I am a nurse in a hospice. Do not say these sentences to a dying person

Akash Arjun

Global Courant

Dying is an inevitable part of life. Although it happens to everyone, death is not often talked about. It remains a taboo for many people, surrounded by fear and uncertainty. The way death is portrayed in movies or television isn’t always accurate either.

As a result, there are many widespread misconceptions about death and people dying, Hadley Vlahos, a registered hospice nurse who lives in the New Orleans area, tells TODAY.com. Vlahos breaks down some of these myths and talks about the reality of death in her new book:The In-Between: unforgettable encounters during life’s last moments”, on Tuesday, June 13.

While we tend to avoid discussing death, most people tend to be curious and have questions, says Vlahos. “I certainly don’t have all the answers, even though I’ve seen death enough times that I have a general idea of ​​what to expect,” she writes.

What are some common misconceptions about the dying process, hospice, and death?

MYTH: Death comes suddenly

While sudden and unexpected deaths do happen, dying (especially in old age) often happens more slowly and gradually than people realize, explains Vlahos. “The vast majority of people die from a terminal illness, not an accident,” says Vlahos.

A terminal or end-stage disease is one that is incurable and will inevitably lead to death — examples commonly seen in hospice patients include cancer, heart disease, Alzheimer’s disease, and chronic obstructive pulmonary disease, says Vlahos.

Some patients deteriorate rapidly, but in most cases dying is more of a process than an event, explains Vlahos. That process can begin much sooner than one realizes. “Our bodies will gradually begin to shut down. … A few months in advance, we start to see people eat a little less or sleep more … and really just get a little tired of daily activities.

In the final days before death, says Vlahos, people often sleep most of the time and may stop eating or drinking. They can go into a “semi-comatose state,” she explains, before they stop breathing.

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“Our bodies naturally know how to (shut down). … It’s like our bodies know how to give birth; our bodies know how to die and they will do it on their own,” says Vlahos.

MYTH: Dying is always painful

Pain need not be part of the dying process, notes Vlahos. However, the illnesses or conditions that precede a person’s death can cause painful symptoms. Fortunately, these can usually be managed.

The goal of a hospice is to make the dying process as comfortable and painless as possible, says Vlahos. This may include pain medication, supportive care such as oxygen and fluids, and mental health or social support. In many cases, Vlahos says she sees patients become very calm and peaceful in the hours before death.

“It’s ultimately up to the patient and their family, but we don’t have as many restrictions on giving painkillers so we can make patients comfortable,” says Vlahos, adding that the goal is to help patients relax and improve their quality of life to improve. when it ends.

However, Vlahos warns against the myth that hospice care involves administering lethal doses of pain medication, which is false. “We don’t give that big of an amount, and there’s a big difference between what can take away pain and what’s enough to kill someone,” she says.

MYTH: Death is a medical event or failure

“The reality is that it is impossible to avoid death,” says Vlahos. Despite this, death is still seen by many as a failure of the medical system or a medical event rather than a natural occurrence, even if an illness is terminal.

“If it’s going to happen, no one can escape it,” she adds.

Vlahos says she often sees this in the language people use around terminal illness — “when people say, ‘I’m praying for a miracle,’ or ‘Don’t stop fighting’… people,” Vlahos says.

She says patients and their families will often tell her that such expressions are actually “very demotivating” because they make them feel like they’re giving up or doing something wrong by accepting the possibility of death.

“In my opinion, it is how it should be to let a patient (die) on their own terms. … In my opinion, you are taking your life back,” says Vlahos.

MYTH: Hospice is only for people who are about to die

“Many people think that hospice is only for people who have a week or a few days left to live, and that’s not true,” says Vlahos. “We can include people who clinically have six months or less to live, as determined by a physician…but it’s not an exact science,” she adds.

Even if people have more than six months to live, Vlahos says, hospice can help them become more comfortable and empower them to make decisions about end-of-life care. “We can get to know them so that when it’s time (to die) we know their wishes and can make sure they have the most peaceful death possible,” says Vlahos, adding that she’s even had hospice patients for over a year see life. year.

“People think that once you’re in hospice you can never get out, but you can come to hospice, change your mind and get off and come back,” Vlahos says. “It’s not a prison.”

Hospice patients can live on their own terms, says Vlahos, which includes enjoying their favorite activities, food, and drink (or even the occasional alcoholic drink, if safe to do so).

Hospice care also does not have to take place in a hospital or institution. “It is not necessarily a place or site. Hospice is a service that comes where you are,” says Vlahos. This can be in a hospital or nursing home, but also at a patient’s home or with a loved one.

MYTH: Hospice speeds up the dying process

Another common misconception is that hospice speeds up the dying process. There’s no evidence that hospice care accelerates death, says Vlahos, adding that she often sees terminally ill patients live longer than originally expected after moving to hospice care. “Studies have shown that people can live up to 20 days longer in hospice when you look at the differences between patients with the same illnesses,” she adds.

At the root of this myth is another misconception, says Vlahos, namely that opting for hospice care means giving up. “In reality, it’s just a different kind of treatment. … We don’t give up on people. We are still providing care. We just focus on comfort rather than healing,” says Vlahos. Hospice care still includes some procedures, such as catheter insertion or wound care, she explains.

“Many people who have a terminal illness and have been in a hospital for a long time feel like they have given up control…of power and beauty in that,” says Vlahos.

MTYH: Dying people see light at the end of the tunnel

Fact: The most common vision for death is no light at the end of the tunnel

What a person sees, hears and feels in the moments before death can vary greatly. According to Vlahos, it is common for people to experience end-of-life visions or hallucinations in the last days or hours. However, most of these aren’t the stereotypical “light at the end of the tunnel,” she says — instead, they’re often visions of deceased loved ones, especially parents or spouses.

“It’s a common, inexplicable medical phenomenon that we see, as well as the wave of energy (before death),” says Vlahos, adding that visions of deceased loved ones can occur in all patients, regardless of religious or spiritual background.

Dying patients can interact with their deceased loved one as if they were in the room, says Vlahos, while simultaneously interacting with living people in that same room. “I often feel like I’m with people when they’re between two worlds,” she notes.

Often, people will describe their deceased loved ones coming to get them to go on a trip or go on a trip together before death, adds Vlahos. “It’s a certain peace that can’t even be explained in words.”

This article was originally published on TODAY. com

I am a nurse in a hospice. Do not say these sentences to a dying person

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