Transcript 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
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Nursing staff are frequently exposed to death
Interpersonal competency
Being present and bearing witness
Holistic care
Dying is a Unique Experience
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There is no typical death
Patient preferences
Staff need to advocate for patient choices
Dying is a Physical,
Psychological, and Spiritual Event
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Family is seen as a unit of care
Interdisciplinary care is important as death
nears.
Open, Hones Communication
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Convey caring, sensitivity, and
compassionate attitude.
Provide information in simple terms
Patient awareness of dying
Maintain presence
The Imminently Dying Patient
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Determining prognosis
Signs/symptoms only a guideline
Dying process
Psychological and Spiritual
Interventions
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Fear of the dying process
Fear of abandonment
Fear of the unknowing
Nearing death awareness
Withdrawal; spiritual care
Physical Symptoms
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Confusion, disorientation, delirium
Weakness and fatigue
Drowsiness, sleeping
Decreased intake; difficult swallowing
Surge of energy
Fever
Incontinence
Decreased urine output
Symptoms of Imminent Death
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Decreased urine output
Cold and mottled extremities
Vital signs and breathing changes
Respiratory congestion
The Death Vigil
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Family presence
Common fears
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Being alone with patient
Painful death
Time of death
Giving of the “last dose”
Interventions
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Reassurance and education
Role model comforting
Physical comforting
Honor culture, and family wishes
Care Following Death
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Communicating death
Death pronouncement
Preparing family
Care after death
Organ donation procedures
Death rites and rituals
Assistance with calls, notifications
Destroying medications
Support
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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.