A Caregiver’s Dilemma: Is the Patient Better Off at Home?

In caring for someone we love the question arises, what symptoms can be managed?  What aspects of the situation are beyond the scope of a medical professional?

Beyond our capabilities?

When we know that someone we love is dying, we suffer too.  We have our own sense of loss to deal with, added to the uncertainty of our role in caring for our loved one. 

To even contemplate looking after a dying person at home is daunting, challenging. 

But we know that some who are familiar with these situations, like hospice nurses Callanan and Kelley, maintain that the best care for a person who is ill is most often that given by family and friends in the familiar surroundings of their home.

There are undoubtedly physical symptoms. 

Dry mouth, weight loss, fragile skin and pressure sores, nausea and vomiting, constipation, diarrhea or incontinence, and breathing difficulties are just a few.  No one patient will have all of these symptoms, but in general, some physical symptoms are to be expected. 

For most of these, medical professionals can offer remedies.  In others, keeping the patient comfortable can be a matter of routine. 

In Final Gifts, Callanan and Kelley suggest that most physical symptoms can be alleviated to a large extent.

Pain is best handled by giving regular moderate doses of painkillers, rather than ‘holding off’ until the pain becomes unbearable and then taking a large dose.  The authors state that regular pain medication in moderate dosage can be increased over time as the pain increases, and in the meantime, the patient will be more comfortable overall.

What can’t be controlled?  These are personal attributes: the patient’s temperament, their response to the situation in which they find themselves. 

Dealing with emotions and attitudes requires some detective work on the part of the caregiver, some skillful prodding. 

It is not possible for you, the caregiver, to sort out these issues but hopefully, by being aware of what the patient is feeling and needing, by listening to and discerning just what they are trying to communicate, you will be able to assist them in finding ways of dealing with emotional issues.

I cannot emphasize enough how helpful I have found the wealth of knowledge and sound, practical advice given in Final Gifts, Understanding the Special Awareness, Needs and Communications of the Dying.

These hospice nurses have learned a great deal about death and those who are terminally ill, and if you are in a situation of caring for someone on this final journey, this book is a travel guide that will see you both safely home.

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