Palliative care - When family disagree

Caring for a person at the end stages of life will be one of the most saddest and distressing things a carer will do.

Having good memories of a loved one's death and feeling that you did everything possible to attend to the wishes of a dying person, will ultimately assist you in the grieving process.

There is much you can do to comfort a dying person. You can start by having an understanding of a loved one’s wishes as they approach end of life. Do they have any preferences for care at this stage of their life? How can you ensure a loved one receives the care they deserve?

It can be very frustrating and lonely for carers if you are unable to communicate with the person you are caring for and understand their needs. This is especially true for those with advanced dementia or stroke. Always continue to talk to the person as if they can hear you.

Explain what you are going to do and talk to them like you would normally. Hearing is one of the last senses to go. 

Avoiding family disputes

Unfortunately disputes about treatment options are common at end stage of life. Family members can avoid confrontation by talking to a dying person openly about their wishes and preferences for treatment early on.

Encourage a loved one to set down their wishes concerning future treatment in an advanced health care directive. This doesn't mean that a person can't change their mind about treatment options during the course of an illness.

It is much easier to make treatment decisions when discussions have been had previously between the dying person, the carer and the family. 

Getting support 

Having a family conference before there is deterioration to end stage of life can be beneficial for all parties as it gives family an indication of what decisions need to be made.

Talking to a variety of health professionals regarding a palliative care approach can help with decision making and what to expect.

Also talking with friends who have been through similar experiences can be comforting. Always ask for help if you feel you are not coping. Let people close to you know what is happening in your life as help can sometimes come from unexpected places.

If death is expected make sure the nursing home or hospital staff know who to contact and whether you would like to be contacted over night.

Sometimes people die suddenly and it is not possible for nursing staff to contact family members before death occurs. If family disagree on treatment issues try talking to a social worker or palliative care counsellor. 

Helpful resources

•  Ask your doctor to refer you to a social worker or counsellor
•  Find support and get help with talking about death and dying by visiting Palliative Care NSW
•  For information about palliative care and to search for palliative care services visit CareSearch  
• Call The Commonwealth Carer Resource Centre for help being a carer on 1800 242 636 or visit www.carersaustralia.com.au

Related articles

• What is an Advanced Care Directive?
• Caring for someone at end stage of life