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Preparation and Care for the Time of Death

Preparation and Care for the Time of Death. Colette Rudolph; St. Alexius Hospice Coordinator BSN, RN, Certified Hospice and Palliative Care Nurse. The Aide, Dying and Death. Nursing staff are frequently exposed to death Interpersonal competency Being present and bearing witness

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Preparation and Care for the Time of Death

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  1. Preparation and Care for the Time of Death Colette Rudolph; St. Alexius Hospice Coordinator BSN, RN, Certified Hospice and Palliative Care Nurse

  2. The Aide, Dying and Death • Nursing staff are frequently exposed to death • Interpersonal competency • Being present and bearing witness • Holistic care

  3. Dying is a Unique Experience • There is no typical death • Patient preferences • Staff need to advocate for patient choices

  4. Dying is a Physical, Psychological, and Spiritual Event • Family is seen as a unit of care • Interdisciplinary care is important as death nears.

  5. Open, Hones Communication • Convey caring, sensitivity, and compassionate attitude. • Provide information in simple terms • Patient awareness of dying • Maintain presence

  6. The Imminently Dying Patient • Determining prognosis • Signs/symptoms only a guideline • Dying process

  7. Psychological and Spiritual Interventions • Fear of the dying process • Fear of abandonment • Fear of the unknowing • Nearing death awareness • Withdrawal; spiritual care

  8. Physical Symptoms • Confusion, disorientation, delirium • Weakness and fatigue • Drowsiness, sleeping • Decreased intake; difficult swallowing • Surge of energy • Fever • Incontinence • Decreased urine output

  9. Symptoms of Imminent Death • Decreased urine output • Cold and mottled extremities • Vital signs and breathing changes • Respiratory congestion

  10. The Death Vigil • Family presence • Common fears • Being alone with patient • Painful death • Time of death • Giving of the “last dose”

  11. Interventions • Reassurance and education • Role model comforting • Physical comforting • Honor culture, and family wishes

  12. Care Following Death • Communicating death • Death pronouncement • Preparing family • Care after death • Organ donation procedures • Death rites and rituals • Assistance with calls, notifications • Destroying medications

  13. Support • Ask for help • Post clinical debriefing • Care of the patient and family at time of death entails unique concerns and is best provided by an interdisciplinary team.

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