In The Face of Death: Care at the End of Life

Abstract

Research background. Nursing care for patients with terminal conditions is one of the leading problems in health care. Health care specialists caring for the dying patient are under enormous psychological stress. Before death the patient requires medical and family support because death provokes feelings of fear or anxiety. During nursing care for dying patients the most important issue is to help people to live fully up to the last moment of his life. The aim of the research was to analyse the aspects of care of dying patients. Research methods. The subjects, 250 health care specialists (doctors, nurses), 57 dying patients’ family members and significant others, filled-in a questionnaire consisting of a Frommelt’s approach to nursing care for dying patients, a modified Collet-Lester scale of death fear, and a questionnaire for the dying patients’ family members and significant others. Results and conclusions. The vast majority (92.4%) of respondents were religious, had experienced bereavement, care for person with incurable illnesses and have knowledge about death. The most important concern of respondents related to the process of death of themselves or their close relatives was due to the pain in the process of death. The majority of respondents (93.1%), especially with higher education, had a good attitude towards nursing care for dying patients. Respondents with the experience of bereavement more often noted that families caring for the patient with incurable disease need for emotional support and that close relatives should participate during the patient’s process of death. Respondents who had work experience with the dying patients significantly more often believed that possibility of the dependence on painkillers should not be considered when it comes to the dying person. According to them, the family members who remain with the dying patient disturb the nursing care. Respondents who have had knowledge about death significantly more often noted that the care for patient’s family members should continue throughout the period of mourning and bereavement, and indicated that they were upset when their patient ceased to believe that he would recover. Respondents who felt threatened by the current bereavement and were more worried about their own death significantly more noted that the stress was the most common psychological problem in the end of life. As proved by the survey outcomes, the majority of the patients (75.4%) were frequently visited by family members. During the time of their disease, most of the patients (77.2%) stayed alone just for short periods of time. At the time of death, the majority of the respondents (61.4%) stayed at the bedside of their family member, 38.6% of the respondents indicated that the dying person frequently felt pain, and 19.3% of them stated that the pain was felt for a short or an insignificant period of time. About half of the respondents claimed that their family member could not eat or bree the independently. Over half of the patients who passed away (52.6%) did not discuss their nursing requirements, such as reanimation or intensive care, at the end of their lives, however, 35.1% of the patients did that. Approximately half of the patients discussed their funeral-related wishes and said good-bye to their family members or significant others. The majority of the survey participants-patients’ family members and significant others (82.5%) indicated that the patient in hospital had been properly cared for.

Keywords: dying patient, death, nursing care.