Cultural Awareness re: Last Rites?

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Hello,

My husband’s aunt, who is Catholic, was recently admitted to a secular hospital for a kidney infection. After a few days, she was transferred to the ICU. None of the staff discussed the possibility that this infection might be fatal. Finally, her goddaughter, a nurse, was able to talk to a nurse at the hospital and discovered that our aunt was declining rapidly and her chances of survival were “slim to none.” At this point, the family contacted the priest.

Of course, I’m a little upset, but I’m trying to set aside my feelings about this. I would like suggestions as to how/ to whom to write a letter suggesting that different cultures have different attitudes about death, that some families don’t want to be kept completely in the dark or maintain a false optimism. Of course, we ARE praying for a full recovery!

Conversely, how can family members communicate their need for honest assessments of a loved one’s health and prognosis without seeming (and feeling) morbidly pessimistic?
 
Praying for everyone involved. Personally, I believe in full disclosure to everyone, not just immediate family.
 
Hi!
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First of all, we need to understand what death is.  It is not the end, but the beginning, of eternity.  We all die.  As Catholics, we believe that the moment of death should be chosen by our Creator, God, in His time.  When we die, we go into a new life.  It is a very gentle process apart from the physical dimensions.  Death is a spiritual process that happens to a physical being.  We were not created for this world, but for the next.  We were created for heaven.

By virtue of the fact that every individual was created by God, they have an innate dignity due them, from beginning to end.  All human life is sacred, because it comes from God.  And it does not matter what state of life this person is in, rich or poor, what disability they may have, etc., they have worth in God's eyes, and should have worth in ours.  We must respect every human being and offer compassionate care for the sick and dying.  

 The patient, in order to be on this journey, needs support from others.  Death is also an opportunity to celebrate a life, to come together, to nurture one another as we come to the natural end of our lives.

There's nothing more touching than a family gathered around a dying person, saying the Rosary together!  I hope when my time comes, I can find someone to do that for me.

God bless!
 
AlwaysAsking said:
Hello,

My husband’s aunt, who is Catholic, was recently admitted to a secular hospital for a kidney infection. After a few days, she was transferred to the ICU. None of the staff discussed the possibility that this infection might be fatal. Finally, her goddaughter, a nurse, was able to talk to a nurse at the hospital and discovered that our aunt was declining rapidly and her chances of survival were “slim to none.” At this point, the family contacted the priest.

Of course, I’m a little upset, but I’m trying to set aside my feelings about this. I would like suggestions as to how/ to whom to write a letter suggesting that different cultures have different attitudes about death, that some families don’t want to be kept completely in the dark or maintain a false optimism. Of course, we ARE praying for a full recovery!

Conversely, how can family members communicate their need for honest assessments of a loved one’s health and prognosis without seeming (and feeling) morbidly pessimistic?
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I am surprised that a nurse broke that news to the Goddaughter, that usually is the responsibility of the physician, and with HIPPA regulations being what they are, personnel are usually very careful about whom they relay information to, and what information is given.

When a family member is admitted to the hospital the patient (or someone authorized by the patient if the patient is not capable) should give the names of the people they want information given to, and the family should up front tell the physician that they want full disclosure of the patient’s condition–no hemming and hawing around. And they should insist that it be given in language understandable to the layperson–not in medical terminology they can’t understand. However, some people have a difficult time handling such information if given directly and may become angry or go into denial. It is difficult to predict such reactions, and the family usually knows best who can respond well in a crisis. So it is a good idea to have a family member or two designated to be the contact person, and to be around for support for other family members who may have difficulty processing what is being said. People in crisis often have trouble listening and understanding and remembering what is told them.

I worked in an ICU for nearly 20 years and have seen all kinds of situations, some were handled poorly, some were handled quite well. Usually it works out better as I described above. But you need to be proactive about it. Some physicians themselves aren’t comfortable with giving bad news and have trouble talking to families, others are very good at it. Usually that is a skill most acquire over time. If you want to hear it straight, make that known. You will not be viewed as morbidly pessimistic. In fact, it will make communication easier.

As for the letter, you should describe the situation as it occured, and give your reasons for why you think the situation was not handled correctly. Be polite and professional about it. Most hospitals take these letters seriously and try to improve their patient satisfaction and will consider reasonable suggestions. You also may want to speak to the patient and family liason about this. They can be a big help in such situations.

Prayers for you aunt’s recovery.
 
CB_Catholic said:
I am surprised that a nurse broke that news to the Goddaughter, that usually is the responsibility of the physician, and with HIPPA regulations being what they are, personnel are usually very careful about whom they relay information to, and what information is given.
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Thank you Carolyn. In this case, the ICU nurse acted appropriately, as our widowed aunt’s adult children are her closest relations and they had no idea what was going on. As you say, different people process information differently and I wasn’t there, but everyone was grateful to hear the truth. The priest came yesterday, and while my father-in-law doesn’t think his sister was aware of his presence, my F-I-L is relieved that she had last rites (and without a doubt, this is what our aunt would want).

So I think a few weeks from now, my husband, father-in-law and I will try to draft an informative letter, with your valuable insight. We didn’t even know if a hospital would care, so thank you for that encouragement. And your prayers! I am still praying for a full recovery!!

-Liz
 
Contact the HR department of the hospital and ask what training they provide for staff on end-of-life religious practices for various faiths. If they do not provide training that includes calling a priest for a dieing Catholic, or notifying the family in time for Viaticum, insist that they create training. Contact priest at the parish in which the hospital is located and get him involved in giving a talk to staff, etc.
 
AlwaysAsking said:
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Of course, I’m a little upset, but I’m trying to set aside my feelings about this. I would like suggestions as to how/ to whom to write a letter suggesting that different cultures have different attitudes about death, that some families don’t want to be kept completely in the dark or maintain a false optimism. Of course, we ARE praying for a full recovery!

Conversely, how can family members communicate their need for honest assessments of a loved one’s health and prognosis without seeming (and feeling) morbidly pessimistic?
Click to expand...
well I don’t know within what culture these events transpired but I don’t think any American hospital or doctor nowdays would withhold critical information about her condition from the patient or her next of kin. Bear in mind, the latter is whoever the patient listed as the recipient of this communication. The patient, or the person representing her, should make sure the hospital has relevant information about their wishes regarding visits from clergy, religious affliliation etc. In most hospitals other than the assigned hospital chaplain, who will enter the room only if invited, outside clergy can come in only with the patient’s express request or permission.

Families also need to be education not to wait until the patient is in extremis to send for the priest. The sacrament of anointing, confession and communion should be made available as soon as the need for surgery, hospital admission, or other treatment is known. Here at least it is very hard to find a priest at the last minute. The sacraments strengthen for the rigors of fighting an illness or challenge that expects recovery, as well as for those close to death.
 
AlwaysAsking said:
Thank you Carolyn. In this case, the ICU nurse acted appropriately, as our widowed aunt’s adult children are her closest relations and they had no idea what was going on. As you say, different people process information differently and I wasn’t there, but everyone was grateful to hear the truth. The priest came yesterday, and while my father-in-law doesn’t think his sister was aware of his presence, my F-I-L is relieved that she had last rites (and without a doubt, this is what our aunt would want).

So I think a few weeks from now, my husband, father-in-law and I will try to draft an informative letter, with your valuable insight. We didn’t even know if a hospital would care, so thank you for that encouragement. And your prayers! I am still praying for a full recovery!!

-Liz
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Actually diversity and cultural sensitivity training, and spiritual care of patients is actually mandated for hospital accreditation these days, and most hospitals do have programs in place for their employees. It is one of the standards of the Joint Commission for accreditation. I forgot to mention that. However, sometimes compliance isn’t what it should be, or there is a communication failure along the line, and it may not necerssarily be a cultural issue. You can contact the patient liason now to address your concerns, and it might help to give you more peace of mind, and more immediate action to address anything that went awry. Not only for your family, but for others. And you are very welcome.
 
Just a quick update:

Aunt Joan regained consciousness a couple of days ago, and has since been moved out of the ICU. Thank you very, very much for your prayers!

-Liz
 
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