End of Life

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Spiritual, religious, and cultural beliefs and practices play a significant role in the lives of patients who are seriously ill and dying. Attention to the spiritual component of the illness experienced by the patient and family is not new within the context of nursing care, yet many nurses lack the comfort or skills to assess and intervene in this dimension. Spirituality contains features of religiosity, but the two concepts are not interchangeable (Puchalski, Lunsford, Harris, et al., 2006). Spirituality refers to “one’s relationship with the transcendent questions”. For most people, contemplating one’s own death raises many issues, such as the meaning of existence, the purpose of suffering, and the existence of an afterlife.

Goal of End of Life Care

A common goal for the dying patient, family members, and the health care professional is for a meaningful dying experience, in which loss is framed in the context of a life legacy. Such an experience includes support for the patient's suffering, the avoidance of undesired artificial prolongation of life, involvement of family and/or close friends, resolution of remaining life conflicts, and attention to spiritual issues that surround the meaning of illness and death. I have had the opportunity to be present at several of my family member’s bedside at the time of their deaths. The common factors they each had was trying to find hope in the middle of the despair of death. I believe spirituality gives individuals facing death hope and provides the comfort they need to resolve conflicts, release anxieties and fears, and finally to get a sense of purpose for their lives.

I personally believe that the aim of opening the communication about ones spirituality at the end of life or to someone facing a terminal diagnosis is to encourage a time of self reflection and open dialogue between the patient, family and caregivers. The more often the health care professionals...
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