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The alphabet for compassionate dying

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MedlinePlus, the National Institute of Health, published an article on Jan. 7, 2013 for a new link called Palliative Care. Palliative care is a strategy for helping patients that have an incurable disease. Its focus is on making the patient as comfortable as possible.

The link for MedlinePlus’ article on palliative care takes the reader to the website for CureSearch for Children’s Cancer. CureSearch for Children’s Cancer is a research group that tries to cure cancer in children. When that is not possible, CureSearch tries to help children and family members cope with a dying child.

If you know someone with a child dying of cancer or any other disease, this is a very supportive and knowledgeable organization. Much of their information will be useful in helping any person of any age and disease deal with their coming events. The site is sensitive to the patient's and to the family's needs.

One of the first examples of palliative care was the hospice movement that started about 30 years ago. Many think that hospice facilities are places that take care of patients in the final days of their lives. This is true, but hospice or other palliative care can begin as soon as a terminal diagnosis is made. They don’t treat diseases. They make the patient as comfortable as possible at the physical, emotional and spiritual levels. Hospice services can be done in the home, in an assisted living or a rehabilitation facility. Hospice will come to you.

Getting hospice services or palliative care involved is not giving up. It is a realization that the only solution for a cure is a miracle, and these miracles have been witnessed by nearly everyone that has worked in these areas. For most patients, the goal of palliative care is to minimize all forms of pain and to make the last days as pleasant and meaningful as possible.

The abbreviations for compassionate dying are:

DNR/DNI/AND

DNR stands for Do Not Resuscitate. DNI stands for Do Not Intubate. AND stands for Allow Natural Death. These are the definitions provided for each of these protocols by CureSearch. They have direct implications for the treatment of a person in an “end of life” situation.

  • "A DNR or “Do Not Resuscitate” order applies to situations where your child has a respiratory arrest (stops breathing) or a cardiac arrest (heart stops beating). DNR means that no CPR (chest compressions, cardiac drugs, or placement of a breathing tube) will be performed.
  • A DNI or “Do Not Intubate” order means that chest compressions and cardiac drugs may be used, but no breathing tube will be placed.
  • An AND or “Allow Natural Death” order is a term used at some hospitals as an alternative to the more traditional DNR order. While a DNR simply states that no attempts should be made to restart breathing or restart the heart if it stops, an AND order is used to ensure that only comfort measures, designed to provide excellent control of pain or other symptoms, are taken. This includes withholding or discontinuing resuscitation, artificial feedings, fluids, and other treatments that prolong the dying process without adding to your child’s quality of life. Allowing a natural death means not interfering with the natural dying process. It also means that every effort will be made to have your child’s time of death be calm and peaceful, with you and your child surrounded by as many family and friends as you, the parents, and your child wish.”

There are several other tabs on this website besides the one defining the care done under DNR/DNI/AND protocols. They include: Making Decisions about End-of-Life Care, End of Life, Immediately After Death, and Months and Years after Death. There is substantial support for the patient and the family through the whole dying process.

One of the major goals of spiritualism is to remove the fear of death from everyone. Spiritualism helps you realize that your soul is eternal, and the goal is to realize that you are as much a part of the Creator as is humanly possible. We believe that no soul is ever beyond redemption. We know that the soul continues after the transition from being encased in a physical body.

One final practical note is that not all medical systems embrace palliative care. If you or a family member have a diagnosis of a serious or terminal illness, you may want to ask the direct question,

“Do you have a palliative care wing or hospice associated with this hospital?”

If your decision is to prolong your child’s or your life at any cost, then a hospital without a hospice or palliative care program is for you. If you are focused on quality of life over length of days, you may consider a palliative care program to work better for you.

You have the right to make decisions for yourself. Recent history has shown that some hospitals will try to force treatment on a child if it looks like parents are withholding approval of treatments that the hospital and doctors deem necessary. The “suggested by the author” titles at the end of this article include one such case in Akron involving an Amish family with a young girl that wanted no further cancer treatments.

If medical professionals attempt to steer you towards treatments that you don’t want, tell them your decision is your own. There is nothing more personal than dying, and you have the right to make these decisions as you see fit.

For those that encounter people that have a terminal illness, it is critical that you support the patient in whatever decisions they make. You are not in their skin, their mind or their soul. Support their decisions as best you can. If their decision is not what you would do, get over it and gently walk with them. Use your spare time with them to think about your own wishes when you face your own death.

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