Importance of Quality of End-of-Life Care

I have learned from my life in medicine that death is not always an enemy. Often it is good medical treatment. Often it achieves what medicine cannot achieve—it stops suffering.

—Christiaan Barnard (Good Life, Good Death)

I have been with Epoch Elder Care as a Facility Nurse for almost 2 years now and it gave me the opportunity to work with elderly very closely which involved not only taking care of their health and medicines but also to understand the needs of this venerable group. PCC (Person centered care) is one of the concepts on which Epoch stands firmly, it means to focus on each individual needs and to provide them the right to choose for themselves.

Another concept that Epoch believes in is “Quality end of life care” which means to:- maintain the comfort, choices, and quality of life of a person who is recognised to be dying (in the terminal phase); to support their individuality; and to care for the psychosocial and spiritual needs of themselves and their families.

Death is inevitable, and a natural part of life which we all understand but it is also very difficult to come to terms with. It is natural for people to try to extend life of the demising elderly by providing them all kinds of better care which involves good treatment at best hospitals, or opt for ventilator support or surgical procedures – (tracheostomy for airway) etc. More often we don’t realise that by trying to prolong life in an artificial manner, we are often adding on to their suffering, forcing them to go through pain and not taking into consideration what their wishes are. Working at Epoch I have realized that end of life or palliative care is a very crucial aspect of caring for an elderly. It is of utmost importance to understand what they need and how can we fulfill those wishes. Some important factors of end of life care are:

• Pain and symptom management- their physical comfort is most important
• Maintaining personal hygiene- timely sponges, oral hygiene, skin is moisturised etc
• Surrounding them by committed carers and loved ones
• Communication and team work between caregivers, family members and healthcare providers
• Nutrition & hydration
• Doing everything possible to ensure all the above goals are achieved

When it comes to health, age is an important factor. As the body continues to age, it’s ability to heal itself diminishes, therefore one must chose the curative path carefully. Several drug interactions and interventions may complicate existing health issues and aggravate physical and psychological health adversely. Feeling healthy and happy is a result of several factors including social, psychological and spiritual well being and support. It is important to focus on spending more time and attention with the elderly, join in and facilitate activities which they still enjoy, keep them happy & comfortable as much as possible and ensure every small wish is fulfilled.

_“At youngest we are most pure. At oldest most experienced.

But at both we are the softest at heart.

Maybe that’s why those ages get along the most”._

Older people are not very different from children: when it comes to looking after them, they need the same care and attention that a child needs, most importantly they need to be surrounded by people who love them and care for them selflessly.

Giving importance to small joys like having an ice-cream or singing their old song while making their life a meaningful one is what one should be aiming for, than letting medications and investigations dominate their everyday life.