Terminal Care

My profession as a nurse for the elderly was very much influenced by dying people. One develops a procedure to let the process run in a dignified manner; one looks for people who can be there, whether from the family or from the staff. The farewell after death should also be dignified. The deceased person has led a life, like all of us, with all its varying mistakes and confusions. Whether the person had a good life or not, we can’t judge. Every dying person has to decide that for himself or with a pastor or some other person. Professional care can only provide the basic conditions and sit for a few hours before the other residents or patients call and have to be cared for.

As a manager of an old people’s home, it was always important for me to play an active role so that there was an understanding in the house of what is important during the process of dying. Sometimes it was difficult when employees pointed out their workload and complained that they could not provide this important service to the resident. Rarely, but often present, there were employees who seemed to have no empathy with the elderly or the dying. For them, the door had to be closed. There were also relatives who tried to discuss objectively the procedure after death, although dying resident would rather have had their hand held, or hear the voice of their relatives.

How to prepare such situations was a topic I often discussed with staff. I noticed that it is possible to arouse commitment with the staff by making a plan. Often enough, the committed employees were disappointed because other employees did not stick to the plan or because relatives frustrated all arrangements. But if it worked, the experience was different, and everyone was happy. Teaching reverence for the dying is not so easy, but that’s what it’s all about. You need time for preparation and time during the process. You don’t find time when there is no reverence for the dying.

In my last employment there was no time, and therefore no reverence for the dying. I died a little bit each time I heard how the death of a resident had happened, or how the memory-service was conducted. There were some employees who tried to keep up the commitment, but for many, there was no time. I had the feeling that I had failed because the commercial tasks had occupied me so much and I didn’t find the time to actively help shape this important area.

I think many people expect residents of an old people’s home to die in a hospice-like situation, but too many are still being delivered to the hospital to die because the staff does not receive support. Part of the reason is that nursing care for the elderly has become a profitable business. Another reason is that idealists like me tend to run themselves into the ground.

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