Growing up, the way in which the vast majority of us experience death firsthand is through the loss of loved ones, so it makes sense that the shock and grief that can accompany these experiences would shape our attitudes towards the topic of death in general. 

Sudden and unexpected deaths are obviously horrible, but there is an added layer of complexity that comes with knowing that a person is beyond cure and approaching the end of their life.

Terminal illness gives family members and friends the chance to say goodbye and prepare for the loss of a loved one, but watching a friend or family member deteriorate rapidly towards their impending death can be an extremely harrowing and torturous experience. 

Entering palliative care signals a shift in a person’s mentality.

This is the point where the hopes and dreams of recovery make way for the reality of death and the need to feel as comfortable and supported as possible. 

While every person who chooses a career caring for others is special, those that take on the responsibility of comforting people in the final moments of their lives are even more unique, as their working environment is often filled with families who are going through one of the worst experiences imaginable.

Providing comfort to people and families at this vulnerable moment of their lives is an intimate service that requires understanding, and even with years of experience and a professional working manner, it’s not uncommon for the palliative care environment to take an emotional toll on staff.

Carolyn Botto is a registered nurse at Calvary Health Care Bethlehem who has a background in oncology and a care-related working history that spans three decades.

Carolyn’s interest in palliative care started almost 30 years ago after witnessing the suffering of people who did not have the option of comfort based care, and Carolyn was nice enough to share some of her experiences with HelloCare. 

“The first experience is challenging. Death is a taboo subject in our society and rarely a topic of serious conversation;” said Carolyn.

“Palliative care is only a recent addition to training programs for medical and nursing students.

“Death rarely occurs in the home or involves the community so we are distanced from this reality.

“Many students will come to Bethlehem and have their first experience of a person dying.

“Without exception, they are reassured that it is not to be feared.

“With expert care, the symptoms and the emotional journey for patients and families can be managed well.”

Forging relationships with those you care for is regarded as one of the most fulfilling aspects of being an aged care employee, but it is important for those working in palliative care to be mindful of becoming overly involved with their residents.

Although it’s quite natural for staff to feel saddened by the death of a patient, it is important for palliative care staff to remember that this is not their burden to bear. 

“This is not our life story or sad loss. It is owned by someone else who allows us the privilege of being present,” said Carolyn.

“Our role is to provide support to the best of our ability.”

“The holistic approach in Palliative care means that we get to know more about people’s lives than would usually be the case.”

“Contacts can be intense, but this is what provides the value and rewards in this type of work.”

Carer fatigue – often referred to as burnout – has a wide variety of symptoms ranging from becoming withdrawn and having poor sleeping habits, through to a loss of appetite and feelings of stress and anxiety.

Burnout is a form of depression that can have devastating effects on carers’ overall mental health, and combating these issues requires staff to utilise support around them and do their best to find a good work/life balance at home.

“The level of support provided at Bethlehem is excellent,” said Carolyn.

“The Bereavement team provides reflection gatherings to share memories – things that have been touching, challenging, or even humorous.

“Cohesive teamwork supports morale, with regular meetings, staff are able to discuss any challenging cases and share care if necessary.”

“The team will provide mutual support informally and management is aware of the needs of the team in this potentially difficult area of work.

“Many people work out their own ways of relieving stress with activities away from work, such as burning off stress with a 10km run or relaxing with mediation.”

Typically, serious conversations about death and dying are either scarce on nonexistent within Australian households, which compounds feelings of uncertainty when death becomes reality.

Palliative care staff provide much-needed guidance to both patients and family members in their time of need, adding a layer of meaningful purpose that few job titles can lay claim to. 

Providing Palliative care is a meaningful job,” said Carolyn.

“There are immense returns and work satisfaction in being able to provide care for vulnerable people.

“Palliative care attracts people with an amazing capacity for caring which creates a special work environment.”

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