PEACEFUL DEATH: I've been reading Dr. Lani Leary's book "No One Has to Die Alone". It's a great book as it offers a lot of practical information about being a caregiver and understanding the perspective of someone who is approaching the end of their life. Biggest gift is the advice of what to say before your loved one dies: I love you. Thank you. Please forgive me-or- I forgive you. It's ok to go.

My main takeaways:
* Fear of isolation and dying is the greatest fear of dying patients. It's important to be there and express your love in whatever way you can.

* It's important for caregiver to consider our current frames in which we view death. Thinking of death as normal and natural (vs. being avoided and ignored) and as a transition, a change (vs. an end, punishment, or judgment) will help your loved one and you embrace the power and potential death can teach us about living a full life. Death is a reality. a Dying becomes a problem depending on how we think about it and respond to it.

* Disease, decline, and dying are about daily loss nad it's hard for the dying are about daily loss. Over time, the dying person surrenders their abilities, roles, strength, independence, and sense of control. Be cognizant that there is loss at many levels. They are losing their health and vigor, privacy and mobility, and dreams for the future.

* Hearing is the last sense to go. Don't talk about the dying as if they can't hear you. Be careful not to talk in a childish voice or treat them like they are less intelligent or responsibility.

* Practical needs to attend to: Comfort (hydration, good sleep environment, noise level, safe mobility). Medical mgmt/advocate. Home mgr. Companion offering emotional support. Researcher getting data on treatment options, etc. Facilitator- managing who the person wants to see? Family mediator- brings family members up-to-date. Listener- Being witness and validate their experiences without judgement

* As a person makes their journey from this plane of reality, they may start to lose control of their mental, emotional, and physical abilities. Giving the dying person control over their process of leaving and understand their wishes(how do you want to die, who do you want to spend your last moments with, what do you want to leave as your legacy, what do you value ) will honor them. Don't try to judge the dying's choices or try to understand them. Just honor them even if you don't get them.

* Biggest guilt/shame for caregivers. Not being there when the person dies (often the dying die when their loved one is away to spare the loved one pain). Not supporting them (also unresolved issues).

GRIEF* How someone grieves is as unique as your fingerprint. Grief work is repetitious and comes in waves. Body experiences grief as stomach hurt. throat closes up. joints ache. Muscle weakness. Oversensitive to noise. Lack of energy. Shortness of breath. Dry mouth.

* Behavioral responses: Sleep/appetite disturbance. Avoiding reminders of deceased. Searching and calling out. Visiting places as reminders of deceased.

* Cognitive response: Confusion. Disorientation. Lack of Focus and inability to read or remember. Grief feels like a loss of security, and when we lose the person that helped us know our best self, we may forget temporarily who we are in the world.

* Don't set stds for the pace of grief or for i's intensity, demonstration, or verbalization.

*Masculine type of grief is private, quiet, and externalized by building memorials. Masculine grief is action oriented and problem focused versus emotion and person focused. Masculine mourner engages in activities to restore life to balance and order. Attends to new tasks, distracts himself through actively engaging in projects or movement, and works at developing a new role and relationships. Easier when given a map of sorts, with resources about what to do, how to do it, and when it will end.

*Feminine - externalizing grief in writing/speaking.
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