Nursing care of the dying patient

Abstract

When a patient is dying, treatment moves away from active efforts to cure the disease and concentrates instead on minimising distress and controlling symptoms. The nurse’s aim in caring for a terminally ill patient is to provide personal support in maintaining an acceptable lifestyle and in enabling a peaceful death, having regard to the patient’s culture and beliefs, values, preferences and outlook on life. For relatives and friends of the dying patient, the emotions connected with losing a loved one can be intense. The response to a loss may reflect the intensity of the previous relationship and the prospect of an impending loss can engender acute anxiety, distress and guilt at real or imagined past failings. An emotional response on the part of relatives to the impending loss and to the death when it occurs is a normal reaction and to be encouraged. Helping relatives through this experience is an intrinsic part of good nursing practice. Suppression of grief engenders tension, whereas expressing emotions and weeping, if this occurs, helps to reduce the stress of the situation (Lipe, 1980). The nurse’s personal concern and support are often highly valued by both patients and relatives alike. Having someone to share the experience with them, explaining what is happening and acknowledging their psychological pain can help in coping with their distress. Just as relatives may find it helpful to express feeling verbally or to weep, so too may the nurse. She should not feel embarrassed to admit that she experiences an emotional reaction when a patient that she has cared for is dying and that she therefore finds her task upsetting at times.

‘Communication with the dying patient is not limited to words. Many times words are insufficient. The most important activity for the nurse is to simply be there.’ (Drummond, 1970).