Critical events in the dying process: the potential for physical and psychosocial suffering.

Full Abstract

BACKGROUND: Understanding what aspects of the dying process motivate terminally ill individuals to consider hastening their death, can lead to improving end-of-life care. OBJECTIVE: Advance knowledge regarding critical events within the dying process that have the potential to give rise to physical and psychosocial suffering such that an elder wishes for or considers a hastened death. DESIGN AND METHODS: Face-to-face in-depth qualitative interviews conducted with 96 terminally ill elders, 15 of whom discussed an event in their dying process that resulted in suffering so great they wished for, or considered, a hastened death. Data were content analyzed to identify and categorize the main themes and patterns involved in these elders' experiences. SETTING: The interviews were conducted on palliative care hospital units, and in outpatient clinics, free standing hospice facilities, and home hospice. RESULTS: Four critical events emerged: perceived insensitive and uncaring communication of a terminal diagnosis; experiencing unbearable physical pain; unacknowledged feelings regarding undergoing chemotherapy or radiation treatment; and dying in a distressing environment. Respondents discussed physical and/or psychosocial suffering that occurred at these events, and the end-of-life care practices that reduced their suffering. CONCLUSION: Awareness of events common to the dying process, the potential physical and psychosocial suffering that may arise at these events, and the end-of-life care practices associated with reducing that suffering can lead to health care professionals being able to take a proactive rather than reactive approach to end-of-life care.

Author information

Author/s: Schroepfer, Tracy A (TA);

Affiliation: School of Social Work, University of Wisconsin-Madison, 1350 University Avenue, Madison, WI 53706, USA. tschroepfer(-atsign-)wisc.edu

Journal and publication information

Publication Type: Journal Article

Journal: Journal of palliative medicine (J Palliat Med), published in United States. (Language: eng)

Reference: 2007-Feb; vol 10 (issue 1) : pp 136-47

Dates: Created 2007/02/14; Completed 2007/03/30; Revised 2007/11/15;

PMID: 17298262, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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