Mother Teresa of Calcutta once said, “Let us touch the dying, the poor, the lonely and the unwanted according to the graces we have received and let us not be ashamed or slow to do the humble work.” This quote came to mind after reading a question posted by Julie on NursingVoices. Here is Julie’s post:

“I am a second year BScN nursing student and have my first single client focus. My client is on palliative care and I am hoping to expand my knowledge and therapeutic communication skills of clients on end of life measures. Any opinions, advice or information would be greatly appreciated.

Thanks so much, Julie”

Julie’s question isn’t unique. Nurses have been struggling with the issues surrounding palliative care for a long time. It’s hard to know what to say to someone who is dying. Palliative care focuses on the comprehensive physical, psychosocial, emotional, and spiritual care of terminally ill patients and their families. In the United States, hospice nurses provide care primarily under the guidelines of the Medicare Benefit Act of 1983, a federal program that allows patients to die in their homes, with their families and friends at their side. According to a recent Gallup poll, more than 90 percent of Americans wish to be in their own homes or in a homelike setting when they die.

The first step in caring for the terminally ill is to become aware of your own feelings about death and dying. The dying patient becomes a symbol of what awaits each of us at the end of our life. You will become more emotionally available to your dying patient once you embrace your own mortality.

The ability to communicate with a terminally ill patient hinges on a nurse’s knowledge of the five stages of death and dying as described by Dr. Elisabeth Kübler-Ross in her book, On Death and Dying. The five stages go in progression through denial, anger, bargaining, depression, and acceptance. This knowledge will enhance your ability to understand what your patient is going through. You must also understand that your actions speak louder than words. Sit down when your patient is talking to you. This shows empathy, and it shows that you really want to hear what your patient is saying to you. Speak from your heart, but also understand that sometimes the best thing to say is nothing at all. Sit and listen quietly if your patient wants to talk.

I’ve cared for many terminally ill patients throughout my nursing career and most of them have told me that they were afraid of dying alone or in agonizing pain. I would hold their hand and tell them that I was going to do everything in your power to make sure that they will not die alone or in pain. Taking care of a dying patient can be a spiritual experience. Please join us at NursingVoices. and share your experience with us. We’re waiting to hear from you.