Living the Dying Process and Preparing for Death

Tuesday, 14 July 2009: 2:05 PM

Camille P. Claibourne, APRN, BSN, BA, PhD
Nursing Graduate Program and College of Business Health Care Administration, University of Louisiana in Lafayette, Lafayette, LA

Learning Objective 1: The learner will be able to describe varied experiences of hospice patients preparing for death and associated end of life tasks during the dying process.

Learning Objective 2: The learner will be able to define challenges faced patient and methods to assist living the dying process.

Purpose: The purpose of this presentation is to share results of a qualitative research study that examined how people with a life-threatening illness prepare for death and to understand and describe the dying process.

Methods: In-depth interviews were conducted with hospice clients and analyzed using thematic analysis.  Twelve themes emerged and that described the participant’s experience of dying and how he or she prepared for death.  These themes were compared to conceptual framework landmarks originally developed by Ira Byock.

Results: The data revealed additional landmarks that could reshape models of care for people living with a life-threatening illness.  I found that the end of life is an ending and a beginning. 

Conclusion: This finding is very important because if the topic of death, due to denial, has created obstacles for dialogue and practice, then shifting the conversation to living will enhance the interactions with dying people.  The study is also important as dying is a universal and inescapable reality for every human being. Understanding the dying process as both a state life and death preparation can better assist support and education for nurses and caregivers. Though the end of life tasks spoken of by the participants are congruent with the literature, this study reveals a concentration on tasks for living at the end of life far more important than death preparation. These living at the end of life tasks are both the physical limitations associated with a terminal illness and tasks associated with living after death or leaving a legacy.  Although the dying experience for these participants was individually unique they all communicated the need for supportive care as essential. In addition, the participants embraced the chance to contribute to this research and to tell their story. Listening to these people was a powerful experience and a life-changing opportunity.