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The Humanity of a Dignified Death

By Mr. Isaac Gideon Akonde, MIoD, FGCNM

A founding Director, COMPASS-Ghana

Working as a health care professional in a District hospital in Ghana for several years placed me in a unique and humbling position to care for and support thousands of patients and their families whilst they seek medical care. Whilst the majority through the joint efforts of the medical team recovered from their ill-health, some sadly passed on in the process. Whereas some of the deaths were attributed to sudden onset of life-threatening conditions that gave no room for planning, others (perhaps the majority) resulted from chronic, terminal conditions where the patient had an opportunity to make certain decisions. In all of this, one of the terrible experiences as a health profession is the sight of a patient who is at his/her worse vulnerable state and in severe pain with little or no knowledge or support on how to deal with it. Even though I had seen and experienced several cases of people in their last days, I came face-to-face with reality about ten (10) years ago when my dear Mum was diagnosed of a terminal stage cancer. As with most situations and in line with Ghanaian culture where death is hardly discussed with the dying, the doctors explained to the family the stage of her condition and the fact that she was in her last moments instead of doing so with my Mum.  They gave the family the option of sending her home or keeping her in the hospital ward. Considering the excruciating pain my Mum was going through, we chose to keep her in the hospital so that the pain could be managed by the healthcare team. Unfortunately, whilst on admission for eight (8) days, neither my Mum or the family had the needed education, support, pain management and counselling to help her navigate the last moments of her journey with dignity. I am unable to tell if my Mum had the requisite knowledge of her condition and its stage to make informed decisions about her life and her family prior to her death.  Sad as it may seem looking back several years down the line, this may largely be blamed on the country’s overall health system approach to a holistic palliative and end-of-life care.

Those facing serious illness or approaching the end of life need compassionate, coordinated, patient and family-centered care based on their needs or wishes. This will ensure that patients have the knowledge to make informed decisions and enhance their quality of life and helping to relieve the emotional and financial burdens on their families. Over the last several years, health care providers and advocates for persons with serious illness have worked for changes that support this vulnerable population of Ghanaians. Among those changes is the effort of making palliative care services available across health care settings (including home-based care) with the goal of improving quality of life for both the patient and the family. Palliative care is appropriate at any age and at any stage in a serious illness and can be provided together with curative treatment.

Studies show that early access to palliative care for seriously ill patients improves their quality of life and in some cases even prolongs it. This can be achieved through care planning based on open, honest communication about severity of illness and medical treatment options; effective pain and symptom control; and highly coordinated care that addresses the physical, emotional, social, and spiritual needs of persons with serious illnesses.

Health facilities and home caregivers, particularly those working with older people, need to be prepared and adequately resourced to support people who are dying. Training around death and bereavement is important but equally so is how to provide compassionate and dignified end-of-life-care because everyone deserves a dignified, pain-free and supportive death. I believe therapies to treat diseases especially those that are life-threatening, need to be balanced with therapies to relieve suffering or improve the quality of life of the ill in the process or provide a peaceful death to the dying.

Whilst progress is being made on medical care and technology, we need to continue to think about how we incorporate standards of humanity into caring for the people we love, should they suffer any chronic, life-threatening, or terminal illness. In the ordinary Ghanaian setting and perhaps in many other African settings, conversations about serious and/or terminal illness can be difficult to have, but they are important nonetheless in ensuring that the care delivered is compassionate, person-centered, and warranted.

This is one of the cardinal pillars of COMPASS-Ghana; to train, equip and empower professional workforce with the approaches, skill, and knowledge in supporting a dignified End-of-Life care for all individuals regardless of their socio-economic status.

COMPASS-Ghana is a Ghana-based registered Not-for-Profit Organisation that partners with Ghana-based specialists to help address the urgent and critical need for Palliative and End-of-Life care in Ghana in collaboration with key stakeholders such as community workers, traditional and religious leaders, and other health NGOs with the core values of resilience, unity and a passion for positive change. COMPASS-Ghana is currently supporting and partnering with institutions in Ashanti, Eastern and Greater Accra Regions with the ambition of a nationwide and Sub-Saharan coverage. COMPASS-Ghana seeks to integrate world-class standard on palliative and End-of-life Care into the Ghanaian healthcare system. COMPASS-Ghana has a joined vision with its UK arm, COMPASS-Ghana (UK), which is a UK registered charity with the role of mobilising funds and other logistics to support the Ghana arm in implementing this essential humanistic project.

COMPASS-Ghana is Ghanaian-owned, here to stay, and has the capacity to pursue this vision. Please join the train and be part of the positive change everyone deserves in life’s journey!