Taking care of someone at the end of life is different than taking care of someone who is going to get better. Most people don’t know this, including, maybe particularly, people working in healthcare.
Taking care of someone at the end of life is different than taking care of someone who is going to get better. Most people don’t know this, including, maybe particularly, people working in healthcare. In addition to the difference of care is the fact that most of us don’t have role models for how people die. We have television and the movies, but people don’t die like that. When our patient doesn’t die like what we see in the movies, when they make a strange face or sound, when they don’t say something profound and then just close their eyes, most of us think something pathological is happening and maybe we are supposed to “fix” it.
As managers working in hospice, skilled nursing facilities, assisted living, and even senior communities, part of our job is to educate our employees in end of life care. As mentioned above, most of our staff will not know there is a difference in care. Staff will end up suggesting or even pushing IVs, feeding tubes, unnecessary medications, and providing inadequate pain management for patients.
We must provide staff with information about the dynamics of dying; signs of approaching death that indicate months, weeks, days, hours, and the moment of death. Teach them about the natural progression toward death. Teach them what to do while that progress is occurring. Teach them about nutrition, skin care, pain management, communication skills, what to do at the moment of death, AND what to do following the patient’s death.
To retain staff you must not only teach skills for end of life care, but provide self care tools for your staff also. When all of your patients die, or a good number of them, healthcare workers need to know how to take special care of themselves. Monthly staff support meetings and developing a buddy program are a couple of ways to help in retaining and keeping your staff healthy.
Not only will hands-on care employees benefit from this knowledge, but so will management and even owners and office staff. An overall understanding of end of life care, how it is provided and why, will make for a more harmonious and quality driven workforce. Most importantly, patients and families will be receiving appropriate, high level care.
I have spent my career educating people about the dynamics of dying. Working with HCP, we have created a “This is how people die and here is what you do to provide care” course. It is relatively short, easy to understand and addresses the questions, “what is happening” and “what can I do while it is happening” when we are caring for someone who is dying.