Improves quality of life in clients and their families facing end of life issues
Palliative care
Comprehensive care delivery system for the terminally ill that is usually implanted when a client is not expected to live longer than 6 months
Hospice care
Palliative or hospice:
Used for anyone w/ serious illness or major illness
Palliative
Palliative or hospice:
Imminent death
Hospice
Palliative or hospice:
Entered under one diagnosis, although they may have many issues
Hospice
Palliative or hospice:
Pain control
Palliative
Palliative or hospice:
Do not have to have a terminal diagnosis
Palliative
Palliative or hospice:
Symptom management–consultive services
Palliative
Palliative or hospice:
High amounts of pain meds/anti-anxity meds
Hospice
*anything to make dying as comfortable as possible
What is the greatest threat to comfort?
Pain
What are characteristics of discomfort?
- Pain
- Anxiety
- Dyspnea
- N/V
- Dehydration
- Diarrhea/constipation
- Urinary inconcinence
- Cant do ADL
Clinical findings approaching death
How is LOC?
Decreased
Clinical findings approaching death
Muscles relax or tense?
Relax
Clinical findings approaching death
How is breathing?
Altered—labored, reg, irreg, apnea, Chyne-Stokes
Clinical findings approaching death
What is in airway?
Mucous collection
Clinical findings approaching death
Do they have incontinence? How is urine output
Yes; decresed
Clinical findings approaching death
How is skin?
Mottling with poor circulation
Clinical findings approaching death
How are pupils?
Nonreactive
Clinical findings approaching death
How is pulse and BP?
Pulse: weak
BP: dropping
Clinical findings approaching death
Extremities warm or cool?
Cool
Clinical findings approaching death
Do they perspire?
Yes
Clinical findings approaching death
How is ability to swallow?
Inability to swallow
What are nursing interventions we can do for the dying?
-Continuity of care by limiting staff changes
-Give priority to control the symptoms!
-Administer meds that manage pain, air, hunger, and anxiety–> manage SE of those meds
-Repositon to maintain airway and comfort
-Maintain skin/mucous membrane integrity
-Provide envrion. that promotes self esteem and dignity
Encourage use of relaxation techniques such as guided imagery and music
Directive document for med. treatment per clients wishes
Living will
Document that appoints an individual to make med. decisions when a client is no longer able to do so on his on behalf
Durable power of attorney