When a Window Is More Than Just Something We Look Through

When a Window Is More Than Just Something We Look Through Posted By:
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I am sure you have heard the phrase “window of time” applied to many different aspects of life. I’m also sure you've used this colloquial phrase, but have you ever thought about what that means? If you were to search for information about it, you’ll see that the “window” refers to a specific period during which a particular task needs to be completed or is most effective.

I want to talk about this in the context of serious illness and especially end-of-life care. "Window of time” is a phrase that I commonly use, not only with patients and loved ones, but also when speaking to and educating colleagues. The concept of this window implies that there is a limited time for success; this success often means honoring patients’ wishes for how they want their end-of-life journey to look, such as how they want to spend their time since they have accepted that their time is short. 

This window is not one that we look through, but I would offer that it is one that reflects or embodies our limited time. This is usually the time we have to prepare to support someone at the end of their life, and, in my experience, it’s the precious time we have to plan to safely get someone out of the hospital with the support and care they need to complete their journey at home, surrounded by familiarity and folks they love. As an inpatient palliative care healthcare professional (HCP), I would describe this window as a time when patients are as medically optimized as possible, able to be transported, and hopefully able to get out of the hospital, if that is their goal.

It is often an interesting and delicate, but lovingly heartwarming, conversation when patients and their loved ones recognize that this window exists and can work with me as a palliative HCP to ensure a plan to fulfill and honor their wishes. As HCPs, we must recognize that missing this window creates a missed opportunity, often resulting in hospital deaths and creating complex grief for the loved ones who remain. Understanding the concept of the “window of time” serves to emphasize the importance of timely action, while recognizing that certain opportunities, like the ability to honor and support someone’s end-of-life journey, is inherently time sensitive. Missing the window means that we have misunderstood the cues from a body that is going through the natural process of dying. It does not mean that we can no longer support the patient, but it forces us to change our methods and often means patients cannot be discharged to have their preferred end-of-life journey.

Being able to recognize the “window of time” as HCPs caring for seriously ill patients places us in a position to provide recommendations in line with patient’s wishes and to support and empower patients and their loved ones to embrace the precious time they have on this end-of-life journey. Together, we can all work to normalize death and dying.


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Filed under: Miscellaneous , NPs & PAs

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