Planning for Death and Dying while Healthy: Lessons from the Gulf War Mobilization

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Abstract

To enable nurses to assume an active role in helping patients and families discuss and plan ahead for end-of-life decision making, factors that influence response to being asked to consider one's death while one is still healthy need to be considered. Members of the National Guard were interviewed about the cognitive, behavioral, and affective responses they had when they were asked to make plans and decisions to be implemented in the event of their injury or death as part of mobilization for the Gulf War. Content and thematic analyses revealed six patterns in their responses: reference to a context of meaningfulness; recognition of infrastructure that provided direction; awareness of social support; overriding concern for family; denial and avoidance, most notably in the service of protecting family members; and focus on tasks. Nurse practitioners and educators can use these findings to guide program format and content as well as future research. Key words: advance care planning, death, dying, education, end-of-life decision making, grief, military, National Guard, nurse, nurse practitioner, prevention

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