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Unit 12 Caring For Resident When Death Is Imminent and Following Death

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Title: Unit 12 Caring For Resident When Death Is Imminent and Following Death


1
Unit 12Caring For Resident When Death Is
Imminent and Following Death
  • Nurse Aide I Course

2
Caring for Resident When Death Is Imminent and
Following Death
  • Introduction
  • Death is defined as the final stage of life. ?
    The nurse aide will need to develop a realistic
    attitude toward the topic of death to meet the
    physical and psychological needs of the resident
    and the family as they experience the dying
    process. ? This unit also includes care of the
    body following death.

3
Factors Influencing Attitudes
4
  • 12.0 Explore personal feelings concerning the
    concept of death.

5
Caring For Resident When Death Is Imminent and
Following Death
  • Factors influencing attitudes 
  • Personal experiences 
  • Culture 
  • Some fear death 
  • Others look forward to and accept death 

6
Caring For Resident When Death Is Imminent and
Following Death(continued)
  • Factors influencing attitudes 
  • Religion 
  • Belief in life after death 
  • Reunion with loved ones 
  • Reincarnation 
  • Punishment for sins 
  • No afterlife 

7
Caring For Resident When Death Is Imminent and
Following Death(continued)
  • Factors influencing attitudes 
  • Age
  • Children view death as temporary

8
Caring For Resident When Death Is Imminent and
Following Death(continued)
  • Factors influencing attitudes
  • Age 
  • Adults may develop fears of
  • pain and suffering
  • dying alone
  • separation from loved ones
  • Elderly generally have fewer fears

9
Special Needs Of Dying Resident
10
  • 12.1 Identify the special needs of a dying
    resident.

11
Special Needs Of Dying Resident
  • Visits with family/significant others
  • Features of residents room
  • pleasant as possible
  • lighting that meets residents preferences
  • well ventilated
  • odor free

12
Special Needs Of Dying Resident(continued)
  • Features of residents room
  • Contains personal items which provide comfort and
    reassurance
  • Pictures
  • Mementos
  • Cards
  • Flowers
  • Religious objects

13
  • 12.2 Identify eight comfort measures that may be
    used with the dying resident.

14
Special Needs Of Dying Resident(continued)
  • Comfort Measures
  • Attention to skin care
  • Good personal hygiene
  • Oral hygiene - denture care
  • Bedding changed as needed
  • Back massages

15
Special Needs Of Dying Resident(continued)
  • Comfort Measures
  • Frequent position changes
  • every two hours
  • P.R.N.
  • Good body alignment
  • supportive devices
  • prevention of deformities and pressure ulcers

16
Special Needs Of Dying Resident(continued)
  • Comfort Measures
  • Head of bed elevated to facilitate breathing
  • Modified diet

17
Caring For Residents When Death Is Imminent
And Following Death
Nurse Aide's Role
18
  • 12.3 Describe the nurse aides role in
    relationship to the to the needs of the dying.

19
Caring For Resident When Death Is Imminent and
Following DeathNurse Aides Role
  • Source of strength and comfort
  • Open and receptive
  • Know own feelings about death and do not project
    those feelings onto resident.

20
Caring For Resident When Death Is Imminent and
Following DeathNurse Aides Role(continued)
  • Empathetic
  • Calm and efficient
  • Normal tone of voice
  • Good listening skills
  • Non-judgmental

21
Individual Resident's Reaction to Death
22
  • 12.4 Review the various reactions residents may
    have as they face death.

23
Individual Residents Reaction To Death
  • Accept or be resigned to death
  • Open and receptive
  • Communicate about uncertainties
  • Fearful or angry
  • Despairing and anxious
  • Hostile
  • Thoughtful and meditative

24
Five Stages Of Grief, Death And Dying As
Described By Dr. Elisabeth Kubler-Ross
25
  • 12.5 List and describe the five stages of grief,
    death and dying.

26
Five Stages of Grief, Death and Dying as
Described by Dr. Elizabeth Kubler-Ross
  • DENIAL
  • Defense mechanism
  • Buffer against reality
  • Emotional escape hatch
  • Resident may request another opinion

27
Five Stages of Grief, Death and Dying as
Described by Dr. Elizabeth Kubler-Ross
  • DENIAL (continued)
  • Resident may avoid discussion of death
  • Feeling of, This cant be happening to me.

28
Five Stages of Grief, Death and Dying as
Described by Dr. Elizabeth Kubler-Ross
  • ANGER
  • Bitterness and turmoil
  • Sense of unfairness
  • Blame of others such as health care workers
  • Feeling of, Why me?

29
Five Stages of Grief, Death and Dying as
Described by Dr. Elizabeth Kubler-Ross
  • BARGAINING
  • Turn to religious and spiritual beliefs
  • Promises to God and others
  • Comfort and hope when all seems lost

30
Five Stages of Grief, Death and Dying as
Described by Dr. Elizabeth Kubler-Ross
  • BARGAINING (continued)
  • Generally know this wont work
  • Frustration and anger dissolve into depression
  • If only...I will

31
Five Stages of Grief, Death and Dying as
Described by Dr. Elizabeth Kubler-Ross
  • DEPRESSION
  • Belief that hope is lost
  • Overwhelming despair
  • Introverted and withdrawn
  • Reminiscing and reviewing life
  • Sleeplessness
  • I always wanted to

32
Five Stages of Grief, Death and Dying as
Described by Dr. Elizabeth Kubler-Ross
  • ACCEPTANCE
  • Calm and subdued interest in life
  • Strives to complete unfinished business
  • Helps loved ones accept death
  • Needs others to validate worth of life
  • Ive had a good life.

33
Signs of Approaching Death
34
  • 12.6 Recognize the signs of approaching death.

35
Signs Of Approaching Death
  • Changes in sensory functions and ability to speak
  • Vision
  • increased secretions in corner of eyes
  • blurred vision
  • failing vision
  • no eye movement/staring

36
Signs Of Approaching Death
  • Changes in sensory functions and ability to speak
    (continued)
  • Speech
  • becomes difficult
  • hard to understand
  • may be unable to speak
  • Hearing - last function to be lost

37
Signs Of Approaching Death
  • Changes in circulation and muscle tone
  • Circulation
  • fails
  • heat gradually lost from body
  • hands and feet cold to touch and mottled
  • face becomes pale or gray and mottled
  • perspiration may increase (diaphoresis)

38
Signs Of Approaching Death
  • Changes in circulation and muscle tone
    (continued)
  • Muscle tone
  • body limp
  • jaw may drop
  • mouth may stay partly open

39
Signs Of Approaching Death
  • Changes in Vital Signs
  • Respirations
  • slower
  • shallow
  • labored
  • may experience dyspnea, apnea, Cheyne-Stokes
  • mucous collects in the throat and bronchial tubes
    (death rattle)

40
Signs Of Approaching Death
  • Changes in Vital Signs (continued)
  • Pulse
  • rapid
  • weak and irregular
  • Blood pressure drops
  • Temperature
  • elevated
  • subnormal

41
Signs Of Approaching Death
  • Urinary and anal incontinence
  • Decreased peristalsis, abdominal distention
  • Release of flatus
  • Decreased pain
  • Loss of consciousness

42
Nurse Aide's Role In Spiritual Preparation For
Death
43
  • 12.7 Define the role of the nurse aide in the
    spiritual preparation for death.
  • 12.8 Contrast the spiritual preparation for death
    practiced by those of various religions.

44
Nurse Aides Role In Spiritual Preparation For
Death
  • Priest, rabbi, minister or other clergy may be
    contacted at request of resident or family
  • Privacy to be provided when clergy with resident

45
Nurse Aides Role In Spiritual Preparation For
Death(continued)
  • Support residents religious/spiritual practices
    even if different from that of nurse aide
  • Listen respectfully to religious/spiritual
    beliefs
  • Participate in religious practices if asked and
    acceptable

46
Nurse Aides Role In Spiritual Preparation For
Death(continued)
  • Treat religious objects with care and respect
  • medals
  • pictures
  • statues
  • bibles
  • Encourage family and friends to be included

47
Nurse Aide's Role In Meeting Family Needs
48
  • 12.9 Identify the needs of the family as they
    encounter the dying process.

49
Nurse Aides Role In Meeting Family Needs
  • Available for support
  • Use touch as appropriate
  • Courteous and considerate
  • Respect right to privacy
  • Let family assist with care, if they desire,
    where appropriate

50
Nurse Aides Role In Meeting Family
Needs(continued)
  • Use good communication skills
  • Listen and provide understanding throughout the
    grief/loss stages
  • Answer questions or refer to supervisor

51
Hospice Care
52
  • 12.10 Discuss the hospice philosophy.

53
Hospice Care
  • Health care service offered
  • in hospitals and extended care facilities
  • by special facilities
  • usually in the individuals home
  • Continuing care provided by team of health
    professionals
  • Designed for residents with terminal illness

54
Hospice Care(continued)
  • Acceptance of death as imminent (6 months or
    less)
  • Assures that individual dies with dignity and
    comfort
  • Not concerned with cure or life-saving procedures
  • Emphasis on pain relief
  • Trained volunteers and professionals make regular
    visits.

55
Hospice Care(continued)
  • Provides counseling for individual and family
  • Emotional
  • Psychological
  • Spiritual
  • Financial
  • Bereavement
  • Family included in all aspects of care as desired

56
Postmortem Care Care Of The Body After (Post)
Death (Mortem)
57
  • 12.11 Discuss the meaning of postmortem care.

58
Postmortem Care
  • Care Of Body After (Post) Death (Mortem)
  • Begin care when instructed by supervisor
  • Treat body to privacy, respect and gentleness
  • Give care before rigor mortis sets in

59
  • 12.12 List five reasons for doing postmortem
    care.

60
Postmortem Care(continued)
  • Reasons for Postmortem Care
  • Prevent discoloration and skin damage
  • Maintain good appearance of body
  • Identify body and prepare for transportation
  • Position body in normal alignment
  • Arrange time family to view the body

61
Demonstration and Return Demonstration
62
  • 12.13 Demonstrate the procedure for postmortem
    care.

63
The End
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