It’s never easy for anyone to learn that their loved one is nearing the end of their life despite providing them with the best medical care. When it’s time for your loved one to rest, they may opt to spend the rest of their life peacefully surrounded by their loved ones in privacy. The moment they decide to spend their remaining time at home, the palliative care team will prepare them for a terminal discharge.
To learn more about terminal discharge and how you can provide the best comfort to your loved one, we’ve made a brief discussion about it below.
What is a terminal discharge?
Terminal discharge is the process of discharging a patient home from a hospital in the last hours or days of their life so they can pass away peacefully at their home.
In terminal discharge, the wishes and comfort of the patient are prioritised. The hospital staff or palliative care team will assess if the main caregiver of the patient can manage their needs at home. At times, equipment may be needed such as oxygen concentrators or hospital beds to better aid the patient when they spend their remaining hours or days at home. However, there are also times that the care needs are too high so the private services of a professional healthcare worker may be needed.
The family of the patient will be briefed on the signs and symptoms to look out for when the patient is at the end of their life, which medications to administer, and the steps they have to take once the patient has already passed away. The hospital may also refer the patient for home hospice care, but if they are already on home hospice care the hospital would just need to update the hospice that the patient is for terminal discharge.
What are alternative care options for a loved one who is terminally discharged?
An alternative care option for a terminally discharged patient is hospice care. Hospices focus on caring for the patient in the final stages of a patient’s illness and their quality of life since they don’t have much time left. A patient is considered to be suitable for hospice care if they have the following:
- They have repeated infections
- They visit hospitals or emergency rooms frequently
- They are unable to perform daily activities such as eating, walking, toileting or dressing among others
- They have consented not to undergo further ineffective treatments
- They have frequent and uncontrolled vomiting, nausea, pain, or shortness of breath
- They have significant body changes
- They have increased sleep or confusion
- They have the desire to focus more on quality of life than treatment
Another alternative is engaging with the services of a home hospice care team who are professionals who can tend to the needs of your terminally ill loved one in the comfort of their home. They usually work with the family to create a schedule of visits and provide help with daily activities.
Finally, you also have the option to look and care for your loved one with support from private caregivers or nurses. This can be costly but you’ll have the freedom to arrange visiting schedules so you can spend more time with your terminally ill loved one and give them the best care with minimal support.
What are different points you would need to consider before a loved one’s terminal discharge?
Here are several things you would need to consider before your loved one’s terminal discharge to give them the adequate care and comfort they need before they pass away:
The wishes and needs of your loved one
Before your loved one passes away you must consider their preferences, desires and needs regarding their care and comfort. You must discuss with them their care options as this would give you clarity on the care they want in the later stages of their illness and life.
You should take into consideration certain documents they have executed such as any power of attorney or advance care plan. Moreover, you must assess their needs and symptoms if they are manageable at home and weigh all options carefully before making the ultimate decision. The goal is to give them a comfortable resting place while also respecting their wishes.
The ability of your family to cope with your loved one’s condition or passing
If your loved one has chosen to pass away surrounded by family, one thing you should take into consideration is how you and the rest of your family will handle the grief of your loved one’s future passing. It may be difficult for your family to cope and accept the future passing of a loved one.
Aside from taking into consideration the emotions of your family, another thing you need to consider is whether you will be able to provide the adequate care your terminally ill loved one needs. Different patients have different needs and some would need intensive care and assistance. Your family should be willing to learn how to handle different equipment and have the desire and confidence to care for your loved one.
The 24/7 support and care
It’s given that a hospice and home hospice care team will provide 24/7 care and support to your loved one. However, if you have chosen to care for your loved one by yourself, you should determine first if you’re able to provide support and care round-the-clock. Moreover, you should also determine if a private caregiver will be primarily giving such assistance and care.
The equipment and resources needed
As we have said, different patients have different needs and some would need specialised equipment to support their final days at home. The hospital may loan this equipment to you, but there are those which you would need to buy yourself. Moreover, you also need to consider the space where you’ll place this equipment.
What happens when your loved one is back home?
If you have chosen to care for your loved one at home, there may be healthcare professionals who will schedule visits to ensure that your loved one takes the necessary medication and receives the necessary support. If you have decided to hire the services of a private caregiver, they can provide such assistance instead.
If you’re caring for your loved one, you can also experience issues such as exhaustion, burnout, guilt, grief, and conflict. While you must care for your loved one, you should also make sure that you’re taking care of yourself. You have the option to hire the services of a private caregiver or nurse who can help you or you can find support from your other family members.
Coming to terms with your loved one’s future passing can be hard not only for your loved one but also for you. Other than making sure that they receive adequate care and support from you, you should also take into consideration that you’re not spent from taking care of your loved one. There are available professional services or home care in Singapore which you can hire to help you care for your loved one for the final moments of their life while also giving you time to spend quality time with your loved one.