The Dying Process....

I was just reading certain passages from a book written by Julia Lawton called the The Dying Process regarding palliative care from patients points of view and her observations certainly gave me much food for thought and confirmed my own feelings and thoughts on palliative care in this country.

I am not 100% convinced by Palliative Care facilities and principles, it seems the best intentions are in theory correct but are left for too much interpretation and scope which therefore means the kind of palliative care service practiced or given varies from either very good or to very bad.

For instance it seems to me that you have those that are elderly and ill seem to be placed in these facilities who are about to pass and you are wondering if this is a nursing home drive through service? Then you have those with terminal illnesses who are still trying to battle their illness and haven't given up on their lives yet but have no choice because there aren't adequate facilities to have them at home or they require a pain management relief which isn't provided at your garden variety public or private hospital, therefore the policy of the public health system is to dump them into a Palliative Care facility/hospice.

This can't seriously be psychologically good for these type of patients. Imagine having a terminal illness and a will to still live? You are still in control of your mind but may have physical limitations and you are forced into sharing a ward and witnessing the public deaths of others? Not only does the person dying before your very eyes lose their own dignity and privacy as a person, but you have to feel their pain and their indignity also? It's very confronting and seems to prolong your own agony. I could only imagine it would feel like dying countless of times.

And please don't give me the well "nurses and doctors see it all the time". Sure they do, they are trained and paid to do this, but they aren't dying themselves, they go home to their comfortable lives knowing they have their health and families. They go home to forget about it. But when its you or loved one seeing this day in and day out, It would be psychologically devastating, and feeling this sort of depression, it would only exacerbate and be deterimental to your own condition.

It seems the feelings of those going through this are second place to the issues of lack of funding, not enough experienced staff, nurses, and very few doctors whom main concern is to prescribe morphine and then their role is done. Palliative care is to provide comfort and pain relief. But does it really? Is changing the diaper of an incontinent patient really caring? How would this comfort a patient knowing why they are in this morbid atmopshere when they are glued to their bed waiting for death and watching the deaths of others? In fact I would begger to differ on the definition of caring in a palliative care setting from my own experiences.

It seems like the terminally ill and elderly are written off and are left to hide from those the medical profession have deemed incurable from society in a geriatric hospice. You're a social leper.

It seems the terminallly ill aren't encouraged to live the rest of their lives as well as they can, When you are cut off from society, you are no longer included or encouraged into society? Palliative Care facilities don't encourage nor do they give hope to those the most vunerable in society. It's all about waiting to die and changing the sheets of the bed for the next victim.

It's no coincidence that terminal patients who are admitted into these facilities deterioate quickly. In a week a patient who could use a walking frame to walk and who could feed himself can a week later, sleep the entire day, need someone to help him eat and is told they cannot leave their own bed. How can one in this setting possibly try and live as well as they can with the little time they have left?

It seems the psychology is that these people are encouraged to depend on and in most cases lacklustre staff or student nurses on medication, being able to go to the toilet and their very own existance on these people, this way they are easily manipulated and taken care of in nursing terms. They lose themselves to another and aren't given the opportunity to truly live the best they can in the sunset of their lives.