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The emotional responses of the dying patient and family
Several studies in western cultures have examined this topic. First, a focus group study that included physicians, nurses, social workers, chaplains, hospice volunteers, patients, and family members of recently deceased patients, found six features of a 'good death'.


 * 1) "Pain and Symptom Management" should be done so a patient does not die in pain with an uncomfortable symptom such as shortness of breath.
 * 2) "Clear Decision Making". The pain and symptoms may be improved through good communication and clear decision making with physicians. Patients may want to participate in these treatment decisions.
 * 3) "Preparation for Death". Patients and families want to know what to expect at the end of life. Patients may want to ensure  that plans related to the death, such as a will and funeral, are made.
 * 4) "Completion". This may include "not only faith issues but also life review, resolving conflicts, spending time with amily and friends, and saying good-bye". The focus group noted that other rituals may be important for other cultures.
 * 5) "Contributing to Others". Terminally ill persons may want to contribute to the well-being of others.
 * 6) "Affirmation of the Whole Person". Dying patients may want to be treated as an individual and with empathy.

Regarding the role of the health care provider, saying goodbye to the dying patient may be important . Black et al provide detailed suggestions for saying goodbye.

1. Choose an Appropriate Time and Place

2. Acknowledge the End of Your Routine Contact and the Uncertainty about Future Contact

3. Invite the Patient To Respond, and Use That Response as a Piece of Data about the Patient's State of Mind

4. Frame the Goodbye as an Appreciation

5. Give Space for the Patient to Reciprocate, and Respond Empathically to the Patient's Emotion

6. Articulate an Ongoing Commitment to the Patient's Care

http://jama.ama-assn.org/cgi/content/full/297/7/716