Humans only get to enjoy a limited time on earth. There is a great deal of debate as to what happens after death, but the one thing for sure is that everyone is going to die. It is a reality of life that makes people depressed and angry, but it is unavoidable. Everyone knows that they are going to die at some stage, but some people have a more definite and imminent date for this event. Those who are terminally ill may only have a short time to settle their affairs.
Those people who are recovering from an addiction have made a decision to face reality without the use of mind-altering chemicals. This means learning to live with both the good and the bad. Those who are sober may have to face a terminal illness. If their sobriety is strong they should be able to do this with grace and dignity. The skills that help them come to terms with their addiction can also be of value to them when facing death.
The World Health Organization defines palliative care as an approach that improves the quality of life for those facing problems associated with life threatening illness. It usually involves the creation and implementation of a care plan with input from a number of health care professionals including:
* Physicians (including Palliative care physicians)
* Nurses (including community nurses)
* Social workers
* Pain specialists
* Occupational therapists
The palliative care team will work with the individual to achieve a number of goals including:
* To maximize quality of life for the individual
* To control pain and any other symptoms that causes distress
* To provide advice and support to family members
* To provide psychosocial and spiritual care
* The goal with palliative care is neither to hasten nor delay death
Palliative care differs from hospice care in a number of important ways. When the individual has reached a stage where they require hospice care it means that they have exhausted available medical options and have had enough with aggressive treatments. In most instances those who receive hospice care will have less than six months to live. Palliative care includes hospice care, but the individual does not have to be dying in order to receive it. Palliative care may include aggressive treatments that would not be an option for those who are actively dying.
Those individuals who are addicted to alcohol or drugs can provide unique challenges to a palliative care team. The issue that causes the most difficulties is pain management. The individual may already be addicted to opiates or quickly develop an addiction. This can mean that they will demand excessive amounts of pain medication which could in turn hasten their death. One of the most respected ways of defining pain is provided by Margo McCaffery where she says that Pain is what the person says it is and exists whenever he or she says it does. This may make it unethical to disregard the addict’s claims of pain and their need for opiate pain medication.
Just because people manage to escape addiction does not mean that they will be spared the vicissitudes of life. Sickness and death are a reality that all humans have to face – only a minority of individuals will die unexpectedly in their sleep. The need for palliative care is something that many people in recovery will need to face. The fact that they were once addicted to alcohol or drugs may mean that they have special considerations in regards to this type of care. A typical concern for those receiving palliative treatments is the use of opiate medications.
Opiate drugs are the most effective treatments for dealing with chronic pain. Just because an individual is recovering from an addiction should not mean that they be denied such treatments. Dealing with uncontrolled pain makes life for people miserable; refusing such individuals proper pain control would be tantamount to torture.
Taking opiate medication under the guidance of a palliative care team does not mean that the individual has relapsed. They are not taking these substances recreationally and the physician will be able to control the amount taking so as to reduce the likelihood of dependence. As the individual reaches the end of their life concerns about dependence will be less important; the main thing is that the individual is comfortable and not in pain.
It is up to the individual in recovery to decide on their need for opiate medication as part of their palliative care package. Those who value having a clear head may decide to try other alternatives first of all. If the pain is controlled using other treatments there will be no need to resort to stronger pain medication.
Facing death is the hardest challenges that most humans will have to face. It is a step into the complete unknown and it means an end to all that is familiar. Death means saying goodbye to loved ones and all the things that make life enjoyable. For a great many people it is not death itself that worries them the most but the process of dying. There are things that people can do to make facing death easier in recovery:
* Those who have been following some type of spiritual or religious path will usually find that this offers comfort and answers for dealing with death.
* If people are members of a twelve step program they will be able to use this program for dealing with death. The 12 Steps can provide the individual with strength and they can keep on practicing the program right up until their death.
* Counseling is usually recommended for people who are terminally ill. This gives the individual the opportunity to voice worries and concerns.
* Death is a natural process. Understanding this process better can help people deal better with it.
* Those individuals who practice meditation may find that this is a great help for controlling pain and coping with the emotions surrounding terminal illness.
* If people try to hide or deny their emotions it can make the process of dying more difficult. Some people feel that they need to put on a positive face for family and friends, but if this is not how they truly feel it can lead to further suffering.
* One of the scariest aspects of dying is the feeling of losing control. The individual can regain a sense of control by taking an active part in their own treatment.
* One of the benefits of terminal illness is that it reminds the individual that each day is precious. It will be up to them to make the most of any time they have left.
* There is no right way to die. It is up to the individual to decide on their own path.
* It is important to understand that nothing is certain – where there is life there is hope. There have been many instances of people being told by doctors that they only have a short time to live yet they managed to rally on for much longer than expected.
* Many people have found that complimentary therapies helped them deal with the symptoms of their terminal illness. These therapies can be a good choice so long as they are not chosen over proven medical treatments.
* Many individuals decide that this is a time for making peace with people with their past. People have a chance to say those things that they always wanted to say.
* The individual may reach a stage where they just want to give up, but it can be a good idea to consider all available treatment options – new treatments are becoming available all the time.
* It may help the individual to realize that they are facing something that all humans will need to face. Every human alive today will likely be dead in 120 years.
* There will usually be practically concerns that the individual will need to take care of before they die. If these are not resolved they can play on the individual’s mind and make the process of dying more difficult.
Those individuals who have developed a high degree of serenity in recovery will find it easier to face death. These are individuals who have mastered the art of dealing with any challenge that comes their way. To them death is just one more challenge and the coping strategies they have developed over the years will help them greatly. Some of these individuals are truly inspiring while going through the process of dying. They are often able to find enjoyment in life right up until their last breath.