Building holistic bridges from life to death.

H ospice and palliative care are intrinsically holistic modalities because we cannot – and must not – separate the caring of the mind, body, and spirit when tending to the suffering of people who have serious illnesses or who are in the process of dying. Many interpretations of palliative care agree that it is about providing comfort, easing suffering, and assisting a person and his/her loved ones to achieve optimum quality of life. Interdisciplinary teams provide palliative care to help people navigate the challenging territory of illness, decline, and eventual death. Palliative care is about encouraging people to live every moment until the last. It is the modality we can employ to help each other understand what it truly means to be " present " and to consider the fact that everything and everyone in this world is impermanent. How To PRACTICE PALLIATIVE CARE Although most of us imagine that we will live a healthy life until we are in our 80s or 90s and then peacefully die in our sleep, it just doesn't seem to happen that way most often. As Joan Didion (2005) tells us so eloquently in the opening lines of her book, The Year of Magical Thinking: " Life changes fast; Life changes in the instant; You sit down to dinner and life as you know it ends " (p. 3). Accepting our own impermanence as human beings here on earth must become an integral part of our holistic nursing theory and practice. Therefore, I offer three guides on how to practice palliative care. FIRST, Do No Harm. These famous words of Hippocrates come to mind when assessing what is needed to provide comfort. It is so much more than vital signs, lung sounds, and heart rhythms because it takes time to know a person who is seriously ill. If we enter a room with preconceived ideas of what " we " are going to do to make the situation better, we may be doing more harm than good. And, as we have learned in our holistic model of nursing, pain and disease can be signals of internal conflict (Ferguson, 1987). Therefore, it is important to spend time with the person who is ill and, if possible, with family and friends in order to understand what the issues are beyond a particular disease process. Although pain can be alleviated with medications quite successfully, we also know …