‘We are very sorry, there is no more active treatment that we can offer you, we are referring you for palliative care.’ These can be frightening words, even when they are not totally unexpected.
We are all fragile human beings and illness in its many guises can visit us uninvited at any age. Modern medicine has made wonderful advances offering cure or comfort to an increasing number of illnesses. Ethical medical research continues to expand offering a better quality of life to many who suffer. Sadly, cure is not always possible, and in such situations, compassionate care is a fleshing out of the Gospel where Jesus reaches into the heart of all who suffer with the touch and words of comfort, wholeness and peace The sick person needs to know that their voice is heard at every stage of their illness and in a particular way when they have reached a palliative stage of their journey. Many but not all wish to be told the truth about their condition by their doctors and the manner in which this news is delivered is important. A private meeting where the sick person may have the company and support of a loved one needs to be set up where the sick person, clinician and their advocate can speak openly and honestly about their concerns, fears and hopes for the future. Some may wish to be on their own with their doctor and nurse and this too needs to be respected. Many ask families and staff to listen to and honour their wishes at this most critical time. Some may wish to ask what medical and nursing care will be made available to them and is it realistic? What are the cost implications and if so, who pays? Will the person be able to continue to live at home or is admission to Nursing Home or Hospice necessary? They may need help to put financial or legal affairs in order and may need the support of a Social Worker and Solicitor to do this. All will wish to be kept comfortable and every effort undertaken to keep pain or distressing symptoms at bay.
Depending on the nature and stage of illness, the person may have a list of wishes that they would like to enjoy while they are able. A chapter of a book may need to be completed, a favourite place visited or a grand-child welcomed into the family. Some may wish to celebrate their marriage to their partner or attend a child’s wedding. Reconciliations with family or others may be necessary before the person is able to complete their journey on earth and every effort needs to be made to help them to achieve this desire. The search for meaning in their illness will continue, all the stages of loss and grief, like anger, denial and bargaining will bubble up at different or maybe unexpected times. The person and family throughout this journey need sensitive, compassionate understanding and support so that acceptance and peace can finally be found. The cultural and faith norms of the person and family must be respected and honoured. Where an active faith is present, the presence of a minister of religion and the reception of the Sacrament of the Sick or other ritual can be a source of healing and comfort for the person and family, enabling them to surrender their lives in peace to the God who is calling them home. Many wish to plan their funeral liturgy, both in its content, place and meaning, and the celebration of their life, these wishes should be given respect.
‘Palliative care accompanies the sick person and their family on this final journey, whether the care is at home, in a hospice or hospital.’
© Siobhan O’Keeffe 2020, all rights reserved
First published in the Sacred Heart Messenger, February 2021