TRAINING STAFF TO CARE FOR DYING CLIENTS
How does a developmentally disabled person who is approaching old age perceive death and deal with it? What support can be offered? In discussing the needs of people with mental retardation who are old with regard to death, one must understand the current methods of dealing with their dying. Our discussion will focus on alternatives or choices for the person with mental retardation who is old, emphasizing a hospice model of care. Training and support for caregivers is essential for improving the way we take care of clients who are dying.
There are four areas on which to focus the training: physical plant, medical care, psychosocial care, and administrative issues.
The design of the physical plant of a residential center can present many problems for a client who is dying. A staff person should understand what environmental needs the client has. Possibilities for sunlight, a view of the outdoors, relief from mechanical noises (housekeeping machinery, traffic, grounds-keeping machinery), and frequent social contacts should be considered. Decoration with photos, letters and cards, and artwork--the client's own, or those given by friends--is comforting. Flowers and beautiful objects--stones, crystals, patterned scarves--should be easily seen and changed often. In one case, caregivers did all they could for a person who is dying, but because they had no knowledge of what the physical environment could potentially consist of, they were unable to make the changes that were needed. The client's room remained drab, with little privacy.
Medical care has presented a range of problems. Choices about the best medical care for clients who are dying are to some degree optional. Our goal is to choose treatments that are in the best interest of the individual client, if the client is unable to make his own decisions.