1 / 29

Death and Dying

Death and Dying. Objectives. Describe the 5 stages terminally ill people generally pass through. List 3 reasons why many people choose hospice care when they are terminally ill. Describe the functions of a living will. Learn how to be of help to someone who is dying. When does death occur?.

jaxon
Download Presentation

Death and Dying

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Death and Dying

  2. Objectives • Describe the 5 stages terminally ill people generally pass through. • List 3 reasons why many people choose hospice care when they are terminally ill. • Describe the functions of a living will. • Learn how to be of help to someone who is dying.

  3. When does death occur? • In the Past • When the heart and lungs ceased to function • In the Present • CPR • Life-Support Machines

  4. Stages in the Acceptance of Death • 1. Denial- No, not me • Initial shock • Allows time to think about situation • Patients should get 2nd opinion • Just listen to them at this stage

  5. Stages in the Acceptance of Death • 2. Anger – Why me? • After they realize they are going to die • Feel as though they’re being treated unfairly • Anger often directed at medical staff and loved ones • Let them know it’s ok to be angry and accept their feelings

  6. Stages in the Acceptance of Death • 3. Bargaining – Yes, but… • This is a final attempt to avoid the inevitable • They may pray to God and promise to reform life • Continue to offer emotion support and encourage to get a second opinion if they haven’t already.

  7. Stages in the Acceptance of Death • 4. Depression – It’s me • Sad and worried about their affairs • Can feel they are losing everything • Just be with them, often times silently

  8. Stages in the Acceptance of Death • 5. Acceptance – It’s part of life • Its hard to imagine, but most people get to this stage • Have taken care of their affairs, final arrangements and said their goodbyes • At this stage, try and help them with any last requests or arrangements that they think they need.

  9. DEATH CAN INVOLVE FEARS THAT ARE PHYSICAL, SOCIAL, AND EMOTIONAL • PHYSICAL - Helplessness, dependence, loss of physical faculties, mutilation, pain • SOCIAL - Separation from family, leaving behind unfinished business • EMOTIONAL - Being unprepared for death and what happens after death

  10. INTERVENTIONS FOR FEARS • Talk as needed • Avoid superficial answers, i.e. “It’s God’s will • Provide religious support as appropriate • Stay with the patient as needed • Work with families to strengthen and support

  11. PHYSIOLOGY OF DYING • Somatic death or death of the body • Series of irreversible events leading to cell death • Causes of death varies • However, there are basic body changes leading to all deaths

  12. THESE BASIC BODY CHANGES RESULT IN THE DEATH OF ALL VITAL BODY SYSTEMS • PULMONARY: • Unable to oxygenate the body • Assess for poor oxygenation-skin pale, cyanotic, mottled, cool • in dark skinned - assess mucous membranes, palms of hands, soles of feet

  13. CARDIOVASCULAR • Large load on heart when lungs fail • Heart not getting needed oxygen • Pumping heart not strong enough to circulate blood • Blood backs up causing failure • Leads to pulmonary and liver congestion

  14. BLOOD CIRCULATION • Decreased, as heart less able to pump • May have a “drenching sweat” as death approaches • Pulse becomes weak and irregular • If pulse relatively strong, death is hours away • If pulse is weak and irregular, death is imminent

  15. COMBINATION OF THESE EVENTS LEADS TO CELL DEATH, AND DEATH OF THE ORGANISM (HUMAN) As pulmonary and cardiovascular systems fail, other body systems begin to fail.

  16. FAILING METABOLISM • Metabolic rate decreases, almost stopping • Feces might be retained or incontinence might be present

  17. FAILING URINARY SYSTEM • Urinary output decreases • Blood pressure too low for kidney filtration • Further load on cardiovascular system due to increase circulating volume

  18. FAILING NERVOUS SYSTEM • Decrease oxygen to the brain, means decreasing brain function • Sensation and power lost in legs, first, then arms • May remain conscious, semi-conscious, or comatose

  19. SPECIFIC SENSORY DECLINE • Dying person turns toward light - sees only what is near • Can only hear what is distinctly spoken • Touch is diminished - response to pressure last to leave • Dying person might turn toward or speak to someone not visible to anyone else • Eyes may remain open even if unconscious • Person might rally just before dying

  20. FURTHER NEUROLOGIC DECLINE AT DEATH • Pupils might react sluggishly or not at all to light • Pain might be significant • Assess for pain if person unable to talk: restlessness, tight muscles, facial expressions, frowns • Provide pain medication as needed

  21. NEVER LOSE SIGHT. . . • Death is the end, as we know it, for that person • We can only support, listen therapeutically, and • Make the person as physically comfortable as possible • We can also use our knowledge and expertise to strengthen, support, and prepare the family

  22. Death with Dignity • What dying people need • Hospices • Palliative Care • Living Wills

  23. What Dying People Need • Try and allow them to have as much control as possible • They need to be able to express their feelings • Should be able to choose their doctor, visitors, funeral arrangements and will • Just listen and be honest to maintain trust

  24. Hospices • Allows you to die at home or in a home-like environment • Provides medical care, but no extensive equipment • Provides emotional and legal support for family and patient • Has unique features • In home hospice teaches family patient care

  25. Palliative Care • Type of care for people who have illnesses that do not go away and often get worse • It focuses on improving quality of life, not jut in ones body, but also in ones mind and spirit • Type of care provided depends on the patients needs and what is important to them

  26. Palliative Care (continued) • It includes setting goals for body, mind and spirit • Often helps patient make future plans around health and medical care • Includes education about understanding ones illness and how it affects not just the patient, but also loved ones

  27. Living Will • Helps with ethical issues, e.g. life-support • A statement people can sign that instructs their doctors to not use medical equipment just to keep them breathing and their hearts beating • Takes the burden off the family

  28. Medical Power of Attorney • Legal document that lets you appoint someone you trust to make decisions about your medical care if you cannot make them yourself • Also called a “Healthcare Proxy” or “Durable power of attorney for healthcare” • The person appointed usually is authorized to deal with all medical situations and end-of-life decisions

  29. Medical Power of Attorney (continued) • To help the agent make these decisions, the following should be discussed: • Values about quality of life that are important • Types of decisions that might have to be made

More Related