Valla mogu Lis (Valar Doheris). )-the game of thrones
This is our attitude towards death. Everyone will die. Before the death of our loved ones, we should try our best to help them alleviate their pain and accept death. This is also to ease our sadness.
More than five years ago, I asked a friend to show my father's film to an oncologist. Most postoperative tumor patients are faced with the situation of "God rolls the dice". If they don't relapse within five years, people may live longer. If the tumor recurs, the situation will get very bad.
The doctor said, "It's not easy. Maybe within a year, people should be gone. "
I was shocked at that time. My friend who took me to consult a doctor took me to the office and gave me a book published by their hospital. If a person is desperate, the hospital has a mission organization, not to prescribe medicine for the patient, but to give a book to his family.
There are all kinds of cases of cancer patients, which are different from those in chicken soup-most of them have died, and most of them have won, but all the people, facing difficulties, know that the process of death has been recorded. This book has had an impact on the families of many cancer patients-not to cheer them up, but to accept the reality.
It took me 20 minutes to accept the reality. I went to the course of psychological counselor to take care of many people at a critical moment and had to make some decisions:
1. Improve the living conditions of patients
For example, I didn't tell my mother about this life span. But I reached an understanding with her and transferred my dad from a professional tumor hospital to the oncology department of a comprehensive non-tumor hospital. This is a new department, and its strength is not as strong as that of cancer hospital, but the equipment and ward conditions are much better, and there are fewer patients, so nurses can take better care of patients. It is also more comfortable to take care of patients' families.
2. Accompany patients
Every Friday night, I go back to my hometown by train, stay with my father in the ward, and then go back to Beijing on Sunday night. My mother doesn't think it is necessary to come back every week, but I know in my heart that I have to come back every week because these days are numbered.
3. Still try some new treatments.
Although not very useful, I avoided some of the most painful and unlikely treatments in the following treatment.
When a person is dying, caregivers should consider these two things when making decisions:
Quality of life of seriously ill patients
Fatigue degree of caregivers
Miracles are indeed possible, but they must be brought about by major medical breakthroughs, such as the emergence of penicillin, which once saved people who were dying.
Seriously ill patients and their families are the targets of various medical frauds. We must avoid the pits of all kinds of rural old Chinese medicine practitioners and wizards. In addition, don't be kidnapped by cynics around you and let patients suffer from all kinds of unreliable treatments.
| Where should people die?
Psychologists, doctors and patients' families have different views on where patients should die.
1. Hospital
This is the mainstream way now.
Benefits: Doctors and nurses are always around, which is convenient for declaring death and transferring the dead.
Disadvantages: Many hospitals are very short of beds and medical staff, and some hospitals do not allow family members to accompany them, so even when patients die, family members may not be present.
2. At home
This is a way of death that seriously ill patients like.
Benefits: Home is more comfortable, and you can stay with your relatives, your accumulated wealth and real estate.
Disadvantages:
A. Family members may have to ask doctors and nurses to come to the house for treatment (which is also very expensive);
B. Family members who take care of them may be completely unable to rest (one string is tight, and everyone in the hospital can shift shifts), and some people will be afraid of the death of their loved ones and be on the verge of collapse;
C. In some areas, the death of patients at home may lead to the depreciation of property (in some places, there will be no problem unless they die abnormally);
D. Patients who die at home will have trouble at the funeral. Those who die in the hospital can get the medical death certificate of the hospital directly, and those who die at home should go to the neighborhood Committee and community health center for formalities. No one is on duty 24 hours a day in these places. Without a death certificate, the funeral home will not accept the dead.
In rural areas, this is not a problem. In many places, people are engaged in the business of renting equipment to preserve corpses. In some areas, burial is still possible.
3. Hospice care
In recent years, a special type of hospital has emerged. Generally speaking, it was transformed from some small hospitals. They don't have the ability of large-scale rescue. They only monitor heart rate and blood pressure and take oxygen. They are not prepared to make patients better, but hope that their last days (which may last for half a year) will be more comfortable. They are more humane than big hospitals and avoid the fatigue of home care.
Some hospice hospitals can take medical insurance.
However, sending parents to such a hospital still requires strong psychology, and it is also crucial for seriously ill patients to accept this.
My judgment is that after 70 s and 80 s, when they are older, they will gradually accept living in such an institution.
Last-minute treatment plan
At the end of the day, doctors usually communicate with their families early to make sure that patients are in the dying stage and let their families prepare early. One of the decisions is whether to rescue at the last minute.
In the United States, there is a suggestion called DNR (no recovery), that is, the strategy of "never waking up again". If patients or their families and doctors reach an agreement, there will be no large-scale rescue.
This strategy depends on:
The patient won't live long after being rescued.
The rescue process is very painful.
medical expenses
Communication with doctors.
Ask each other sincerely.
If you always regard the doctor as a liar, or a chicken thief who wants to avoid responsibility, or an incompetent fool, you can't communicate with him calmly. Don't blame the doctor when you come up, especially if you are not a long-term caregiver, but just a relative who has just returned to China.
It is the doctor's kindness to let the family members prepare early. You should sincerely ask for the method of "less pain", and the other party will usually give you the best advice.
Be consistent with other family members.
Even if the doctor gives you the best advice, don't start at once, but have a family meeting quickly.
If you are the closest person to a seriously ill patient (spouse, children, parents), you may need to communicate with some people who are slightly away but can be held accountable to get understanding. For example, when my father was seriously ill, the doctor suggested not to go to the ventilator or go to the ICU for emergency treatment. My mother and I both agree with this suggestion, and we should also communicate with Uncle menstruation, otherwise there will be misunderstanding.
3. The will of seriously ill patients.
These things can be discussed with a seriously ill person if he is conscious and highly educated.
In the United States, people who are seriously ill can sign a "letter of intent for survival" to authorize a relative or friend to make a medical decision. To talk big is to authorize someone to extubate. In China, doctors usually ask spouses and children to agree. If a seriously ill patient has reached middle and old age, people generally don't ask his parents' wishes. On the contrary, it is understandable that all decisions are kept from the elderly.
Return to life
Not everyone has the so-called "death on the spot". It is best to make a will early when you are awake, which can save a lot of notarization fees such as changing the name of real estate and bonds.
If a comatose person suddenly wakes up, he should call the person he wants to see most quickly, and everything else can be put down first.
Ask before it's too late. Some people have hidden property or unknown bonds and stocks. If they fall into a coma, they may not get their money back.
5. Euthanasia or assisted suicide
China does not support euthanasia. But in fact, doctors or nurses have some ways to make those who die in extreme pain walk more comfortably. In the United States, 20% of nurses actually accelerated a death.
65438+ In the early 1990s, a doctor in Kaevaljian, USA, invented a suicide machine to help patients in pain commit suicide. Later, he was charged with second-degree murder and sentenced to eight years' imprisonment.
Don't think about it. When the pain in the terminal stage of cancer intensifies, the family members can ask the doctor to give analgesic pump more, regardless of whether the painkillers are good for people's health.
Because it can't get any worse.
Accompanying: Psychological Construction of Seriously Ill Patients
We say that we should try to transfer to a hospital with better living conditions, especially a hospital that allows family members to accompany us.
Companionship is very important, especially for patients with certain diseases who are dying for 6 months.
We should pay tribute to Elizabeth K-Ross, a great psychiatrist, who has long been concerned about dying people and caregivers. In 1969, she put forward a set of five stages of death:
refuse
I'm not gonna die. Some people even have acute amnesia and forget what happened in the hospital. Rejection is a psychological defense mechanism and a way for people to protect themselves.
angry
Love to be angry, feel that the world is unfair, and may scold all living people and say some cruel and straightforward words.
bargain
"Bodhisattva, let me see my grandson get married." This is a way that many people think they can make a deal with some mysterious force. Of course, if the old lady really sees her grandson get married, she may have to wait until she sees her great-grandson.
This also reminds us not to get married in a hurry because our elders are seriously ill. This is just a bargain for seriously ill patients.
Bargaining can really prolong life. For example, Phillips and Smith's research shows that the mortality rate of elderly women in China will decrease significantly before and during important festivals, and will increase significantly after festivals. There is a folk saying that "men are afraid of previous lives and women are afraid of afterlife." There is also some truth. Older women will long to live an extra birthday.
depression
Most people will enter the stage of depression, a sense of loss will strike, and they will soon lose their loved ones. If they can't eat or urinate any more, they will feel that their dignity will be lost. If illness makes him lose his job, his depression will get worse.
accept
Emotional indifference and reticence. At this time, people who are dying are reluctant to talk to others.
K-Ross's point of view is suitable for some people who know that they are doomed to die, or what we call terminally ill patients. Nowadays, many seriously ill patients are often unpredictable, such as patients who have undergone liver transplantation. At the same time, some people will repeat these stages instead of single-line progress.
When death happens,
Don't think too much, just hold the hand of your loved ones.
Grief and recovery
After a person dies, it is his spouse who suffers the most. Widowed people will not only be considered unlucky, but also be regarded as disabled by human beings. This is why in the stressor scale we provide, the stress of widowhood accounts for 100.
In the first year after widowhood, the death rate of widowed people is seven times that of others, especially for men and young women. Remarriage can reduce the risk.
Some people may die of accidents or murders, not diseases. If this death will make his relatives feel remorse, then the best solution for these relatives is to receive psychological counseling.
Only 15%~30% people will be immersed in the pain of losing their loved ones, and most people will finally get rid of the pain with the support of family, friends, social institutions and religion.
Children under 5 can't understand death, but they can basically understand it when they are 9 years old. If children lose their grandparents, we can tell them that death is a terrible thing, but in the end we will all accept it.
I remember when I was about five years old, I asked my mother about death and she said:
"Everyone will die, and so will my mother. It will be many years later, you will have your lover and children, and they will support you through this difficulty. "
I think this answer is very wise.
If children face death by themselves, they will soon understand the irreversibility of death, which will make adults feel particularly sad.
Talking about children's death can be done while watching cartoons or picture books, such as the capsizing of a sailboat in Frozen, the death of Mufasa in The Lion King, and the fading and rebirth of flowers in Rainbow Flowers. Two or three sentences is enough.
Extended reading
Is death education useful?
Some sociologists and psychologists are engaged in "death education", which can be divided into three categories:
Crisis death education: for example, psychological intervention for victims and students who witnessed the tragic situation is also needed in the military.
Daily death education, sometimes the mental health teacher in high school or university will mention this. However, the news that college students lie in coffins often appears in newspapers is basically a gimmick. Real death education is not achieved by scaring girls who are afraid of the dark.
Vocational education on death, such as undertakers, doctors, nurses, lifeguards, policemen and carers, often deals with death, but except for undertakers and medical workers who receive death education at school, most industries receive insufficient psychological support.
In addition, visiting the tomb that has become a scenic spot will not bring any death education, and the alienation of years and relationships will dilute the fear of death. If you visit the Ming Tombs, the Qing Tombs and the Mausoleum of the First Qin Emperor, the main feeling may not be:
If you are the son of heaven, you should also be buried deep underground. ...
Instead, I will go, the emperor is really rich!