People don’t talk about death and dying which means that many people aren’t able to die in the way that they choose.

A message brought to you by the Northwestern Ontario End-of-Life Care Network, a voluntary organization funded by the Ontario government to improve quality of care at end-of-life and enable more individuals to live and die in the place of their choice.

Are you comfortable talking to someone about the end of your life?

Death has been excluded from most people's experience as they grow up. Advancements in medical science and technology have resulted in a belief that death can somehow be avoided. Hospice Palliative Care affirms life and regards death as a normal process. It offers a support system to help individuals live as actively as possible until death. Some suggestions for caregivers:

  • Be prepared, educated and supported
  • Provide time and space for communication
  • Communicate respect and acceptance of the dying person
  • Ask the individual about their needs and wishes and answer all questions honestly and fully
  • Communicate your commitment to provide care for the individual who is dying
Have you thought about the types of treatment and the kind of care you would like at the end of your life?

Shared among individuals at end of life is a strong desire to be treated with dignity, compassion and as a unique individual with unique needs. They also do not wish to be a burden on their family or care providers. Some guidelines for caregivers include:

  • Have an understanding of the process of death and dying
  • Allow the individual to participate in decision making regarding their end of life care
  • Provide access to spiritual support if desired
  • Offer options and ideas to enhance comfort measures
  • Careful management will lead to smooth passage and comfort for the individual and loved ones
If there were a choice, where would you prefer to spend your remaining time?

As more end of life care settings become available, individuals, loved ones and caregivers should think about:

  • The setting which should allow loved ones private, 24-hour access without disturbing others
  • The signs and symptoms of impending death in advance
  • The psychosocial and spiritual issues in the last hours and a management plan to address those needs/expectations
  • Respecting cultural and religious differences
Who are the important people you would like to be with at the end of your life?

Everyone has different needs, but some emotions are common to most dying individuals. These include fear of abandonment and fear of being a burden. They also have concerns about loss of dignity and loss of control. Some ways caregivers can provide comfort are as follows:

  • Keep the person company-talk, watch movies, read, or just be with the person.
  • Allow the person to express fears and concerns about dying, such as leaving family and friends behind. Be prepared to listen.
  • Be willing to reminisce about the person's life.
  • Avoid withholding difficult information. Most individuals prefer to be included in discussions about issues that concern them.
  • Reassure the person that you will honor advance directives, such as living wills.
  • Ask if there is anything you can do.
  • Respect the person's need for privacy.
If there were a choice, where would you prefer to die when the time comes?

More and more people are choosing to die outside of the hospital setting. If an individual is planning to die at home, he/she might want to think about:

  • How skilled around the clock care will be provided
  • Their physical, psychological, social, spiritual needs
  • What medication, equipment and supplies will be needed
Have you completed any of the following: written a Will, made Funeral Plans, appointed a Power of Attorney or completed an Advance Care Plan?

Advance care planning is the process of planning for one’s final phase of life. It includes introspection and discussion with one’s family and health care providers, looking at values and priorities, and deciding what treatments one would want and not want. Caregivers can assist families with end of life support by:

  • Identifying the initial bereavement counselling issues for the family
  • Being aware of the individuals's health status, goals for care, advance directives and substitute decision-makers
  • Give control to the individual