gc06-7 - DO YOU CARE WHETHER YOUR PATIENTS DEATH IS...

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3/12/06 Cassem MGH Psychiatry 1 DO YOU CARE WHETHER YOUR PATIENT’S DEATH IS MEANINGFUL? Geriatric Course University South Florida March 12, 2006 Ned H. Cassem, SJ MD Consultation Psychiatrist , MGH Professor, Harvard Medical School
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3/12/06 Cassem MGH Psychiatry 3 MAINTAINING HOPE IN THE CONTEXT OF FATAL ILLNESS LIVING WITH THE DISABILITY THE MAINTENANCE OF MORALE THE SEARCH FOR MEANING Avery Weisman, The Vulnerable Self
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3/12/06 Cassem MGH Psychiatry 6 THE THEME OF ERIC CASSELL A UNIQUE LIFE LIVED IS A WORK OF ART
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3/12/06 Cassem MGH Psychiatry 7 HOW HELP A PERSON REPAIR THE SENSE OF BROKENNESS? LEARN WHO THIS UNIQUE PERSON IS EXPERIENCE EMPATHICALLY HER/HIS SENSE OF BEING SHATTERED
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3/12/06 Cassem MGH Psychiatry 8 EACH PERSON’S UNIQUE LIFE IS DEFINED BY MANY DIMENSIONS Family: Primary, Extended, Close Friends Culture, Mores, Origins, Geography Ethnicity, Race, Roots Faith, Religion, Values, Role Models Education, Cumulative Experience Socioeconomic status Occupation(s), Work
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3/12/06 Cassem MGH Psychiatry 9 HOPE DEPENDS ON MAINTAINING THE INTEGRITY OF THE WHOLE SELF DEALING WITH LOSS OF SELF (ESTEEM): DAMAGE REPAIR & RESTORATION DEALING WITH LOSS OF OTHERS : BEREAVEMENT
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3/12/06 Cassem MGH Psychiatry 10 SIMMONS ON LIFE’S UNEXPECTED LOSSES “We have seen friends fail and bodies wither. With each loss the trap door opens beneath our feet and we fall, feeling the terrible wind, gazing upward at a life now forever out of reach.” (135-6) P Simmons, Learning to Fall; The Blessings of an Imperfect Life . NH: Homefarm Books. 2000
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3/12/06 Cassem MGH Psychiatry 11
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3/12/06 Cassem MGH Psychiatry 12 WHAT CHRONICALLY DISABLED, DEMORALIZED PERSONS WANT FROM CAREGIVERS Morag Coate, British writer with severe, recurrent psychosis, described the doctor’s role in saving her life: “Because the doctors cared, and because one of them still believed in me when I believed in nothing, I have survived to tell the tale .” -- KR Jamison, Night Falls Fast: Understanding Suicide , NY: Knopf, 1999
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3/12/06 Cassem MGH Psychiatry 13 REHAB OF THE SELF: DEFINING THE PERSON Who is s/he? Who was s/he at the top of her/his game? S/he is the same person now. What defines her/him? Is s/he more than “dying… a lung Ca… crippled… unresponsive…”? Can the Team deliver her/him from anonymity?
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3/12/06 Cassem MGH Psychiatry 14 PROUDEST OF Prowess, strengths, skills, mastery Achievements (Awards, Rank, Recognition, Productions) Legacy AMBIVALENT: The “Black Sheep” DISAPPOINTMENTS, LOSSES, FAILURES Failed Plans, Shattered Dreams Losses, Deaths, Grief, Shame WHO IS S/HE?-- 1
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3/12/06 Cassem MGH Psychiatry 15 FAMILY, LOVED ONES CLOSEST, MOST SIMILAR, MOST OPPOSITE SAVED, WAS SAVED BY CORE ANECDOTES LETTERS TO/FROM, OF GRATITUDE, OF PRAISE ENEMIES WHO IS S/HE?-- 2
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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gc06-7 - DO YOU CARE WHETHER YOUR PATIENTS DEATH IS...

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