End Of Life care for seniors

Death is a natural stage in an aging society and may be associated with chronic conditions such as cancer, heart failure, chronic obstructive airway disease and the complications of dementia illness. A large number of seniors will need end-of-life care over a long period of time.

Countries will need the expertise to address complex issues that deal with end of life for diverse populations and Aboriginal peoples.The burden of middle-aged people caring for dying parents is becoming more prevalent and their needs should be addressed as well.

Myths & Misconceptions of Dying

• Seniors don’t need end-of-life care as they are going to die anyway.
  • Many seniors would prefer to continue living even if they have a terminal illness. They will need help with self-care, emotional support, nutrition and pain control.

• Most seniors die in long-term care facilities and already receive end-of-life care .
  • Only one third of seniors die each year in long-term care facilities. Even health care workers in palliative care and nursing homes require education on stress management and physiological impacts.
• Seniors are prepared for death.
  • Many seniors may be in denial, indecisive and ambivalent. This can interfere with implementation of directives such as what health care they want.
• Seniors die of old age.
  • Aging itself does not cause death. They may die from heart disease, cancer, respiratory diseases and strokes.

• Nothing can be done for seniors who are dying.
  • Many things can be done including informing seniors of their rights, support for family members and exploring end-of-life decisions. Much can be done to enhance the quality of life for seniors and their loved ones.

Improving End Of Life

End-of-life care is an integral part of dying. The following can offer tips so your loved one can have a kind and gentle death.

• Comfort to patient
  • Medication needs to be available to control pain and other treatable symptoms.
  • Optimize physical functions and timely care.
  • Eliminate fear and anxiety.
• Decision-making
  • The patient and family members should be able to choose the use of life-sustaining treatments in the last days of life.
  • Ask permission to do something, respect freedom of choice and encourage them to make difficult decisions.
• Support
  • Support needs are different for everyone including the patient and family.
  • The senior may make decisions that are not in their own best interest, but instead protect their family from emotional or financial pressures.
• Issues to consider
  • Treatment of physical and emotional symptoms.
  • Support of function and autonomy.
  • Advance care planning, patient and family satisfaction, global quality of life.
  • Family burden, survival time, health care and social service provider continuity.
  • Bereavement
• Social Needs
  • Provide supportive environment to strengthen relationships.
  • Opportunities for social contact.
  • Encourage opportunities for life review and reminiscence about old times.
  • Let them discuss their true feelings, dreams, fears, desires and expectations.
• Culture
  • Care is consistent with cultural values and beliefs.
  • Provide access to spiritual guidance and practices.
  • Some cultures do not promote individualism and there the individual may leave decision-making in the hands of others.