1 / 32

Chapter 38 End-of-Life Care

Chapter 38 End-of-Life Care. Question. Is the following statement true or false? Acceptance occurs while clients deal with their losses and are completing unfinished business. Answer. False. Acceptance occurs after clients have dealt with their losses and completed unfinished business.

annona
Download Presentation

Chapter 38 End-of-Life Care

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Chapter 38 End-of-Life Care

  2. Question • Is the following statement true or false? Acceptance occurs while clients deal with their losses and are completing unfinished business.

  3. Answer False. Acceptance occurs after clients have dealt with their losses and completed unfinished business.

  4. Terminal Illness and Care • Terminal illness: recovery from the condition is beyond reasonable expectations • Stages of dying • Denial: psychological defense mechanism; refusal to believe certain information; helps to cope with reality of death

  5. Terminal Illness and Care (cont’d) • Stages of dying (cont’d) • Anger: emotional response to feeling victimized; occurs because there is no way to retaliate against fate • Bargaining: psychological mechanism to delay the inevitable • Depression: sad mood; realization that death will come sooner rather than later

  6. Terminal Illness and Care (cont’d) • Stages of dying (cont’d) • Acceptance: attitude of complacency that occurs after clients have dealt with their losses • Promoting acceptance: nurses can help client to pass from one stage to another by providing emotional support and supporting client’s choice regarding terminal care

  7. Stages of Dying

  8. Terminal Illness and Care (cont’d) • Promoting acceptance (cont’d) • Emotional support: part of missing nursing care; more necessary for dying clients • Arrangements for care: respecting the rights of dying clients

  9. Helping Dying Clients Cope

  10. Terminal Illness and Care (cont’d) • Arrangements for care (cont’d) • Home care • Respite care: relief for the caregiver by a surrogate • Hospice care • Eligibility for hospice care: 6 months or less to live

  11. The Dying Person’s Bill of Rights

  12. Question • Is the following statement true or false? In home care, the focus of support may shift back and forth from the client to the caregiver.

  13. Answer True. In home care, the focus of support may shift back and forth from the client to the caregiver.

  14. Terminal Illness and Care (cont’d) • Arrangements for care (cont’d) • Hospice care (cont’d) • Hospice services: clients receive care in their own homes; multidisciplinary team of hospice professionals and volunteer support are provided

  15. Medicare Home Hospice Benefits

  16. Terminal Illness and Care (cont’d) • Arrangements for care (cont’d) • Terminating hospice care • Residential care: form of intermediate care • Acute care: sophisticated technology and labor-intensive treatment

  17. Terminal Illness and Care (cont’d) • Providing terminal care • Hydration: maintenance of adequate fluid volume • Nourishment: tube feeding and parenteral nutrition • Elimination: catheterization; enemas or suppositories; skin care

  18. Terminal Illness and Care (cont’d) • Providing terminal care (cont’d) • Hygiene: clean, well groomed, and free of unpleasant odors • Positioning: promote comfort and circulation • Comfort: keep clients free from pain

  19. Terminal Illness and Care (cont’d) • Family involvement: maintain family bonds to help coping with future grief • Approaching death: decrease and ultimate cessation of function • Multiple organ failure: two or more organs cease to function • Family notification: family should be aware of approaching death

  20. Signs of Multiple Organ Failure

  21. Summoning the Family of a Dying Client

  22. Question • Is the following statement true or false? Hospice services can be terminated if the client does not meet the Medicare criteria.

  23. Answer True. Hospice services can be terminated if the client does not meet the Medicare criteria.

  24. Terminal Illness and Care (cont’d) • Family notification (cont’d) • Meeting relatives to promote smooth transition • Discussing organ donation • Confirming death: determined on the basis that breathing and circulation have ceased

  25. Age Criteria for Organ Donation

  26. Terminal Illness and Care (cont’d) • Confirming death (cont’d) • Brain death: irreversible loss of function of the brain • Death certificate • Permission for autopsy: examination of organs and tissues of human body after death

  27. Organ Procurement Form

  28. Terminal Illness and Care (cont’d) • Performing postmortem care: • Cleaning and preparing the body to enhance its appearance during viewing at the funeral home • Proper identification • Releasing the body to mortuary personnel

  29. Grieving • Process of feeling acute sorrow over a loss • Pathologic grief: dysfunctional grief; refusing to accept the client’s death • Resolution of grief: time taken for mourning; ability to talk about the dead person; controlling emotions

  30. Nursing Implications • Many nursing diagnoses: • Acute pain, fear, spiritual distress, social isolation, ineffective coping, decisional conflict, hopelessness, powerlessness, dysfunctional grieving, anticipatory grieving, caregiver role strain, death anxiety, and chronic sorrow

  31. General Gerontologic Considerations • Understand that the dying older client is a living person who may want to maintain the same interpersonal relationships as someone who is not dying • Encouraging older clients, who have experienced the death of a close friend or family member, to express feelings associated with grieving is important

  32. General Gerontologic Considerations (cont’d) • Reading obituaries can be an effective coping mechanism in helping to develop a peaceful and accepting attitude toward death

More Related