used appropriately. Further, it is an inviting way of building a trusting relationship. Formal and informal caregivers should practice therapeutic communication in their daily care of patients or loved ones to promote ease of transition during the end-of-life stage.

Kerline Leonard