How do you like your tea?
A professor with theories to dissect and lectures to give regularly found himself looking to his doctor for direction about his prognosis, and said,
“The one thing I feel I have left to make to my liking…is my tea.”
What do you picture when you think of the word choice? Most likely, it is not someone in long-term care or hospice. The perception of lack of choice can become the biggest hindrance to acceptance. Acceptance of prognosis by the person and their healthcare team is the precursor to planning that could reduce discomfort, unnecessary procedures, and fear for both the patient and their family.
Acceptance ebbs and flows differently for each person. Patients have often said that trying to handle each layer of it alone can bring up a sense of loss that trickles into the quiet cracks of their day. What is it like when someone with a life-limiting illness has to reframe what choice means to them? How do simple, daily decisions shift?
Before we ponder these significant questions, let’s go back and reframe the professor’s tea. Instead of viewing it as a last point of control, it is a step in understanding how a care plan can facilitate a transition made to the person’s liking.
The last bag of dead leaves is dipped into the pristine water, slowly tinging it with dark swirls. Some people put milk in their tea, some sugar, and some drink it the way it is. The worst is when someone thinks they are stuck with irreparable, bitter tea. People often feel this way about their prognosis, a hopeless and overwhelming bitterness.
Can one alleviate the taste of bitter, dead leaves?
It takes observation, timing, and emphasizing preferences to find the balance of milk and sugar that is suitable. What does all this metaphorical tea silliness mean? Who has time for assessing palates?
Isn’t the end of life something that is left to fate, or too bitter a thing to have choices about? Let’s review the milk and sugar of what changed the bitter tea…
Observation/Milk:
When are there too many tea swirls in the water?
Healthcare professionals, family, and friends encourage treatment in a specific direction and express how they feel about a patient’s situation. In this stage, a person may be too bewildered and entrenched in bitterness to think of their opinion. The feeling is that there is no repair and no choice.
Observe when there are too many opinions, and no direction.
Timing:
When is it time to take out the teabag?
When are curative procedures causing more harm than good? Palliative care professionals can help people assess their preferences for invasive procedures. Then if necessary, help them transition into symptom management, learning to keep focused on the quality rather than the quantity of life.
Personal Emphasis/Sugar:
Does the person feel involved in their care plan?
After the patient learns their emotional rhythm alongside their team, options, and care plan, this can help lessen the burden and transition into a stage where the patient feels they have choice and dignity in their care.
Choice and dignity are the milk and sugar that eases bitter leaves. It is not an easy stage, and there is no magic formula. No matter what a person is going through, their sense of choice and dignity determines their acceptance, and ultimately their happiness.
More on Personalized Care Plans:
https://nurseslabs.com/4-end-of-life-care-hospice-care-nursing-care-plans/
