Returning to the accompaniment at the end of life as an important nursing care in palliative care

doi:10.15406/hpmij.2019.03.00139

eISSN: 2576-4497

Hospice & Palliative Medicine International Journal

Mini Review Volume 3 Issue 1

Returning to the accompaniment at the end of life as an important nursing care in palliative care

Inmaculada Minguez Moreno

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Department of Nursing, University of Alicante, Spain

Correspondence: Inmaculada Minguez Moreno, PhD student, Department of Nursing, University of Alicante, Zaragoza (Spain)

Received: April 08, 2018 | Published: January 2, 2019

Citation: Moreno IM. Returning to the accompaniment at the end of life as an important nursing care in palliative care. Hos Pal Med Int Jnl. 2019;3(1):1-2. DOI: 10.15406/hpmij.2019.03.00139

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Mini review

The concept of dying has changed through the centuries. The different paradigms of knowledge, have influenced the culture, the science…..etc, as well as having influenced how to live, how to die and about end of life care.

Analyzing the historical evolution of the concept of “accompaniment at the end of life” it becomes evident that many different models exist. The oldest one is known as “The domestic death”¹ or more commonly “The good death”. In this case, people died at home, and the protagonist was the dying person. The death happened next to the family who took part through direction from the dying person.

Between the 12^th-20^th centuries, death as a concept started to acquire a social importance, becoming somewhat of a social ritual. This experience started to become separate from the traditional home and family setting; and instead moved the experience out of homes. Two different stages exist in this process. Firstly, in the Middle Ages, it was called “The one death”¹which was influenced by concepts like the Last judgement, purgatory…e.g.

The Romantic Movement, in the 18^th century, gets a short conciliation with death even seeing the beauty of its own.

In the 19^th century stars the second stage, which can be called “Of the others death”¹ taking relevance in society and being manifested with the cult in cemeteries, exaggerated mourning…

In the 20^th century, after the Second World War, began another stage, which can be called “the forbidden death” or “the technologic death”.¹ In this stage, death is understood separate of life, society and as a medical failure. People die alone in the hospitals far away from their families and homes. It is considered as a non-natural phenomenon.

With the becoming of the 20^th century the paradigms of knowledge started to change. These changes to the concept of dying came in the second half of the century to medicine and nursing, approaching the traditional model which brought new areas of care, like palliative care. Thus allowing death to occupy another time as a part of it.^2–4 This creates a challenge for the nurse who is one of the most essential supports in care during end of life. One of the most important aspects of care is accompaniment for the dying person in order to ensure they experience a worthy death as well as ensuring the families have space for the critical mourning period. The Michigan In service Education Council state in their declaration for the persons who are in the end of life, that: I have the right to not die alone.

This should remain essential to nursing as an important role when being trained, to ensure clear and effective care, as well as an important professional responsibility when assisting people to experience a worthy death and accept death as part of life.