Challenges at the End of Life

Abstract

All human beings share three experiences: birth, life, and death. The first two occurrences, birth and life, are experienced in a wide variety of ways and are frequently discussed in great detail within our westernized culture. Death, however, is not often an experience most people enjoy talking about, particularly in preparation for the event. This is true for many reasons, but one of the reasons is the pain associated with these conversations. They are avoided because planning and discussing death often presents issues associated with irreversible loss.
For individuals living with later stage chronic illnesses and their families, discussing end-of-life brings up many feelings, including sadness, grief, and fear. The variety of emotions people experience as they consider end of life may challenge some to consider or reconsider the meaning of their life.
With the increase of the successful treatments and the result of prolonged life for people living with chronic illnesses individuals and their families often use physical indicators to predict the trajectory of the disease. Signs of decline in health measures as indicated by blood tests and functionality are often used to estimate quality and length of remaining life. However, there are many examples of people who live far beyond the expectations regarding the duration of their lives. Sometimes health indicators plummet one week and the next there are signs of remission. Our society seems challenged to find a balance between hope of continuing to live and accepting the fact that life may be nearing the end (Back, et al., 2003; Clark, 2002).