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This blog post appeared first at our sister site http://intensivecarehotline.com on 29/5/2013
If you are confronted with your loved one approaching their end of life in Intensive Care your world has probably just turned upside down. Maybe you did see it coming or maybe it came out of the blue. Every case is different of course and yet I believe that there are some similarities when it comes to death and end of life in Intensive Care. No matter the situation you are in, I believe that there are a few things that all families want if their loved one is dying in Intensive Care, such as peace of mind that all the right decisions have been made along the way.
Sometimes time can be your enemy and in some situations your critically ill loved one may approach their end of life quickly and unexpectedly where it might take you and your family a long time before you can ever find peace of mind.
Also, keep in mind that the situation you and your critically ill loved are facing is what I would like to refer to as a “once in a lifetime” situation. You therefore want to have things done in a certain way so that you can feel that critical peace of mind for you and for your family.
If you have the time in your situation, how do you want to approach the end of life situation of your critically ill loved one?
Having been involved in many end- of- life situations in Intensive Care myself, I have found that every situation is different and requires an individual approach. Some families are happy to let go of their loved one quickly whereas other families need more time to say goodbye and come to terms with the end of life of their loved one. Neither approach is right or wrong or good or bad. It’s very individual and it has to be respected.
It’s critical that you bring your views into the discussion with the Intensive Care team on how the end of life situation of your loved one needs to look like from your perspective. Also, don’t think that just because the Intensive Care team is dealing with end of life frequently that they can master those challenging situations without difficulties. Even though Patients in Intensive Care frequently approach their end of life, no Intensive Care Unit can claim to be perfect when it comes to end of life care. Having worked in many Intensive Care Units in three different countries, I believe that there is a lot of room for improvement, also because every end of life situation is very challenging for the Intensive Care team as well. Some Intensive Care Units do it better than others. Some individual health professionals in Intensive Care do it better than others. Some Families and some individuals within the Family deal with the situation better than others.
I personally believe that being involved in end of life care in Intensive Care is nothing short of being a privilege. This statement might come as a shock to you, however I can tell you that being involved in the last phase and the last stages of a person’s life can be a huge burden but also a huge privilege. Generally emotions run high and as a health professional you have to manage your own emotions, the emotions of your colleagues and the emotions of the family who is just losing a loved one in Intensive Care.
Strong emotions can be both, a good thing if they are directed in the right channels and emotions can be a bad thing if they are not managed correctly and if they are taking over.
But emotions are a healthy sign in general. It shows that you are fully alive and that you are not disconnected from what is happening all around you. It’s healthy to show your sadness and your grief if your loved one is approaching their end of life in Intensive Care. It’s also a healthy sign that if you want to be involved in the end of life situation and it’s healthy to have your say and to ask questions. Again, just because health professionals in Intensive Care are involved in end-of-life situations regularly and often doesn’t mean that they “know it all” or that they do it impeccably.
Some Intensive Care Units may do it well, others may not. Some individuals in Intensive Care may do it well, others may not.
I think that one important part for you and for your family is to look for your own truth in this challenging situation and also look for some meaning if your critically ill loved one is dying in Intensive Care. Maybe you can find some positives when you are looking for meaning and truth.
Truth is a very thin concept, especially in an environment such as Intensive Care. One minute you might get told that your critically ill loved one is stable and the next minute you might get told that your loved one is not going to survive their stay in Intensive Care. The reality is that things vary and things change.
In next week’s blog I’ll tell you why it’s critical that you find meaning in adversity and I will also give you five action steps on how to deal with the end of life situation in Intensive Care.
Sincerely, your friend
Patrik Hutzel