Transcript Nursing Assistant

Nursing Assistant
UNIT 4 CHAPTER 22: CARING FOR PEOPLE WHO ARE TERMINALLY ILL
Caring for the Terminally Ill
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People die from many different causes at many different ages
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Terminal Illness
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Illness or condition for which there is no cure
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AIDS
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Cancers
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Certain heart conditions
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Chronic respiratory disorders
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Kidney disorders
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Liver disorders
Caring for the Terminally Ill
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In the past, most people with a terminal illness received care at home
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All caregivers could do was make patient comfortable
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We must allow person to live and die with dignity
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When taking care of a dying person you should be aware of the power of
listening and touch
Stages of Grief
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Grief
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Mental anguish, specifically associated with loss
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Dr. Elisabeth Kubler-Ross (1926-2004)
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Psychiatrist
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Wrote famous book, On Death and Dying
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Worked specifically with terminally ill people
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Identified distinct stages of grief
Stages of Grief
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Stage I: Denial
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Occurs when the person is told they have a terminal illness
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Person refuses to accept the diagnosis or feels a mistake has been made
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Denial helps protect a person emotionally from overwhelming grief
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This stage may last only a few minutes or until the person actually dies
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Not your place to convince the patient that the illness exists
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Be honest but neutral
Stages of Grief
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Stage II: Anger
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Occurs when the person realizes that they are actually going to die
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People may feel angry for different reasons
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Each person handles anger differently
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Some people are angry with themselves, and some make take it out on others
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Do not take anger personally
Stages of Grief
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Stage III: Bargaining
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Typically done on a very private basis by the patient
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Person wants to “make a deal” with someone who has control over their fate
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Person may want to live long enough to accomplish a goal or witness a specific
event
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The will to live can be a very powerful life force and may extend the persons life
for many months
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Allow the person to experience the feeling of hope that comes with this stage
Stages of Grief
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Stage IV: Depression
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When the person fully realizes that death will be the end result
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Person will be sad and may have regrets about things they were not able to do
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Some are quite withdrawn and quiet
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Normal part of process
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Be supportive
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Some people require medical intervention
Stages of Grief
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Stage V: Acceptance
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When a person comes to terms with the reality of their own death
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Is at peace with this knowledge
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Complete unfinished business
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Says goodbyes
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Plan funeral service
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Usually want to talk about their death
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Some people gain acceptance months or years before it happens
Wills
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A will is a legal statement that expresses a person’s wishes for the
management of their affairs after death
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Person must be deemed competent when will is made to be valid
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Many health care facilities offer assistance
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You may witness wills
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By signing you are just saying you watched the person sign
Dying with Dignity
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Advance Directives
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Allows a person to make wishes know about health care decisions
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Many pertain to “end of life issues”
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May elect to avoid “life sustaining treatments”
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Respiratory ventilation
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CPR
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Feeding Tubes
Dying with Dignity
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Advance Directives
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May elect to have supportive care only
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Will not prolong life but will make person more comfortable
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Oxygen
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Pain medication
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ROM
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Grooming
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Hygiene
Dying with Dignity
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Advance Directives
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DNR (do not resuscitate)
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Also called a no-code
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Only means CPR will not be performed to save a persons life
Dying with Dignity
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Hospice Care
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Hospice organizations have the mission of offering the terminally ill person the
best quality of life possible
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Care is provided by a multidisciplinary care team
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Doctors
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Nurses
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CNA’s
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Clergy
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Social Workers
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Mental Health Professionals
Dying with Dignity
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Hospice Care
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Team not only takes care of the patient, but takes care of family as well
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After patient’s death, hospice provides grief counseling and other types of
assistance to the family
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Available to patient’s and families 24 hours a day 7 days a week
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Care provided in patient’s home, long term care center, hospital, and hospice
houses
Dying with Dignity
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Hospice Care
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Care given is palliative care
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Focused on relieving uncomfortable symptoms
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Pain medications
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Chemotherapy
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Radiation
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Oxygen
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Surgery
In no way is a terminally ill person is told to give up hope for recovery
Dying with Dignity
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Hospice Care
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Can also assist with equipment
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Hospital bed
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Bedside commode
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Mechanical lifts
Focus of hospice team is to honor the wishes of the patient and family
Effects of Caring for the Terminally Ill
on the Caregiver
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Caring for a terminally ill person will affect you
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We actually go through the grief process
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May feel inadequate when we watch others grieve
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Make sure to take time for yourself
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Use clergy and counseling services available
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Openly talk about your feelings on death with friends and family