If we consider that all care should have social, emotional, cultural and spiritual components, that we should work with others, then all care is to a certain extent palliative and so is end-of-life. But end-of-life itself is a specific, immensely personal and immensely meaningful moment. For the Mosaic Home Care Team, these are the most sensitive and aware moments, moments that resonate for all within the circle.
One of the best-known commentators on end-of-life is a Professor Kellehear and here he comments on Kubler Ross’s work:
How Mosaic Client Services Team coordinates palliative care or end-of-life for a new client
When a client starts with our services they maybe at end-of-life. The assessment process would focus on the person (person centered care), their care goals as they pertained to care and comfort (physical, emotional, spiritual and social). All caregivers are briefed on the case so everyone is providing an integrated care approach.
Compassionate listening to family as well as the person: we are always open to compassionate listening to the family of a person going through the end-of-life. The depth and willingness to open up to a member of our team varies and is dependent on the relationship they have built with us as a group, or perhaps one member of the team. This is not something offered but is “understood” to be part of our role. We are also here to connect family members with community support services (i.e. Evergreen, local HUB chapters) should they need additional support and counselling.
Compassion towards the Care Team: Mosaic client services spends time discussing changes in the client and their care plan with the PSWs and nurses, so they are prepared. It is also important to assess how impending death is affecting each of our caregivers emotionally. Client services keeps in contact with the personal support caregiver and/or nurse on the team, to see how they are doing, to let them know they have our support with any assistance they may need on proper end-of-life care.
Mosaic Services at end-of-life
- The focus of our services switch to Care and Comfort
- We work closely with the family and person to accommodate for changes to cognition and physical ability.
- We will follow directives of the person and/or the family and the medical team regarding, feeding and hydration.
- Keep the lips and mouth moist to reduce discomfort
- Play soft music, person centered connection, meaningful conversation, touch or eye contact.
- We may also look at photos, review events, experiences and thoughts
- Compassionately listen to the client if they are discussing events of their own life.
- Sit quietly as a comforting presence.
- Use gentle touch as a reminder that you are there.
- Move close and talk gently,
- Limit noisy distractions, ask visitors to talk quietly if visiting. Our home care Personal Support workers will limit the time of visits according to person and family wishes.
- We will listen quietly if the person needs to express thoughts, worry or feeling.
- Providing information and resources for the families as needed. Some of the more intensive supports for complex care needs would be addressed by our Elder Care Plus® Care Navigation, Social Work and Counselling services.
At the end-of-life, meaningful moments can be created. We will be there to support the person and family. We will respect your wishes and needs, providing more or less social and emotional support as needed, respecting privacy and personal preferences. We can only do this by knowing the person and the family. While we bring all our skills, experience, compassion and empathy to bear, we realise that this moment is like no other for the person, close friends and family and of course those who are contracted to provide supportive care.