As Hospice/Palliative Care providers we are in a unique position to prepare the loved ones of clients for the grief work ahead. We are even more fortunate to be able to provide services, under most Hospice programs, for bereavement support. This entry focuses on how proactive grief work cannot only be beneficial for the survivor but also for the patient approaching death.
On a number of occasions, I have sat bedside with an actively dying client that was more anxious about how their spouse, children, and or significant other will navigate the world without their presence. After taking time to explore the source of the anxiety, I realized that all of the attention to the client’s signs and symptoms were barely scratching the surface of the emotional pain associated with dying.
In an effort to “treat the patient”, I learned to develop “The Care Plan After Death” with the loved one. This was also therapeutic to the family; oftentimes the first time they took an opportunity to think beyond death is during this discussion. The approach is very informal and remains framed towards the client’s dying healed/well. It can be difficult to have the loved one think of themselves at this time; but if it means reducing anxiety, worry, pain from the client—they are more obliged to participate.
Here are just a few questions that have been helpful to approach the topic:
Sample Trigger Questions for Care Plan After Death
I learned that your husband is having a hard time thinking of what your life will be like when he is gone. Are you willing to reassure him that it will be hard but you will be okay?
Could we talk about a few of his concerns and your future plan to share with him? This may reduce his anxiety and yours too.
Right now he handles the finances and he is worried that you will have to take care of this when he is no longer here; would it help if I found a class that you could sign up for to introduce you to budgeting? I bet this will make him feel better about your family’s financial security.
These are just a few starters to helping a loved one plan for very practical task that may be keeping both parties from peace during an emotionally and physically difficult time. Serving as a facilitator for this type of discussion has allowed the patient and loved one an opportunity to explore underlying stressors and encourages the loved one to prepare for what will be a very different reality.
This short introduction to Care Planning after death is likely discussed in clinical team meetings, under “unmet emotional needs” or similar domains. This entry calls for providers to explore unmet needs from the perspective of how the survivor’s wellbeing may have an impact on the patient. Also used as an entry point for working on anticipatory grief with Caregivers and loved ones of terminally ill patients.
Watch and share this five minute video about the need for prophylactic end-of-life conversations. Laura Heldebrand, an ICU nurse tells her mother's story.
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