Death and Dying

Dealing with Death

Death is an unavoidable part of life that affects everyone in some way at some point in their live, whether we experience death from the passing of a loved one, a close friend, or simply someone we worked with.  The grieving process is what we all go through just after the death of someone close.  Bereavement is the state or condition caused by loss through death.  Grief is the sorrow, hurt, anger, guilt, confusion, and other feelings that arise after suffering a loss.  The way in which we express our grief is called to mourning.  (Cavanaugh & Blanchard-Fields, 2010).  There are four main aspects of grief that people must go through to accomplish the process of coping with a loss: the reality of the loss, the emotional turmoil, adjusting to the environment, and loosening the ties with the deceased.  It is much easier to go through the grieving process when the death is expected, when the death is unexpected it becomes much more difficult to handle.  (Cavanaugh & Blanchard-Fields, 2010).  One to two years is a normal amount of time for someone to grieve after the death of someone; however this time period may vary with the person, depending on specific factors like age and closeness to the deceased.  People deal with death in different ways.  In United States, we hold events that are meant to celebrate the passing of the person, such as funerals, wakes, and memorials.  After these events people tend to remember the individual in a number of different ways.  For example, some individuals carry an object around as a reminder of who they have lost.  The best way to deal with the loss of a loved one is to surround yourself with other loved ones and friends.  (Cavanaugh & Blanchard-Fields, 2010).  Surrounding yourself with loved ones and close friends helps with the grieving process by knowing there are still people involved in their lives and to help them remember the good times that were shared with those who have passed rather than sitting around wishing they were still alive.  Often when an individual passes away there are many different kinds of resources to aid in the processes of death and grieving.  At Maple Crest there are pamphlets on how to deal with death and what they are experiencing and how to accept it and move on, such as, As death Approaches and When Death is Near.  There are also experienced people to talk to, to aid in the process and help get them through the tough times being experienced. 

 

References

Cavanaugh, J. C. & Blanchard-Fields, F. (2010). Adult development and aging. Belmont, CA: Wadsworth. (Cavanaugh & Blanchard-Fields, 2011)

Death and Dying at Maple Crest

            Death and dying are things that are unavoidable when working at a nursing home. While death is a normal process of life, it is something that is very uncomfortable for people to talk about.  By treating death as a taboo topic, we don’t allow ourselves to make peace with the end of our lives.  This cheats individuals of the opportunity to make plans at the end of their life and to have an open dialogue with family members about end of life plans.

A term that is used by researchers is “good death”.  Now the term good death may be confusing because normally when thinking about death we only think about sadness. The term good death refers to when a person is not only kept free of pain but retains a high measure of control, autonomy and independence over his or her fate (Scarre, 2012). He or she retains the ultimate say over what treatments should be administered, and when those treatments should stop (Scarre, 2012). A dying person should be enabled, wherever possible, to make her final dispositions as she wishes, and attain a state of bodily and mental peace (Scarre, 2012). Maple Crest does a good job of giving residents a voice by allowing them to have a say so in their treatment plans (if they are cognitively fit) and in the daily activities that they participate in.

At St. Joseph’s Hospital Health Center in Syracuse, New York, they have instituted a program called “Seeds of Hope” (Kowal, 2013).  This program was instituted by a nurse named Susan Baum who through her own personal experience of losing a loved one and the culminating professional experiences of witnessing numerous natural and imminent deaths of critical care patients throughout her career (Susan Baum, 2014). As a part of this, program patients receive handmade blankets from the hospital volunteer group.  Family and friends honor their passing loved one by personally making handprints of them that are laid over poetry created by the staff.  All families receive Forget-Me-Not seeds that are packaged with an appropriate poem or prayer.  Along with the handprints, some families have asked for locks of hair and ventilator water (representing the last breath of their loved one).  Families stay and reminisce around their loved one while sharing a meal or conversation.  Every family receives a bereavement guide as well as personal mailings from staff-of words of encouragement and counsel-for up to one year after their loved ones passing (Susan Baum, 2014).

            Maple Crest also addresses the needs of the family members of their residents by providing them with them with “Care Notes”. Care Notes cover a variety of topics such as getting through the first week after the funeral, grieving the loss of your parent, sources of strength after the death of a spouse and using good memories to help heal grief among other topics. Through care notes, family members are able to prepare themselves for the death of their loved ones and how to deal with some of the emotions that come with death process.  Care notes also help family members realize that the feelings that they are feeling are normal after the loss of someone that they loved and cared deeply about.

          

 Death and dying are two topics that many people are uncomfortable talking about. Maple Crest however finds a way to address this topic with its residents and their family members. By providing the residents with a sense of self control in their lives they are allowing them to face death on their terms and thus create an environment where they can die in peace. In addition, by  providing their family members with the Care Notes, they are also helping them prepare for the death of their loved ones. By implementing some of the aspects of the Seeds of Hope program Maple Crest will able to take their death and dying care a step further and provide residents, family members and staff with appropriate care when dealing with death and dying.

 

References

Kowal, C. (2013) Helping your patient's family deal with death. Retrieved from http://www.nursetogether.com/helping-patients-family-deal-with-death

Scarre, G. (2012). Can there be a good death? Journal of Evaluation In Clinical Practice, 18(5), 1082-1086. doi:10.1111/j.1365-2753.2012.01922.x

Susan Baum (2014) Retrieved from http://daisyfoundation.org/daisy-award/daisy-nurses/2011/10/baum_susan

 

 

Social Cognition and Meals at Maple Crest

For nursing home residents socialization is a big part of daily life. The increased percentage of depression in adults over 55 is not an unavoidable part of aging but something that positive social interaction can help to stave off (Margrett, et al., 2010). In a review of a study concerning depression in the elderly (Margrett, et al., 2010) suggests that in those nearing 100, an appreciative view of their maintained abilities can lead to a more positive outlook overall This indicates that positive interactions where residents focus on what they can do rather than what they can’t are powerful in keeping them mentally engaged.

            At Maple Crest breakfast, lunch and dinner are served “family style”. This gives each resident not only the power of choice but the opportunity for essential interactions with peers and staff. In many households the dinner table has traditionally been the gathering place for all occasions. Likely many residents can recall passing stories around the table along with the main dish. Instead of an unfriendly and alienating cafeteria atmosphere, the dining area at Maple Crest includes large circular tables situated to allow for clusters of residents to gather around and share a meal together.

            For many, there is no precedent for interactions in nursing homes. When confronted with new situations people tend to fall back on previous experiences, using what they have experienced in the past to base new interactions off of or social knowledge (Cavanaugh & Blanchard-Fields, 2010). While being confronted with a whole new way of life and having no social knowledge to rely on for many interactions could be depressing, the simple act of sharing a meal together can give comforting context to many residents. Similarly, when individuals are accustomed to forming their own menus and determining their own meal times, it could be distressing to move into a new facility where this is predetermined. While it is necessary to have some of these factors set up ahead of time in order for cooks and staff to orchestrate dining for all residents, Maple Crest provides as many options as possible in order to give each resident their own choices. Every lunch and dinner comes with several options which can be put together in several ways resulting in a number of different meal combinations available to each individual. The power to choose between chicken or beef, yams or mashed potatoes, and baked beans or mixed veggies all in one meal is significant when depending on others for many other tasks in one’s life. Maple Crest has done a remarkable job of offering options and comfort simultaneously, creating daily opportunities for the mental enrichment of all their residents.

References

Cavanaugh, J. C. & Blanchard-Fields, F. (2010). Adult development and aging. Belmont, CA: Wadsworth. (Cavanaugh & Blanchard-Fields, 2010)

Margrett, J., Martin, P., Woodard, J. L., Miller, L. S., MacDonald, M., Baenziger, J.,…& Poon, L. (2010) Depression among centenarians and the oldest old: Contributions of cognition and personality. Gerontology, 56, 93-99. doi: 10.1159/000272018