Question

As we explored this week, late adulthood is a dynamic, rich time of life with many transitions and times of both growth and loss. One of the most profound experiences in late adulthood is that of death and dying – both our own death and the loss of loved ones. In our readings this week, we learned about how important cultural contexts are in understanding the death and dying process. As current/future healthcare professionals, having an understanding of how others process death and grief is key to being able to provide quality support and care. For our final assignment for this class, you will be reflecting on the following scenarios.

Part I: Imagine…you are 77 years old. You have lived a happy, fulfilling life, but have recently learned you have terminal cancer and are reflecting on how you want to spend your last few months and what you would like for your final wishes. In 1-2 pages, describe what you would like this last chapter of your life to look like. Consider:

• What is your cultural heritage? What cultural traditions do you or your family hold that would impact your dying process and last wishes? (i.e. I’m Irish and my family and cultural heritage view death as a time to celebrate the life of a loved one with a long Irish wake, stories about our loved one, laughter, etc. We view funerals as a time to be very emotionally expressive about our loss).
• How does your family communicate about or view death? What impact does communication with loved ones have on the death and dying process?

Part II: Imagine…you are a nurse, social worker, hospice volunteer or other healthcare professional working with a 77-year-old terminal cancer patient who is struggling with her end of life decisions. She is stoic and hard-working. Her culture values privacy and independence. She doesn’t wish to burden her family and so changes the subject anytime her children try to broach the topic of her final wishes, taking care of her house/pets, her will, etc. She becomes uncomfortable anytime you or other care providers ask to discuss her wishes on things such as DNR orders, religious wishes, or final arrangements. Her children are concerned about her and are worried they don’t know how to best fulfill her wishes and are imploring you to help. In 1-2 pages, consider:

• How might your own views on death and dying impact your work with this patient?
• How might you seek to guide or help this patient and her family through this time?
• What cultural context might be at work here to consider?

Answer 1

PA RT 1

question :-What is your cultural heritage? What cultural traditions do you or your family hold that would impact your dying process and last wishes?

i am an indian and according to us death is a process which everyone go through and each of us think death as a greving process where we have lot of rituals related to funerals are being done which includes all poojas and gatherings where the sorrow of lost one is shared .Dying with dignity still remains a dream for most people in the world.as i am a HINDU the cultures most Hindus choose to dispose of a person’s body through cremation usually within a day of the death. In Hinduism, death applies only to the physical body; there is no death of the soul.

Hindus don’t believe in the resurrection of the material body. They believe that upon death, the soul, which truly represented the person, has departed or detached. The body has no significance and, therefore, no attempt is made to preserve it.We view funerals as a time to be very emotionally expressive about our loss

While some Hindus do bury their dead, the most common practice is to cremate the body, collect the ashes, and on the fourth day, disperse the ashes in a sacred body of water or other place of importance to the deceased person.and on the 16 th day of death food is given to people as a part of grief and for the soul to rest in peace

Dying with dignity still remains a dream for most people in the world but we consider to fulfill all there deams and wishes come true before they leave us and wwe also assurre that they meet all their children before they leave and to have a peaceful

question:-How does your family communicate about or view death? What impact does communication with loved ones have on the death and dying process?

according to me and my family death is considered to be an emotionally unwell moment for the family .thinking that a person amoung us is going to leave us is an extreamly sad situation where the loss of the person cant even be aaccepted by the family.the love and care we give and we get from the loss is going to be missed for us and all over is a very big process of mouring and we cant re bring the lost one.

the responsibilities taken by theloved one is being missed for example grantmothers used to feed their grand childrens these are having a great emotional building and the people to adapt with the loss takes a long time and they need more psychological support

PART 2

Qestion:-How might your own views on death and dying impact your work with this patient?

How might you seek to guide or help this patient and her family through this time?

What cultural context might be at work here to consider?

answer: viewing a death ,death is a process which everyone go through and each of us think death as a greving process where we have lot of rituals related to funerals are being done . Dying is a multi-faceted process that is uniquely individual to each person.The most common signs and symptoms before death include: increased pulse/respiratory rate, Cheyne-Stokes respirations, cool/mottled skin, and decreased urine output.It is important to provide support for the patient and family throughout the entire dying process.Be sure to communicate to the family when a patient’s death becomes imminent so that other family members and/or clergy can be called.vitnesing death is a part of my job and responsibility as a nurse i should

*asess the needs of patient

*check for health status

*asses for her wishes

* Provide care and support to the patient and to respect her autonomy while continuing to support the family as they struggle to adjust to the impending reality of loss

*well know about her family and cultural background

*support the patient and family by educating them on what they might expect to happen during this time,

*addressing their questions and concerns honestly, being an active listener, and providing emotional support and guidance

*Regular observations should be made and good symptom control maintained, including control of pain and agitation .

*Attention to mouth care is essential , and the family can be encouraged to give sips of water or moisten the mouth with a sponge

*respect all the culture of the patient and give a respectful send off

* it is important to keep the patient’s area as comfortable and peaceful as possible. Common lights and noises can contribute to restlessness and agitation; therefore it is advisable to keep lights soft, shades closed if possible, and external noises limited to a minimum.

*have knowledge about how patients experience and express pain, maintain hope in the face of a poor prognosis, and respond to grief and loss will aid health care professionals. Many patients' or families' beliefs about appropriate end-of-life care are easily accommodated in routine clinical practice.

*consider desires about the care of the body after death, for example, generally do not threaten deeply held values of medical science. Because expected deaths are increasingly the result of explicit negotiation about limiting or discontinuing therapies, however, the likelihood of serious moral disputes and overt conflict increases.