Compassionate Considerations

On Palliative care: How do you tell a person that he is dying?

Posted on 06 February 2010

It had been a very busy week.  Yet despite the busy-ness of preparing for the Leadership Conference, one thing was foremost in my mind the past couple of days.

Last Tuesday, I visited someone in the Intensive Care Unit of the National Kidney Institute.  Due to the many things demanding for my attention, it slipped thru my mind about the promised visit. It was already past 9Pm when I strolled through the lobby and corridors of that said hospital, triggering in me past memories of when my Dad was given a second lease on his life after surviving Klebsiella pneumonia.

I walked through the familiar corridors and up the second floor.  I did not know who the patient was. I only had a name.  One of the ICU nurses stopped me and said “Visiting hours are over” but I said I was not there for a social visit, I was there for a pastoral care visit.

She led me to one of the units where a man was attached to several machines.  He looked at me and perhaps wondered who I  was.  I approached his bed and introduced myself.  I heard the nurse use the phone and called for the relatives and said “the pastor is here…”

This man is dying.  The doctor gave him 3 – 6 months left to live.  He is only 59 years old, yet he has considerably aged because of the toll the cancer is exacting on his body.  He was recently diagnosed with colorectal cancer – but he went for a check-up because of his pneumonia.  Several tests and MRIs later – he was diagnosed with Stage 4 -colorectal cancer.

Does he know? I earlier asked his daughter during our brief encounter in the office.  “NO” we have not told him. I was reminded of an earlier writing I read about this.  When the person who is dying is not informed of his condition – they can oftentimes tell that something so major is happening to them.

While I respect the desire of the family not to inform the person of his real condition, I also wondered about the needs of their father.  About the needs of someone who is about to leave his family behind.  I would personally want to know if my time is up.  There are still many things that a dying person needs to settle in his life so that when that inevitable time comes, the person may be more ready and be more at peace.

Because death does not just occur at the cessation of breath – the process even begins days or weeks or months in advance.  A dying person would need to make amends with his past and settle emotional accounts, to grieve the things he had lost and could never have because death had already come knocking on the door.  Death does not just to happen to the person but to the family as well.  When a family made a decision not to tell a dying person the real situation, they have placed themselves in a position where they would need to create a facade of well-being, a facade that gets more and more difficult as the time draws near.

I disinfected my hands with alcohol and proceeded to place my right hand on his forehead and my left hand on his left hand. A big part of palliative care is answering the need of a person to still feel the touch of another human being.  To be connected to another human being more than being connected to machines, is an utmost need for them.  I started to pray and at times, struggled with my words because praying for a dying person who is not informed of his impending deaths would be totally different from a prayer for someone who has been told of the inevitable.

I felt steps of people around me.  We were being surrounded by the family members.  I prayed for God’s mercy expressed in His loving care for their father, for the comfort for the whole family – and for the immediate needs of finances because the bill has gone up to P300K.  I prayed for God’s loving will to be made manifest in all of their lives.

After the prayer, I looked up and saw how young the children were.  Two of the boys were still of highschool and college age and two daughters were in their early twenties.  There was a young girl who introduced herself as a granddaughter.

Lord God, they are too young to lose their father…. I silently prayed inside.

We made our way back to hospital corridors.  I was sobered by what this family is going through – and at the same time got quieted by the memories of when I was also seated in one of those benches by the corridors,  as I pondered how to get financial help when we needed it at that time back in 2001.

If you were the person dying and you have several weeks left to live- would you want to be informed of the coming of the inevitable?

Driving back home – I prayed again for the whole family.  For the person who is about to die and for the children he is about to leave behind.  God grant them your peace and comfort and may they all find their strength, individually and as a family, only in you.