A hospital in Hamilton, ON Canada has initiated a novel 'three wishes programme" in an effort to making dying in an ICU a bit less impersonal.
Dr. Deborah Cook, a professor of medicine at McMaster University and an ICU physician at St. Joseph’s Hospital in Hamilton explains that humanising the environment when somebody is dying can be a real challenge in the ICU. The three wishes programme is one way of trying to address this challenge.
The programme is simple and includes three elements: eliciting wishes from dying patients, their loved ones and the medical team responsible for their care and trying to make these wishes come true. However, this programme is different from the Children’s Wish Foundation, which tries to fulfil the wishes of kids with terminal illnesses. The focus is not to take children to Disneyland or make them meet their favourite celebrity. The goal of the programme is to honour and remember the dying person in an environment that is focused more on seeing the person as a patient.
Dr. Cook says that the environment in the ICU is “technologically oriented and somewhat cold and far removed from home, which is where most people say they would like to die. So in that setting we were trying to develop a programme that would help to humanise the dying process and make the death experience more personal.”
When a patient's death seems to be inevitable and imminent, healthcare providers in the ICU team will start to collect wishes for, and if possible from, the person. In this particular study, only a small portion of the wishes came from the patients because they were too sick. Also, none of the wishes were glamorous or unrealistic but instead were simple, special, situational and implementable such as going out in the sunshine, having a final toast, meeting a beloved family pet etc.
Under the three wishes programme, the team follows up with the patient's family members after the death of the patient and helps them cope with the pain and grief of losing a loved one. This not only has a long-lasting impact on the family members' experience, but also reminds the clinicians of the primary reason why they went into healthcare.
Dr. Cook says.“The programme is really a vehicle for the human connection that we all seek in times of tragedy.”
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