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The dying process handled with dignity and finesse

Patient Spotlight May 15, 2018 By Carrie Dougherty, MSN, CRNP

Like her father, Mrs. Miller developed cancer at a young age. She and her husband were divorced, but shared a teenage daughter. It was a complicated family life, as Mrs. Miller recently entered a new relationship.

While in the hospital, Mrs. Miller felt tired and weak, and it became clear that she was actively dying. Our palliative care team was asked to see her. Mrs. Miller’s daughter was quickly summoned to the hospital, where she was joined by her mother’s boyfriend. Her daughter did not realize that her mother’s death was so close. When her family arrived, Mrs. Miller appeared restless and tried to get out of bed.

The palliative care nurse practitioner handled this gut-wrenching situation with finesse. She knew that they all had a complicated family life, but also knew how important it was for them to be together. She explained to the family the details of Mrs. Miller’s care and what they could expect. She and Mrs. Miller’s nurse worked together to find the right combination of medications to keep her comfortable, but that also allowed her to be present with her family. The palliative care nurse quickly entered orders so that Mrs. Miller could officially be admitted as a hospice patient to ensure the family would have access to bereavement resources.

Mrs. Miller was too exhausted to speak—or maybe she just couldn’t find the right words. She held hands with her daughter and provided reassuring grips when she could. The chaplain was a vital member of her care team—she gave hugs, exhibited an empathic demeanor, and suggested that they play some music to reduce the tension in the room. Mrs. Miller’s daughter recommended one of her mother’s favorite songs. Mrs. Miller lit up and nodded her head to the music.

The chaplain selected a beautiful handmade quilt among those that are donated to hospice patients by the Women’s Board. She placed it over the foot of Mrs. Miller’s bed and offered it to her daughter as a keepsake. She asked Mrs. Miller and her daughter if they wanted some time alone. They said no initially, but eventually, the rest of the family stepped outside and gave them some time together. Mrs. Miller’s daughter showed courage and love despite the fact that she had a strained relationship with her mother’s boyfriend. She acknowledged that her mother wanted him there and that it was alright.

The chaplain returned and asked Mrs. Miller if she wanted to see a clergy member. She nodded yes, and a priest was called. Mrs. Miller and her family held hands together, said the Our Father, and then she received last rites shortly before her last breath.