what can I read about dealing with death and family of the dying

[Grnrn]

Hi all,

I am not a hospice nurse but need help with dealing with dying patient and family. I am planning to work in acute hospital setting (cardiology). While feeling deep sympathy for the patients and their family during the moment of patients' death, I am very awkward when it comes to the final moments and soon thereafter.

Can anyone recommend good literature (book or articles) about what exactly to say and do or not to say and not to do? Is there some sort of practical guide that I can use?

Thank you in advance!

[talaxandra]

I think it's great that you're thinking about this ahead of time :) We live in such a death-averse society in general, and this is in some ways more pronounced in health care.

You might find this link useful for finding books that address your needs.

A couple of suggestions

- never give families a timeframe for death. I usually say that everyone's different, that I have a better idea the closer it is but that I've been wrong often, and that I think it won't be long now if it looks imminent;

- I always tell family members who are thinking about leaving (for a coffee or for home) that sometimes patients wait for the arrival of a family member, or for a special date to pass, and sometimes they wait to be alone or for just wstaff to be in the room, so if the patient dies while they're away that may have been the patient's preference. It's also what my grandmother did, adn I tell them that, too;

- it's okay for you to be upset when your patients die, and it's okay for families and patients to see that you're distressed, too. Just don't be more distressed than the family!

[DLS_PMHNP, MSN, RN, NP]

"Final Gifts"

It is written by 2 RNs. Best Hospice read in my opinion.

[tewdles, RN]

Good luck to you, thank you for taking the time to prepare yourself so that you will be therapeutic for the family.

I would always recommend Dr. Kubler-Ross, her work is dated but remains valuable. I also like "Handbook for Mortals".

[AtlantaRN, RN]

"what dying people want" is a great book.

[Grnrn]

Thank you all for your posts and tips.

I am familiar with Kubler-Ross. I had read "On Death an Dying" while caring for a patient with ovarian CA in home care. Although I loved her approach, philosophy and writing, I do not remember there being specific tips on what to do. I shoudl still skim through her book again though. I have already reserved the Final Gifts at my library! More on the way! :)

[melsch]

I will second Final Gifts. That is a great book, and one of the few non nursing books on death I have actually read.

[talaxandra]

The great thing for me about Kubler-Ross is that helped me better understand why people (patients and family) respond in such varied ways to death and dying. I tell my patients that I understand it can be hard to express anger, sadness and other emotions to family, as the patients often feel as though they need to be brave for the people they love, but that they're welcome to express those emotions to me, and I promise not to take it personally. I also learned through experience that people rarely progress in an orderly way through the stages, skipping some, revisiting others, and sometimes sticking with one thing for the duration, and that that's okay.

[davebigs]

As someone said previously, the definitive work on dying, I would say is Kubler-Ross's "On Death and Dying" . I would highly recommend getting hold of " On Our Own Terms" by Bill Moyers. It is a 4 part DVD series and can be had on PBS or even at you local library. Have a box of tissue handy.

[husker_rn, RN]

Took a class on death and dying in nursing school and read several of Kubler-Ross' books. They were very informative.