From my mother's sleep: Witnessing the effects of war on the end of life

The moral paradox imposed by war, like the hope of a good death, compels us to accept notions and acts by which we otherwise might be disgusted. As we attempt to understand more fully how to better serve patients from diverse communities in end of life care, those who have experienced war, either by military service or as civilians, deserve our attention. Survivors of the Holocaust, victims of the Bosnian war, and veterans of WWII, the Korean War, Vietnam, and the wars in Iraq and Afghanistan, among others – all come to the ends of their lives with different coping, sensitivities, beliefs, and traditions. These characteristics are multidimensional and essentially confounded by the wartime experience of conflict, violence, suffering, and death. The individuals number in the hundreds of thousands and warrant our development of greater competency and compassion in their care, just as do those of other communities. As an in-patient hospice nurse and public health and nursing graduate student, the author has learned from these patients and their families how the impact of war continues to influence their health through the end of life. Drawing connections between these individuals’ experiences and exposing commonalities among their responses to that influence, she will explore a range of considerations in healthcare that will help their providers better manage their symptoms and ease more of their distress, thereby providing them with more comfort and peace, while they are dying.