I am a geriatric nurse, As some of you may know. I have worked in a number of long-term care facilities over the course of my 17-year career and while it's not the sexiest type of nursing ever, it's one I feel called to, even though I have enjoyed other types of nursing.
One of the joys of working in LTC is the relationships that we form with the residents. Over the course of admission, we see so many changes in our residents. We cheer them on when they attain therapy or other goals and we comfort their pain, whether physical or psychological. Some of our residents are with us for long periods of time. Maybe it's just me, but I feel it's impossible to work in a facility for any length of time and not form attachments to residents. It's the hallmark of what we do.
One aspect of working in LTC is the fact that we see a fair amount of death. Sometimes a resident will slowly decline over a substantial amount of time and sometimes it occurs so suddenly that it takes our breath away. I have been to this rodeo more times than I can count during my career and know there's more to come. Still, I come away from the experience feeling some degree of loss, more often than not.
Let me frank here - the death of a well-loved resident is tough. A nurse can't expect to work in a LTC facility and not be affected by the passing of someone they have spent many hours caring for; it's just not a realistic expectation.
Tonight I am anticipating the passing of a resident that I have grown close to in the short time that I have been at this facility. There's not much left to do but keep her comfortable and pain-free. I won't lie - this one's going to be hard. As I have been caring for her tonight, several thoughts have come to mind about caring for someone dying and I wanted to share them here.
1) Keep the family in the loop.
If there are family members at the resident's bedside, greet them early in the shift and let them know you are there for them as well the resident. It also helps to tell them how long you will be there and what they can expect of you. Ask if they need anything and if they do, get it for them. Be available to them. Family members will often have questions about the process and by answering them you increase their comfort level. If family members are staying with their loved one, make them as comfortable as you can by offering food, drink and bedding. I take a holistic approach in caring for my residents as they enter this last stage of life and part of that is taking care of their families, too. Give families someone to trust and rely on during a difficult time.
2) Let the family reminisce with you.
I wish I could count the number of times over the years that family members have shared with me special stories about my residents. It's yet another connection that can be so important to a family (and to caregivers!). They want us to know what their loved one was like before illness, that they were special and important.
3) Be like Tom Bodett and keep a light on.
This is especially important if the resident is alone. The light shouldn't be bright, but enough that the resident is not feeling that they are alone and isolated. No one should be left alone in the dark.
4) Talk to the resident.
We're told that hearing is one of the last senses to leave. Whether or not the resident is capable of talking with you, tell them what you're doing, that you're there, and above all, that they're not alone. This can even be just simply chatting about the things you enjoyed talking with the resident about.
5) Keep the resident comfortable.
Keep the room warm. It might be too warm for you, but at some point in the dying process thermoregulation declines and even though they feel warm to you, they might not actually be feeling that warmth. Keep the resident's skin clean and dry and keep their mouth clean and moist.
6) Don't be afraid to show emotion.
As I mentioned earlier, one of the joys of taking care of long-term residents is the relationships we build with them but this can be a double-edged sword then they die. We don't have to be a family member to experience loss when someone we've cared for passes away. We've seen our folks through a lot of life changes and we've forged bonds with them through our shared experiences as residents and caregivers, so it stands to reason that the end of that relationship is can be cause for grief. Let that grief out. Don't be afraid to share your feelings with your co-workers. Chances are that they are feeling the same and talking with them can be great support for everyone involved.
Above all else, treat the resident as you would want a parent or child, or yourself, treated under the same circumstance.
I am no expert here, but these are things I've observed over the years I've been practicing. They have been at the forefront of my thoughts the last few days and I wanted to share them. I've talked to some folks over the years who ask, "How can you do that?" My answer? Someone has to and I'm glad it's me.
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