Nobody should die alone. The most important part is that you are with the dying person – the dying person should not be left alone, if possible. Not always is it possible to accompany a loved one on the last way – both my parents died far away from me. My father suddenly, when I was eighteen and away in boarding school – his heart gave out. My mother in Germany, of lung cancer, when I went through the rigors of medical internship in Boston. I remember sitting at night at the bed of a dying patient, and thinking that I should be sitting with my mother.
Many people feel uncomfortable in the face of sickness and dying. Not everybody finds wonderful last words and gestures. Here is what you still can do – naturally – for a dying loved one.
First, however, what you should not do:
• Discuss the ways the person hurt you in the past: It is too late now. Try to grow up before the person dies – work out your own problems
• Go through their things and snoop around. Even if you were the lone heir: Wait until afterward
• Keep friends and relatives away from the dying person to hog her/him for yourself
• Don’t press your personal afterlife believing and articles of faith onto the dying person
What you can do – naturally:
• Sit still at the bedside
• Hold hands: Touch can still be taken in when all the other senses are long gone
• Give a cold sponge bath – lying unwashed in bed is a horrible burden for many sick people
• Sing. I sang for my first, beloved mother-in-law when she was already unconscious. I think she heard me
• Keep the room warm, aired and uncluttered – at home, in the hospital, at the hospice
• Bring pictures from the past that the person might still enjoy – but only a few selected ones – don’t lug into the sickroom whole photo albums
• Forgive if the person was not what you expected from her/him in the past. He/she had her own history – and you might not know all the essential parts – for instance, how this person was hurt when he/she was young
• Remember the past - as long as the person can still talk. This might be your last chance. But don’t push it – take the cue from the dying person, not from your own urgency
• Zip up a light, delicious meal – or just serve fruit. This is not the time to restrict a person to a diet – this is now pure enjoyment
• Read aloud – if he or she can hear it or not: Share what you like to share
• Tell the person what he/she means to you. Sum up your relationship with the dying person – but not financial problems and time constraints the dying puts on you. Your own stresses (and they might be great and overwhelming) you have to work up alone or with other people in your life. Your own life is on hold while this person moves toward death
• Wash the dying person’s feet. Then rub coconut oil into the skin
• Talk about positive things from the past
• Listen to whatever the dying person has to say – if you like it or not
• Pray if the person wants to pray. Shut up if the person does not want to pray
• Declutter the nightstand without getting nosy or possessive
• Brew an herbal tea: Chamomile, holy basil, peppermint, stinging nettle. – or whatever you have at hand Ask the doctor if there are contraindications
• Endure the impending loss – you can – and will - cry later But you will take satisfaction if you stayed strong when you were needed to be strong. Read More
Blog: On Health. On Writing. On Life. On Everything.
My Hospital Manifesto
October 30, 2011
If I would decide how hospitals are governed (and I don’t), these would be important points for me:
1. Food: Thy food be thy medicine – and vice versa – Hippocrates said. What is served as “food” in hospitals these times, is mostly abysmal and just goes to show that conventional medicine is not interested in really finding out the root cause of disease. In many cases, it is nutrition, stupid!
2. Cafeteria: Same for the place where all the visitors come and eat. It could be an educational experience, instead just another gorging with inferior foodstuff, filled with chemicals, trans-fats, sugars and dairy.
3. Quiet: When I was a child in Germany, and my father was a doctor, he used to take me on his rounds. Hospitals then were very quiet places. The nurses (often nuns) would walk on their rubber soles like on cushions, and they spoke with low voices. The doors to patient rooms were double doors – the patient had privacy and quiet.
4. What hasn’t changed much: That the hospital routine is not geared toward patient recovery but to a ward schedule convenient for doctors and nurses: Then as now patients are pulled out of sleep to measure their temperature or draw blood tests at four am. I would like to see more concern for the patient’s wellbeing than for the organization’s.
5. No TV in patient rooms: My guess is that at least seventy percent of all illness is self-inflicted. It used to be that being in the hospital was a time for contemplation about what brought one there. Not any longer – as TV is squeaking and squealing day and night.
6. Conventional and complementary medicines are BOTH used. There should be no bias toward the one or the other – what has been proven to work should be applied: Hydrotherapy, movement therapy, food, herbal medicine and art, music, journaling, acupuncture, massage, and so on – they all should be used to make patients better. As they are in most European hospital. And paid for by national health insurance. And, no, they are NOT going to be broke …
7. More cleanliness in the facilities. More cleanliness of the patients. Used to be that hospital were spic-and-span places where you could eat from the floor; not any longer. Instead of on cleanliness we trust in antibiotics – to our detriment. Same with patients’ cleanliness: Used to be that nurses washed the patients daily; not any longer. Nurses have gone scientific (necessarily so – but who is now responsible for caring?); the paperwork has become overwhelming. Housekeeping has been out-sourced. And simple ideas like a washing and cleaning have become obsolete. But hospital infections are skyrocketing.
8. More friendliness and caring toward the patient. The patient has become a moneymaking device.
9. Less care and resources to be spent on very old, very sick people in their last days of life – more on pediatric and under-served populations. DNR (Do Not Resuscitate orders discussed with every patient and/or every family). It will lead to savings of money and will allow people to die with dignity.
10. In medical schools, only half of the students should be A+ nerds; the other half should be people who really want to become doctors and patient advocates from all walks of life. We need very brilliant students because they push medicine’s frontiers ahead. But we also need caring primary care physicians. And putting them together in medical school will hopefully lead to a dialogue between them.
As I am thinking more about this, I might come up with more ideas. What would you wish to implement in the hospitals of the future? Read More