Palliative Caretakers: A Field for New, Logical Thinking
I have been Co-Counselling since 1981 and have become actively interested in palliative care in the last couple of years.
I would like to be Information Coordinator for Palliative Care/Hospice Workers. Palliative care is the attempt to address the needs of people who are diagnosed as having an incurable illness, e.g., major cancers, motor neuron disease, intractable heart failure, etc. Good palliative care is said to involve biological, psychological, social, economic, and spiritual aspects of the situation. I believe all health care should take these into account, but palliative care is one of the few branches of medicine to truly espouse them. People have always had to deal somehow with the dying; palliative care has arisen in the last few decades in response to several trends, which may be summed up as the failure of modern first-world medicine to deal humanely with those it cannot cure.
A refusal to die can be a useful direction. Further, we can expect average longevity to increase. Still, at this time, it is most likely that there will be a point, unique to each individual, when a disease will kill a person and further striving will not prolong life.
What I am getting at is that without being defeatist, Co-Counsellors, like everyone else, may have to accept that they will be killed-in minutes, weeks, months, or years. They need not feel like failures. They will be cherished by the RC Community before and after death. We can take the attitude of refusing to die while still not denying the fact of death.
I feel a calling to work in palliative care and think that RC can be intrinsic to this work-discharging fear, keeping some attention out, organizing support, thinking clearly. I feel my talents and experience suit me well for this work, and I look forward to learning more.
I acknowledge that my earlier experiences around the death of my grandparents profoundly affected me and that part of my motivation is to improve things for those who live and die with and after me, but I do not think I am "distressed" to be so interested in dying.
Pain management is a major focus of attention in palliative care-the use of analgesic drugs, anaesthetic techniques, surgery, and radiotherapy. For instance, a painful cancer deposit in bone will shrink in response to a dose of radiotherapy, and many people are given morphine in the attempt to relieve suffering. It is possible that systematic counselling attention could deal with the pain from a cancer deposit, but I don't know of anyone who has set this up for themselves.
I think RC can offer some insights into palliative care in the areas of dealing with pain and attitudes toward death. A third area, of course, is grief and bereavement. RC offers many helpful insights in counselling the bereaved and creating support networks.
I would like to hear from RCers who are interested in the above areas (and other relevant ones). Do you know of anyone else who is doing similar work? I know Joan Karp does RC death and dying workshops.
The main thrust of palliative care is to co-ordinate all available resources so that things go as well as possible for the patient. I think this is quite consistent with the theory and practice of RC.
John Gray, M.D.
Tasmania, Australia