SPECIAL PROBLEMS OF TERMINAL ILLNESS FOR PATIENT AND FAMILY

The patient and family may have to deal with:

Image Numerous remissions and relapses and the psychological reactions that arise with each.

Image Lengthened periods of anticipatory grief (the continual ups and downs — the emotional roller-coaster ride for patient and family).

Image Increased financial, spiritual, social, physical, and emotional pressures.

Image The progressive decline of one’s loved one and the emotional responses of family members to this decline.

Image A longer period of uncertainty.

Image Dilemmas about treatment choices.

Image Intensive treatment regimens and their side effects.

Image Post-treatment anxiety. (What next?)

Image Loneliness, for both the patient facing this final journey and for the family anticipating separation.

Image The need to be able to talk when desired and to be assured that someone will listen to the patient’s “story.”

Image The difficult decisions surrounding when to call in hospice care.

Image End-of-life issues, such as family discussions about discontinuance of life support. Special note: If a family has never openly discussed these issues, their trauma will be multiplied and amplified.

Recommendations

  1. Be open to the patient’s terminology. Remember, you cannot push, pull, or rush a person from one stage in the grieving process to another. For instance, if a person is in denial, it is not your role to force him or her to accept the fact that the illness is terminal.
  2. Be available to spend extra time with the dying person if he or she wants you there. If you don’t know if you are wanted, ask! “Would you like to have me stop by this afternoon for a visit and to pray with you?”
  3. Be sensitive to the patient’s desire to be touched or not touched.
  4. Ask what specific things the patient would like to have you pray about; then pray with and for him or her.
  5. Ask about specific concerns of family members. There may be some assistance you can offer. This information will also give you direction from the patient about the things he or she would like to have you address in prayer.
  6. Ask about and read favorite Scripture passages. If the patient can’t think of any, Psalms 139, 91, and 23 are good choices.