How many of you have had an experience with someone’s who’s dying?
Dr. Beth Barba posed that question to the 40 or so attendees of the first LIHC Food for Thought talk in October. Each Wednesday, all students, faculty and staff are invited to come learn about an interesting topic while enjoying a light lunch in the Faculty Center.
Barba (Nursing) noted her area is largely gerontology. UNCG’s interdisciplinary Gerontology Program is particularly strong. In the School of Nursing, she and Dr. Laurie Kennedy-Malone, who leads the Geriatric Nurse Practitioners Program, are among the 18 or so of its faculty members who have expertise in geriatrics, according to Barba.
Surveys of nurses in the workforce tend to show the nurses wish they’d been taught more about how to interact with and talk to those who are dying and their families.
“I do teach a 500 level course on end-of-life care. I’ll teach it this summer – all online. An elective,” she told the Nursing upperclassmen in attendance.
What do the dying and their family members want, when nurses – or any others – speak with them?
Information. A way to maintain a sense of control. To disclose feelings. A need for meaning. Hope.
What do they hope for? Perhaps an afterlife. Perhaps assurance that their life has held meaning. Perhaps a comfortable death.
She noted older adults often have no time for frivolous talking. They’ll cut right to the chase.
On the other hand, an exercise Barba led halfway through her talk was enlightening. The audience broke up in pairs, each role playing. One listened for two minutes while the other described a loss of some sort. And vice versa.
Opening up took a while, some discovered.
Barba noted that’s often how it is, when you speak with a person approaching death. Just be an active listener, she said, showing that you care. “Put yourself in the moment. And being silent is good. Provide serenity.” That could mean anything of a spiritual nature, whether overtly religious if that’s requested or perhaps turning the bed so the person can face out the window. Singing with them or for them can be serene as well.
“Be there, on their journey. You go where they are.”
And Barba gave a tip to ensure the individual goes ahead and says what they want to say – and doesn’t hold back. Say “I have [whatever] minutes. I’d love to come in and sit.” The person will open up to you more quickly.
She made an analogy. “It’s like therapy. You know you have 50 minutes.” The person won’t wait until the 49th to start talking.
“I would just sit. Sit quietly,” she said.
“The person will eventually say what they want to say.”
You might encourage them to tell their stories, if they wish, by asking an open-ended question. And keep in mind that the person dying could be feeling guilt – if for example, they thought their smoking led to the lung cancer. Or they might feel fear. Non-acceptance. Anger.
Physicians are focused on cures, Barba said. “We want them to be.” Dealing with the needs related to dying is often left to the nurses.
People in America don’t die at home much, she noted – they die primarily at nursing homes and also at hospitals and Hospices.
“People want to die at home,” she said.
They have a need to be surrounded as they die by people who care for them.
A writer for Hospice once said the dying and family members have five things that should be expressed to each other:
- I love you. “You can never say that too much,” Barba said.
- I forgive you.
- Please forgive me.
- Thank you.
By Mike Harris
Photography by Mike Harris