I'm so sorry it took me so long to circle back to this for you! These are really great questions.
I've recently seen two people when they were dying i (in a long-term care hospital when visiting my grandmother) and it left me thinking quite a lot. I can't especially get over the fact how the nurses and other staff were dealing with the situation, of course I'm in no position to judge them, but the atmosphere and their attitude seemed really unpleasant and disrespectful to me.
So I'm wondering how should it be done right? Are there any simple principles how should care and communication with a dying person and their close one's look in their last hours? Is a care facility obliged to provide that kind of care and approach?
I do think it's okay for you to have whatever thoughts and feelings you have about what you've seen. While nothing is universal in this regard, I do think that for sure there are ways of treating the dead and dying that are respectful and that aren't, and long-term care facilities very much differ in quality just like any other kind of service. When my mother was recently in one, there were for sure a few times she was so clearly treated like a body and not a person, and she wasn't even dying!
What's "right" is going to depend a lot from person to person, but for sure, if you want to find out what a dying person wants, so long as they are not in the process of actively dying (when it's often too late to get a lot of detail or response), that's who I'd start by asking.
But you also get to have your own wants for the treatment of your loved one! So, it's always okay to talk to a staff person or to find a supervisor when you have concerns. I like to remember that not everyone has family or other advocacy, so when we see something that troubles us with our own loved one and follow up, we're probably helping other people who need advocacy, too, you know?
And I'm also asking because I've been researching care facilities where my grandma could move to soon and out of those tens I've checked out just few provide information about their plans of palliative care/accompanying of patients and just two claim to have a trained non-medical member of staff who specialise in that. And even though my grandma might not need that kind of care anytime soon I'd like her to have a choice of a good care in all the upcoming stages of her life. So I'd like to ask what could be some questions that we could ask the care facilities about the care they provide? And even though it is probably highly individual, is someone with a professional training guarantee of a good care? Anything else I should know?
First up, know that death doulas are all across the globe, and many are available as volunteers, for low-cost or barter. So, if you want help seeing if we can't find someone for your grandmother so that person is there for her and you regardless, just let me know. I can absolutely start by asking my training facility if they know of anyone working in your area.
I would not say many facilities have non-medical or non-clinical staff for patients, but I think that having some is a definite vote in favor of a place. I'd also see if you can't talk to others who have or have had family members at a facility: they will often be more honest about the reality of a place than anyone whose job is on the line.
I would also suggest asking them to just talk you through the whole process of their care, from intake to death. What is provided? Who decides that? What kind of care is available: how about things like a therapist or counselor, religious or spiritual services if that matters to your grandma, flexibility in diet/food, music, etc?
And also last question, what can be some gentle way to initiate a conversation with someone about their death (in order to find out how they would like their last moments to look, sort out property, ask about their preferred way of burial...)? And is it okay to initiate this conversation when the person doesn't bring it up by themselves?
I think you need to use what you know about that person and their relationship with them when it comes to the how, but I absolutely think it is fine -- and good! -- to initiate the conversation with someone about their own death who hasn't brought it up themselves. Sometimes people just don't know how, or are afraid of causing those who will survive pain, of being a burden, and so forth.
What feels like a way to start a conversation about that with your grandmother to you?