End of life care – training makes all the difference


It’s interesting in that two different news stories hit my desk this week.  One was a Wall Street Journal “Ask the Experts” column titled “How can we reduce end-of-life health-care costs?”

The other was an article published online in the Journal of the American Medical Directors Association (JAMDA) titled “Attitudes toward Death, Dying, End-of-Life Palliative Care, and Interdisciplinary Practice in Long Term Care Workers.”  Both articles address something that will become increasingly in the forefront of our national awareness: how we view end of life.

Dr. Kathleen Potempa, interviewed in the Wall Street Journal story says, “We have to become comfortable with the difficult conversations around death and advanced care.”  She notes that we spend a lot of time focusing on birth, but little time focusing on making death an equally beautiful part of the life cycle.

The authors of the JAMDA article note that there is a marked difference in the attitude toward death between skilled care providers and the hands-on caregivers regarding the care of the person at the end of life.  While the professional staff were consistently positive, the hands-on caregivers were more often negative about care and the dying resident.

And while most of us, if asked to ponder the question, would say we’d prefer to die at home without an array of medical devices around us, this is often not the case in today’s society.  Individuals often spend their last days in care facilities, hospitals or other institutional settings.

One way to start the trend toward better care at the end of life is to improve the training we provide those hands-on caregivers.  Help them understand that more isn’t always better; that comfort and reassurance are, in fact, the best medicine for many during their last days.

Give them the skills to understand pain better, too, so that they can know to watch for non-verbal indications of pain and appropriately report these for quick relief.  Teach them the things they can do to sooth, comfort and relieve pain without needing additional drugs and prescriptions.

It’s time to talk about end of life care, and even more importantly, it’s time to teach caregivers about it too.

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