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Complexities in caregiving at the end of life
Date:2/15/2012

reas that are sometimes overlooked in palliative care, namely bodily care and contact, a secure, aesthetic and comfortable environment, and death-related rituals.

"The caregivers described different kinds of communication with patients and relatives, from the giving of advice to communication through non-verbal, physical contact," says Dr Lindqvist. "Rituals surrounding dying and death were not only spiritual or religious but also more subtly existential, legal and professional. One field that has been largely ignored by research is sensory aspects of the caring environment, both at home and in in-patient settings."

The study also shows that non-pharmacological palliative care is based on a number of complex and sophisticated decisions on the part of the caregiver regarding not only what can be done or should not be done, but also when, how and why to whom. This differs from the traditional understanding of non-pharmacological palliative care as 'basic'.

"A good example of this is oral care, which is an important aspect of the care given to a dying person," adds Dr Lindqvist. "It's likely to make the dying person feel better and could ease contact with relatives since it becomes difficult to be close when someone's breath smells strongly. But what happens if the patient refuses oral care? The nursing staff than has to deal with a complicated ethical dilemma. Oral care can also give relatives an opportunity to participate in the caring of a dying relative, and if they do this, it's something that the caregivers must be able to take into consideration."


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Contact: Press Officer Katarina Sternudd
katarina.sternudd@ki.se
46-852-483-895
Karolinska Institutet
Source:Eurekalert

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