-
16. Care for Chinese Families with Patients Facing Impending Death: Nurses' Perspectives
- Hong Kong University Press, HKU
- Chapter
- Additional Information
16 Care for Chinese Families with Patients Facing Impending Death: Nurses' Perspectives AmyYinManCHOW,JessShukFunLO,WendyWaiYinL Iand CarmenYuekYanLAI Introduction The hospita l i s an amazin g place where mos t o f us are born . I t is suppose d to be the place for quic k fixes when we are injured o r sick. Advanced medica l technology ca n sav e lives and reliev e human sufferin g mos t of the time . Yet, this miracle place may fail us when patient s die. Though deat h i s a certaint y of life , no t ever y on e o f u s acknowledge s thi s fact . Afte r hearin g th e ba d news1-4 of a life-threatening illnes s or injury, th e family an d patients have t o face an d prepar e fo r impendin g death . The tim e betwee n hearin g th e ba d news and death is the most precious moments in one's life. Nurses are usually around th e patient s an d familie s durin g tha t crucia l period . The y pla y a significant rol e i n helpin g th e famil y t o us e thi s valuable time . When th e families d o not properly use this special time, they might hav e great regret s during bereavement . There were 34,316 deaths in Hong Kong in the year 2002. The first thre e causes are cancer, heart disease and cerebra l vascular diseases, accounting fo r 11,658, 4,06 9 an d 3,21 8 death s respectively . Althoug h th e majorit y o f th e deceased were elderly people, 8,096 were under th e ag e o f 65, about 23.6 % of the tota l death rat e i n 2002. 5 As most deaths i n Hong Kon g take place i n hospitals, nurse s ar e i n clos e touc h wit h th e familie s o f patient s wh o ar e confronting death . This chapter focuses on what nurses can do to help families cope with death. The principles in psychosocial support in palliative and end of -life car e ar e being adapte d i n acut e setting s and ar e calle d a CDE mode l (explained later) . Deathsi nHospital s In Hon g Kong , th e majorit y o f death s tak e plac e i n hospitals . Even peopl e who appea r t o have die d fro m a sudden illness , accident, o r fatal injur y ar e 226Amy Yin ManCHOW et al. still sent to the accident and emergency rooms (A&E) . A declaration o f deat h will take place i n th e acciden t an d emergenc y room i f resuscitation fails , o r in intensive care unit (ICU ) i f the patient dies there. Thus the family member s have to digest a lot of bad news within a short time. Different famil y member s express shoc k an d grie f differently . Som e resor t t o shaking th e decease d o r slapping the face, hopin g t o wake the person up . They might scold the dea d body loudly, blaming him o r her for no t takin g good car e of him o r herself . Some may cry or yell, banging their head against the wall or performing othe r self-destructive act s t o comba t th e numbnes s an d pain . Sometimes , th e bereaved migh t even faint afte r receivin g the news of the death. Some resor t to religious actions such a s kneeling and prayin g loudly for resurrection , o r bargaining fo r recovery . Lastly , some ma y direct thei r frustratio n t o health care professionals , includin g verba l complaints , scolding , cursin g o r eve n aggression. Th e famil y migh t no t b e cooperativ e with standar d procedures , especially the last office.* The y perceive sending the deceased to the mortuar y as the fina l farewell . Nurse s are tor n betwee n th e regula r demand s o f thei r duty in th e wards...
