Good Dead

Introduction

Denying death is natural, and it may even serve as a healthy purpose when we are young, but this denial often becomes harder to maintain when we become older, especially when we are sick and have watched our love ones pass away. The reasons I choose this topic to write about is because I want to know if one day someone I know is suffering a terminal illness, what should I need to be aware of and what I need to do to make the process easier to bear. In many Western countries today, a deeper recognition for the need to improve end-of-life care is gradually emerging. It has been argued that technological advances in medicine have obscured the need for human compassion for the dying and their loved ones. There is also a growing public demand for a more holistic, integrated approach toward health, illness, death and dying.

Nature of Dying

Dying is a nature human process, Sir Francis Bacon once quote that "It is as natural to die as to be born." (Francis, 2004) Which is true because we cannot escape the dying process in our late life and it is hard to deal with physically and mentally. Therefore, how to face the end of life appropriately is consider as one of the most important issue in healthy aging.

Medical view

In the medical view, the body begins the final process of shutting down, there are certain signs of imminent death, "Decreased social interaction - sleeps more, acts confused, coma. Decreased food and fluid intake - no hunger or thirst. Changes in elimination - reduced urine and bowel movements, incontinence. Respiratory changes -irregular

3

breathing, "death rattle". Circulatory changes - cold and grayish or purple extremities, decreased heart rate and blood pressure." (Symptom management, 2003) It will end when all the physical systems stop to function - Death. The sighs of death are "Breathing stops completely. Heart beat and pulse stop. Totally unresponsive to shaking and shouting. Eyes fixed in one direction, eyelids open or closed. Changes in skin tone - white to gray." (Symptom management, 2003) This is an orderly process of physical changes and these physical changes are a normal, natural way in which the body prepares itself to stop.

Holistic View

The other dynamic of the dying process is on the emotional or spiritual symptoms. In the holistic view, the dying symptoms are "Withdrawal. Vision like experiences (dead friends or family, religious vision). Restlessness. Decreased socialization. Unusual communication: out of character statements, gestures, and requests.) The spirit of the dying person begins the final process of release from the body and its immediate environment. This release also tends to follow its own priorities, which may include the resolution of its unfinished business and reception of permission to "let go" from family members. These events are the normal, natural way in which the dying person spirit prepares to move from this life into the next dimension of life. The most appropriate healthy aging responses to the emotional or spiritual mental changes are those which gives support and encourage this release and transition.

The needs of the dying individual

Dying people are still alive and it may takes weeks, months, or years. They have needs in both medical and mental. According to the hierarchy of the dying person's needs

4

in the text, "To be free of pain, to conserve energy, and to obtain relief from physical symptoms" (Toward Healthy Aging, Pg. 668, 2004) rank the highest in the dying person's needs. I will talk about the pain management in medical and holistic approaches at the following because which is the main concern for the dying person.

Pain control (medical approaches)

Certain life threatening illness are very painful, there are medications to control special pain problems. The first thing to do is determine the cause of the pain by history and examination to find out where and what type the pain is. For the mild to moderate pain, it can be relieved by a mild painkiller such as "aspirin and paracetamol or acetaminophen combined with a narcotic such as codeine." (Symptom management, 2003) The disadvantage of it is expensive and it may cause the patient constipation. If pain becomes severe, more strong narcotics such as morphine may become necessary. There are some misconceptions about the use of morphine, such as it will become addicted and once they are used, nothing else is available. The fact is "addiction to morphine that are given for pain control is extremely rare." (The encyclopedia of health and aging, Pg. 278, 2001) The patient who needs to increase doses of morphine is usually due a worsening of their illness. Also "if a person needs to come off a narcotic drug, this can be done safely under medical supervision." (The encyclopedia of health and aging, Pg. 278, 2001) Therefore when the person uses morphine as their pain control medicine, they will not addict to it if under the doctor prescription. This disadvantage of morphine is it can cause the patient become sedated and unable to communicate. When morphine is first given to the dose is increased, the patient may experience "confusion or drowsiness, decreased

5

alertness, and trouble with decisions." (Symptom management, 2003) However, as the patient body adjusts to the drug, these effects will be subsiding within 48 to 72 hours.

Pain control (holistic approaches)

Feeling of anxiety, despair, loneliness, and a sense of losing control can intensify the physical sensations of pain. Providing emotional support is an important aspect of pain control, because when "emotional needs are not met, the total pain experience, physical and psychosocial, may be exacerbated or intensified." (Toward Healthy Aging, Pg. 669, 2004) The holistic pain control approaches includes "empathetic listening and allowing the dying person to verbalize what is on his or her mind are important intervention." (Toward Healthy Aging, Pg. 669, 2004) Tell the dying person we love him and believe he love me too. Forgive any past estrangement between you and the dying person and ask for his forgiveness too. Giving permission to the dying person to let go, without making him feel guilty for leaving us is one of the greatest gifts we have to give him at this time. If he has religious belief, tell him that God will continue to support him after he is gone and we will meet