End of Life Care Chapter 27
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Questions and Answers

When is palliative care given?

People who have serious, chronic diseases, such as cancer, AIDS, CHF as well as people who are dying.

List 2 goals of palliative care.

Relieve pain, control symptoms, prevent side effects and complications.

Hospice care is ordered by a doctor when a person has 6 months or less to live.

True

Hospice care is generally not available on Sundays.

<p>False</p> Signup and view all the answers

Hospice care focuses on curing the person's disease or disorder.

<p>False</p> Signup and view all the answers

Hospice care focuses on making residents comfortable and managing their pain.

<p>True</p> Signup and view all the answers

Hospice care uses a holistic approach.

<p>True</p> Signup and view all the answers

The resident's family is not involved in hospice care.

<p>False</p> Signup and view all the answers

Mr. Anderson, a resident, talks to God about his terminal cancer. He promises to make peace with his estranged son if he is allowed to live. Which stage of dying is he going through?

<p>Bargaining</p> Signup and view all the answers

Luke, a nursing assistant, knows that his resident, Ms. Wilson is dying. One day she begins to yell at Luke blaming him for a lack of proper care saying, 'If you had been a better caregiver, I wouldn't have gotten sick.' What stage is this?

<p>Anger</p> Signup and view all the answers

Mrs. Morris is a resident who is dying. She has an appointment with her attorney. When he begins asking about her will, she says there's no reason he should bring that up; instead of wanting to discuss her will, she wants to continuously talk about her son. What stage is this?

<p>Denial</p> Signup and view all the answers

Gwen notices that one of her residents is a little distant; when they talk to her, they only want to discuss funeral arrangements. They are very concerned about making sure their family is taken care of after they are gone. Which stage is this?

<p>Acceptance</p> Signup and view all the answers

Angelica is worried about one of her residents who is terminally ill. They alternate between crying and not talking to anyone. Which stage is this?

<p>Depression</p> Signup and view all the answers

How can a nursing assistant (NA) honor the right to have visitors?

<p>Make the room look presentable and clean; help the resident look nice and decent.</p> Signup and view all the answers

How can a NA honor the right to privacy?

<p>Follow their wishes, knock on their door, make sure you give them the choice to have privacy.</p> Signup and view all the answers

How can a NA honor the right to be free from pain?

<p>Pain must be monitored; medication measures must be given.</p> Signup and view all the answers

How can a NA honor the right to honest and accurate information?

<p>All info must be presently honest.</p> Signup and view all the answers

How can a NA honor the right to refuse treatment?

<p>Do not judge these decisions that aren't yours to make.</p> Signup and view all the answers

What are helpful ways for a NA to care for a resident who is dying? (List 6 ways)

<p>Use alternative methods of communication if speech fails; keep the room softly lit; turn and position resident often; change gowns and sheets regularly; observe resident for signs of pain; clean up an incontinent resident promptly.</p> Signup and view all the answers

Why do you think it is important to 'listen more, talk less'?

<p>When people are dying, it’s important to hear them out because showing interest in what they are sharing can make their passing smoother.</p> Signup and view all the answers

What are signs of approaching death? (List 6 signs)

<p>Fever, cold pale skin, confusion, inability to speak, incontinence, perspiration.</p> Signup and view all the answers

When death occurs, the body will not have a pulse, respiration, or __.

<p>blood pressure</p> Signup and view all the answers

The __ drops, causing the mouth to stay __.

<p>jaw, open</p> Signup and view all the answers

The __ may be partially open with eyes in a __.

<p>eyelids, fixed stare</p> Signup and view all the answers

Resident may have both __ and __ incontinence.

<p>urinary, fecal</p> Signup and view all the answers

The pupils will be __ and __.

<p>fixed, dilated</p> Signup and view all the answers

If a family member becomes very upset after a loved one's death, it is helpful for the nursing assistant to ask him to calm down and to stop crying.

<p>False</p> Signup and view all the answers

Family and friends may feel guilt after a loved one's death, especially if there were unresolved issues in the relationship.

<p>True</p> Signup and view all the answers

If family members seem relieved after a loved one has died, it means that they did not care for the resident very much.

<p>False</p> Signup and view all the answers

A nursing assistant should let family members and friends talk about their feelings without interrupting them.

<p>True</p> Signup and view all the answers

A nursing assistant should not let a resident's friends know that she is upset about the resident's death.

<p>False</p> Signup and view all the answers

Reassuring family and friends that they will get over the death of their loved one is helpful.

<p>False</p> Signup and view all the answers

If a nursing assistant wants to attend a resident's memorial service that is being held at a funeral home, what should she do first?

<p>Check with her supervisor first to make sure it is appropriate.</p> Signup and view all the answers

List 5 ways that staff members can cope with the death of a resident.

<p>Not hesitating to express feelings; getting enough sleep; participating in enjoyable activities; spending quality time with the people they love; talking to a counselor.</p> Signup and view all the answers

Which of the following terms means after death?

<p>Postmortem</p> Signup and view all the answers

What is the purpose of an autopsy?

<p>To determine the cause of death.</p> Signup and view all the answers

Generally speaking, how should a nursing assistant position a resident's body after the resident has died?

<p>The resident should be placed on her back.</p> Signup and view all the answers

Where are drainage pads most often needed after a person has died?

<p>Under the perineal area.</p> Signup and view all the answers

Study Notes

Palliative Care

  • Provided for individuals with serious, chronic diseases like cancer, AIDS, congestive heart failure, and those who are terminally ill.
  • Goals include relieving pain, controlling symptoms, and preventing potential side effects or complications.

Hospice Care

  • Initiated by a doctor for patients with a prognosis of six months or less to live.
  • Available on Sundays, contrary to some beliefs.
  • Focuses on comfort and pain management, rather than curing diseases.
  • Employs a holistic approach, incorporating physical, emotional, and spiritual care.
  • Family involvement is encouraged, emphasizing their importance in the care process.

Stages of Dying

  • Bargaining: Individual making promises or deals in hopes of prolonging life.
  • Anger: Expressions of frustration and blame towards caregivers or circumstances.
  • Denial: Refusal to acknowledge impending death; seeking diversion through conversations unrelated to death.
  • Acceptance: Preparing for death, focusing on arrangements for loved ones.
  • Depression: Experiencing deep sadness, alternating emotions, and withdrawal from social interaction.

Nursing Assistant (NA) Responsibilities

  • Honor resident rights by maintaining a clean and inviting environment for visitors.
  • Respect privacy through proper communication and consent for interactions.
  • Ensure pain management by regularly monitoring and administering necessary medications.
  • Provide honest and accurate information to residents and families.
  • Respect the right to refuse treatment without judgment.

End-of-Life Care Techniques

  • Utilize alternative communication methods for non-verbal residents.
  • Maintain a softly lit and calming atmosphere.
  • Frequently reposition residents to enhance comfort.
  • Regularly change linens and clothing to ensure hygiene.
  • Vigilantly observe residents for pain indicators and respond promptly to incontinence.

Signs of Approaching Death

  • Common indicators include fever, cold/pale skin, confusion, inability to speak, incontinence, and perspiration.
  • Post-death signs involve the absence of pulse, respiration, and blood pressure, with the mouth potentially remaining open and pupils fixed and dilated.

Family and Grieving Process

  • Family members may experience guilt, particularly with unresolved issues.
  • Relief felt by family after a death does not equate to a lack of care for the resident.
  • NA should allow family and friends to express feelings openly.
  • Reassuring feelings about temporary grief is not advisable; empathy is crucial.
  • NAs should consult with supervisors before attending a resident's memorial service to confirm appropriateness.

Coping with Resident Death

  • Staff should express feelings without hesitation to aid in the coping process.
  • Maintaining proper sleep, engaging in enjoyable activities, and spending quality time with loved ones are critical for emotional health.
  • Talking to a counselor can provide additional support in processing grief.

Postmortem Procedures

  • The term "postmortem" refers to anything occurring after death.
  • An autopsy aims to determine the cause of death.
  • After death, residents should be positioned on their back, and drainage pads are typically placed under the perineal area to manage potential leakage.

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Description

Test your knowledge on palliative and hospice care with this quiz focusing on Chapter 27. Explore the goals and criteria for care for individuals with terminal illnesses. Assess your understanding and readiness for providing compassionate end-of-life care.

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