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Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

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Page 1: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

Exploring Death as a Series of Losses and Facilitating an

“Appropriate Death”

A Presentation by Elizabeth Causton, MSW

Page 2: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

“The dying process midwifes a person into depth” Dr. Michael Kearney from “Mortally Wounded”

Good palliative care provides the dignity of good symptom control with the integrity of a holistic approach in order to make this inner shift into depth possible

Page 3: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

Baggage Beliefs Opinions Prejudices

Values Biases Blindspots

How we define and respond to loss, just as how we define a good or bad deathis subjective, personal and profoundly influenced by the baggage we all carry

Page 4: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

Questions to consider to increase self awareness:

In my experience death is…. For me an acceptable quality of life exists

when…. The choices that I believe should be

available to people at end of life are…. I think that ‘bad things happen to good

people’ because….

Page 5: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

Death as a series of losses

One’s future A sense of safety and predictability Work and activities Roles Physical image

Ongoing change and loss are certain

Page 6: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

What is perceived as a loss is what is grieved

Companionship / privacy

Prepared meals / prepared meals

Help in the home / help in the home

What is perceived as a loss also affects the quality of one’s life

Page 7: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

Anticipatory Grief:

the grieving that occurs before death for what has already been lost as well for what will be lost

it is not the same as, nor does it replace bereavement

Page 8: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

Exercise on Loss:

Series of losses First reaction

Page 9: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

Common first reactions:

Anger Fear Denial

With greater awareness we can work with less judgement and more compassion

Page 10: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

Bad Death

In pain Alone Burning Choking Drowning As the result of violence Confused Unable to communicate Young Old

Lingering Sudden In hospital Incontinent With unresolved

business/relationships Afraid Without dignity In chaos Others???

Page 11: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

Good Death Pain free Peaceful With loved ones At home Old (very old) With music Accepting Prepared

Sudden With time to say goodbye In sleep Able to communicate Dignified In control With good scotch on the

mouth swab Others???

Page 12: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

“Appropriate Death”*

a death with dignity in the context of who a person is as an individual and in their relationships with others

*a Mansell Pattison term

Page 13: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

Facilitating an Appropriate Death Making sure the patient/resident is as comfortable as

possible ( or as they want to be)

Asking the questions that explore context and history

Giving accurate information with compassion so that patients and families can make informed choices…without judgement

Page 14: Exploring Death as a Series of Losses and Facilitating an “Appropriate Death” A Presentation by Elizabeth Causton, MSW

Empowering information about the possibility of choosing one’s time of death “Dad was a very private man”

“I won’t tell him our daughter’s on the way”

“Wasn’t that just like mom”