“I wish I knew she was dying. L.R. and I have been friends for five years. We have been on the same floor. We ate in the same dining room, at the same table. We went to Bingo and outings together. I knew she wasn’t feeling well but I didn’t know she was dying. I wish I was able to go see her and pay my respect to her.” A.F.
These were the words of one of our Residents when she was told her friend had passed away.
In December 2003, the Palliative Care Committee members realized that a program was needed to honor our residents during their final days of the death and dying process. Prior to 2003, our facility did not have a formal means to address the emotional, social and spiritual needs of family, friends and caregivers during the most difficult time of one’s life: death and dying of a loved one.
Although meals were provided, upon request, to the residents’ families, there were no guidelines or ways to communicate with our staff, guests, visitors, and residents that a resident had entered into and was actively dealing with the final days of his/her life.
| Facility: The Friendly Home
Address: 3156 East Avenue
Rochester, New York 14618 Contact: John Gagnon, Vice President Services
Phone: (585) 385-0294
Fax: (585) 385-0259
On numerous occasions, our residents had voiced sadness that they were learning of their friend’s death after the fact and were disappointed that they did not have opportunity to say goodbye or to pay their respect. Resident A.F. and others were voicing an unmet need.
We became convinced that a program must be developed to:
- Honor our dying residents.
- Communicate to our residents and staff that one of our own had entered the final stages of his/her life.
- Support and care for all aspects of our residents and their families during this special time.
- Care for the emotional needs of our staff, including direct caregivers, who had come to love and respect the dying resident.
|Sara McKeraghan (left), food service department, and Julia Wood, nursing department, wheel an Angel Cart.|
In response to these needs, the Palliative Care Committee’s main objective was to develop a program to specifically address this difficult yet important issue: honoring our dying residents and meeting the needs of their fellow residents, families, friends, and their caregivers. “We do a great job taking care of our residents when they are with us but we are failing to put closure to their final departure from us in ways that honor them and their families,” said the director of social work and Chair of the Palliative Care Committee. The committee realized that this issue should take priority and we set a 2004 goal to have a working program in place.
Our medical director, also a member of the Palliative Care Committee, proposed looking into a neighboring facility’s program and provided a contact name: The chaplain of the facility. As a result, a sub-committee from our Palliative Care Committee was formed to research and develop a program to fit our specific needs and the philosophy of our home. The sub-committee members consisted of a dietitian, a social worker, and a nurse manager.
This committee had subsequent meetings to discuss the name for the new program, the creation and writing policies and procedures to support the program’s structure, and their submission to the Palliative Care Committee for final approval.
Planning the program
The Angel Care Process
Angel on the Door
Soon after permission is obtained, an angel is placed outside the resident’s door symbolizing that the resident has been placed on the Angel Care Program. The symbol becomes a visual way to communicate to other residents, visitors, and staff that this resident is on his/her final days.
Seeing this symbol by the resident’s door, staff members of all departments will then have the opportunity to consider adjusting their assigned tasks in a manner that provides this resident and his/her family with additional consideration for their comfort and dignity. This will also give staff, residents, and guests the opportunity to stop and offer support and comfort to the resident and family.