In final days, quality of life remains the focus of care


In Oregon and other states where people in their final weeks can sign up for services to end their lives, most typically end up not using them.

“When it comes down to the wire, most people don’t really want to decide when they will die; they just want to be comfortable,” says Donna Nolde, manager of Palliative Care Services for Chandler Regional Medical Center.

“Truly, there is no reason to take your life or even to think about it. There is so much available in the community that will help them—things that people are not always aware of.”

Through hospice and/or palliative care, Nolde says, her patients are able to live out their lives with dignity and comfort.

“I never want anyone to feel that desperate,” she said. “There’s always hope.”

Within those deeply held philosophies lie Nolde’s nursing specialty and the compassion she holds for those in her care—a chosen profession through which she is able to understand the fears and frustrations that her patients often share with her.

Some have symptoms that can be frightening or painful; others may feel exhausted and depressed.

But despite policies in states such as Oregon that allow for procedures like physician-assisted suicide, Nolde feels strongly that with the right combination of support and services offered through hospice and palliative care, no one should ever have to feel like they need to end their own lives.

“Palliative care happens from the beginning of a chronic illness until death,” she said. “It is designed to help treat symptoms and provide a quality of care for our patients. We want to improve their quality of life in any way that we can.”

“The secret to the whole thing is to make people comfortable and help them still enjoy life, so this issue never has to come up in the first place.”

At Chandler Regional and its sister hospital, Mercy Gilbert, Nolde—R.N., M.A., C.H.P.N., C.T. — says most of her patients are 65 and older. This group, she freely admits, is “the one I worry about the most.”

“They tend to have the biggest needs, but the fewest services. There are times when people will say ‘I’ve had enough, I’m tired, and I’ve been sick for so long.’”

When Nolde hears her patients express feelings like these, she will listen to them, taking the time that is needed for them to get their feelings out in the open. If they are experiencing pain or other symptoms, Nolde knows that she and her team must do everything they can to manage their care.

“Sometimes just talking about their feelings will help—oftentimes they are depressed and feeling down. We can help find the right people for them so they can continue to talk it out. And if they are having symptoms like shortness of breath or other issues it can be very frightening, so we will determine how we can help to control it, and we promise to help them.”

Through the development of outpatient palliative care community programs, Nolde said elderly patients can now get even more help than ever with everything from getting their medications changed to learning how and when to take them.

“We can help by calling their physicians for our patients—sometimes it’s just a matter of calling the office for them,” she said.



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