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September 2010, Volume 40 Number 9 , p 18 - 19


  • Joy Ufema MS, RN


My patient, 66, has terminal cancer. He asked me what I thought about his choosing cremation over burial. He wants his ashes kept on the living room mantle in his home. His family likes the idea, but to me it seems morbid. What do you think?—M.B., N.H.If the patient and family are comfortable with the plan to keep the patient's cremains nearby, I'd support their decision. I might also share the story of a young father who was killed in a car crash. Using amazing wisdom despite paralyzing grief, his widow had his body cremated. His ashes were placed in a mahogany box and delivered to the family's house. When the ashes arrived, his two preteen daughters exclaimed, "Daddy's home!"In subsequent weeks, the cremains were moved from one bedroom to another—and even to the kitchen for Sunday morning pancake breakfast. An unwritten rule was that the box remained in the possession of whoever needed it most at the time.A few days before what would have been this man's 45th birthday, his grieving parents asked for the ashes. They missed him and wanted him close.This family found immense comfort in this plan. Others may not. Just offer the information and let your patient and his family choose.As the nurse manager of an inpatient palliative care unit, I work with a fine group of nurses, some of whom I've known for years. I'm well aware of the toll repeated deaths can have on them over time. Can you share any specific behaviors that indicate a level of distress requiring intervention?—E.W., CALIF.Working with dying patients and their families certainly can be emotionally draining. Dame Cicely Saunders, founder of the modern hospice movement, spoke of it as "battle fatigue." When a nurse is exhausted mentally and physically from caring for dying patients, she or he needs to work in another specialty for as long as needed to feel refreshed and recovered. Eventually, after this period of healing, the nurse may want to return to work with

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