'A good death'
For most of us, the idea of dying is a frightening one. And that fear can often become overwhelming to one who knows that their days left on earth are limited to just a few.
But at Emmanuel Community, the term "good death" is not an oxymoron. The staff is dedicated to the concept that its residents should spend their last days of life in dignity and comfort -- their minds at peace, their sufferings eased, their family's needs provided for as they keep vigil at their loved one's bedside.
"It's important to give the family time to say goodbye," says Vicki Marthaler, director of spiritual care at Emmanuel. "We try really hard to accommodate the needs of the family."
However, Marthaler adds, it is also important that the staff be supported, as they, too, often develop close relationships with those in their care.
"We (the staff) need to recognize our own grief and sense of loss too," says Marthaler. "Often we've invested so much time and emotion (in caring for the dying person) that it's hard for us to say goodbye too."
But until the moment that the resident expels his or her last breath, that person's life still has value.
"At Emmanuel Home, value is given to each day a person lives... (The staff) believes that death is a part of living, and that dignity and peace can be attained as we 'walk a person home' (into the after life)," says Marthaler. "It is called the 'Emmanuel Way.'"
Providing for a resident's "good death" takes an interdepartmental effort, she explains. Care is taken to afford as much privacy for the family as possible. If the resident has a roommate, that person is often moved to a private room or a temporary living space away from the dying person.
And then, there is the "Comfort Cart." Created especially to provide palliative care for dying residents at Emmanuel, this cart contains inspirational and spiritual literature, notebooks for keeping a journal or allowing loved ones to write down special memories or notes of support, and various supplies for providing physical care, such as Vaseline, lip balm, lotions and other massage materials, perfumes, music CDs containing soothing, inspirational music, colored sheets and pillow cases for their beds, and a green fleece blanket or comforter.
There's also one important piece of instructional literature given to each family, called "Code Status: An invitation to talk of tomorrow."
Co-written by Marthaler and registered nurse Nancy Lickiss -- who serves as the 'neighborhood' manager for the section of the nursing home known as Birch Lane -- this booklet helps families with making end-of-life choices such as whether or not the dying person chooses to be resuscitated when their heart stops.
"After age 75, only 2 percent (of residents) will survive an attempt to resuscitate," Lickiss pointed out.
As a result of being given this booklet and discussing their options with Emmanuel staff, Lickiss said she had four families who changed their initial inclination from allowing CPR to be performed when the heart stops beating, to DNR, or do not resuscitate.
What many people do not understand, Lickiss says, is that when a person has chosen the DNR option, that doesn't mean every effort won't be made to save the person's life beforehand.
Once the person has died, Emmanuel staff also believes in honoring that person's life with something called the "Walk of Honor."
First, a chime is rung three times and the death is announced over Emmanuel's public address system. Then, the body is cleaned and prepared for removal.
As part of that preparation, the funeral cot is draped in a special coverlet that has been prepared for the resident. It will continue to cover the funeral cot as the staff escorts the funeral director to the funeral coach or hearse.
Then, the coverlet is removed and the person who has escorted the person's body from their room says, "It has been an honor to care for (this person). We now commend (him or her) into your care."
They then place a hand over the deceased and say, "May the Lord bless and keep you, now and forevermore, Amen."
But even after the resident has died, Emmanuel continues to provide spiritual care to his or her family. Its bereavement program includes sending a single rose in a vase to the funeral home for services, in memory of the resident; cards are sent out to family members one month following the death, on the birth date of the deceased, on Mother's/Father's Day, at Christmas and on the one-year anniversary of the death.
For more information about Emmanuel's palliative care program, contact Vicki Marthaler, chaplain, or Nancy Lickiss, R.N., at 218-847-4486.