Lancaster Physician Summer 2021 - 13

SUMMER 2021
- I would like to be sure I know what kind of
medical care will help you focus on the things
that are most important to you. Can we plan
to take some time at our next visit to talk about
that? Is there anyone else who should be here for
that discussion?
Patients should provide a copy of their
advance directive to members of their family
and their physician and be sure that it's added
to their medical record. Advance directives may
be changed throughout a person's life, so it's
important for physicians to periodically discuss
this with their patients.
Starting the conversation early with patients
indicates that they are open to talking about
their end-of-life options at the appropriate time,
making it a more comfortable conversation for
everyone involved.
HAVE OPEN AND HONEST
CONVERSATIONS
When a life-limiting diagnosis is given,
most patients understand what this means and
are grateful for their physician's honesty. It is
important to redirect patients' focus from a cure
to discussing their end-of-life goals and wishes.
Physicians should let patients know that they
are there for them and that there are options
available, such as hospice and palliative care, to
help enhance their quality of life.
Here are some examples of what to ask
patients to learn more about their end-oflife
goals:
- When we know that time is getting
shorter, some things take on more importance
than others. What are the most
important things for you looking ahead?
- I want to help you make a plan for your care
that will be right for you and for your family.
Would you tell me about what kinds of things
worry you, looking ahead?
Having answers to these types of questions
will help physicians determine a patient's best
plan of care.
AFTER THE CONVERSATION
Sometimes the loss of patients may have an
effect on your staff. It is important recognize
how they are feeling emotionally, mentally,
and physically.
When someone in your workplace experiences
a loss, it will affect all who come into contact
with that co-worker. If you are one of those
people, you may feel uncomfortable or perhaps
uncertain. " What should I say? " is a common
question. Some co-workers experience feelings
It is also important to encourage patients to
talk with those who will be involved in their
care, such as a family member or friend. Many
times, these individuals are already the patient's
medical power of attorney; having them involved
in the conversation will ensure that they, too,
know what their loved one wants if unable to
speak for themselves.
SHARE THE BENEFITS FOR END-OF-LIFE
CARE EARLY IN AN ILLNESS
Understanding the changes that occur during
the dying process is complex. Hospice providers
are here to help physicians and can add an extra
layer of support and education for patients and
their families. When hospice providers and
physicians work together early in a patient's
illness, it allows the individual to focus on what
is important at a very vulnerable time in their
lives. The team provides guidance and support
through the many facets of a patient's illness -
symptom management, disease process, and
emotional and spiritual support.
Some ways to explain the benefits are:
- I understand that you want to be in the comfort
of your own home with your family. When
you receive hospice care early in your illness, you
and your family will have the things you need,
including access to a nurse 24/7, to avoid an
emergency room visit or hospital admission.
- When you receive hospice care, I will remain
involved in your care and work closely with
hospice staff to ensure that your hopes and wishes
are honored.
* Cards, phone calls, hugs, and lunch
dates can mean a lot.
* Know that each person grieves
differently - avoid judgments.
* Allow the tears and don't turn away.
Training and online resources, such as those
through Hospice & Community Care's Pathways
Center for Grief & Loss, are available
for physicians, practice teams, and patients.
of helplessness. What matters most is not what
you say but the fact that you care. Comfort
comes not from words but from emotion,
expressed and received. Without emotion,
the most you can offer someone is advice, and
advice is not what someone needs when they
are grieving. Your willingness to show that you
care is what's best.
Grief is a natural, healthy response to loss.
Mourning is the way you express your feelings
of grief. One needs to feel safe and accepted to
be able to mourn. It is a process that takes many
months. Your acceptance of your co-worker's
feelings - whatever they are - and your
willingness to listen will help your co-worker to
mourn. It is the best gift you can give.
SOME WAYS TO HELP YOUR
CO-WORKER ARE TO:
* Be willing to listen.
* Avoid clich├ęs ( " At least he didn't
suffer " or " I know how you feel " ).
* Don't avoid the person.
* Be sensitive for months to come.
* Don't offer advice - just listen.
* Offer to share the person's work load,
if possible.
TO LEARN MORE ABOUT END-OF-LIFE CARE AND GRIEF SUPPORT,
PLEASE VISIT HOSPICEPROFESSIONAL.ORG OR CALL (844) 422-4031.
LANCASTER 13 PHYSICIAN
http://www.HOSPICEPROFESSIONAL.ORG

Lancaster Physician Summer 2021

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