Patient, family, and caregiver support and education takes time. A fifteen-minute blood pressure and cognitive status check is not what end of life care is about — that’s home health.
End of life care is about bonding and developing trust, not just with the patient, but with the family and the caregiver, as well.
The caregiver needs some one-on-one time with the hospice nurse so that they can vent, ask questions, and tell their story. That takes time.
The hospice nurse should be able to sit with the family and caregiver over a cup of coffee, explaining signs of approaching death, explaining how to provide care and support as end of life nears — that takes time.
A home visit in the middle of the night because a family is scared of the changes occurring is not the time to quickly say “everything is fine” and then leave. It is a visit for sitting down, talking about fears, reminding the family of the signs of approaching death, and offering reassurance that all is as it should be — that takes time.
A dying-minutes visit should not be a fifteen-minute stop, simply confirming that death is happening. During the dying-minutes visit, a hospice nurse should stay to support those present. The nurse should guide them through this life-changing experience. Make this a sacred experience for all so they can carry a sacred memory with them— that takes time.
A death-pronouncement visit is not a brief, ten-minute visit as I’ve heard one coordinator explain it. It is a visit to listen to what happened. It is a time to reassure the caregivers that nothing pathological happened. It is a visit to offer guidance and ideas about funerals. It is time to help the family put pictures of their special person up — that takes time.
End of life care is not primarily about the physical, although it does have its own expertise relating to the physical. End of life care is about support, guidance, and education. It is about the patient, the family, and the caregiver and — that takes time.
Something more… about End of Life Care Includes a Cup of Coffee
If you would like to learn more about how I believe a “death call” should be handled, get a copy of The Final Act of Living: Reflections of a Longtime Hospice Nurse. Turn to page 121 and read that chapter.
