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Unit 12 Caring For Resident When Death Is Imminent and Following Death. Nurse Aide I Course. Caring for Resident When Death Is Imminent and Following Death. Introduction

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unit 12 caring for resident when death is imminent and following death

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

Nurse Aide I Course

DHSR Approved Curriculum-Unit 12

caring for resident when death is imminent and following death
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.

DHSR Approved Curriculum-Unit 12

slide3

Factors

Influencing

Attitudes

DHSR Approved Curriculum-Unit 12

slide4

Objective

12.0 Explore personal feelings concerning the concept of death.

DHSR Approved Curriculum-Unit 12

caring for resident when death is imminent and following death1
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 

DHSR Approved Curriculum-Unit 12

caring for resident when death is imminent and following death continued
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 

DHSR Approved Curriculum-Unit 12

caring for resident when death is imminent and following death continued1
Caring For Resident When Death Is Imminent and Following Death(continued)
  • Factors influencing attitudes 
    • Age
      • Children view death as temporary

DHSR Approved Curriculum-Unit 12

caring for resident when death is imminent and following death continued2
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

DHSR Approved Curriculum-Unit 12

slide9

Special Needs

Of Dying Resident

DHSR Approved Curriculum-Unit 12

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Objective

12.1 Identify the special needs of a dying resident.

DHSR Approved Curriculum-Unit 12

special needs of dying resident
Special Needs Of Dying Resident
  • Visits with family/significant others
  • Features of resident’s room:
    • pleasant as possible
    • lighting that meets resident’s preferences
    • well ventilated
    • odor free

DHSR Approved Curriculum-Unit 12

special needs of dying resident continued
Special Needs Of Dying Resident(continued)
  • Features of resident’s room:
    • Contains personal items which provide comfort and reassurance
      • Pictures
      • Mementos
      • Cards
      • Flowers
      • Religious objects

DHSR Approved Curriculum-Unit 12

slide13

Objective

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

DHSR Approved Curriculum-Unit 12

special needs of dying resident continued1
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

DHSR Approved Curriculum-Unit 12

special needs of dying resident continued2
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

DHSR Approved Curriculum-Unit 12

special needs of dying resident continued3
Special Needs Of Dying Resident(continued)
  • Comfort Measures
    • Head of bed elevated to facilitate breathing
  • Modified diet

DHSR Approved Curriculum-Unit 12

slide17

Caring For Residents

When Death Is

Imminent And

Following Death:

Nurse Aide's Role

DHSR Approved Curriculum-Unit 12

slide18

Objective

12.3 Describe the nurse aide’s role in relationship to the to the needs of the dying.

DHSR Approved Curriculum-Unit 12

caring for resident when death is imminent and following death nurse aide s role
Caring For Resident When Death Is Imminent and Following DeathNurse Aide’s Role
  • Source of strength and comfort
  • Open and receptive
  • Know own feelings about death and do not project those feelings onto resident.

DHSR Approved Curriculum-Unit 12

caring for resident when death is imminent and following death nurse aide s role continued
Caring For Resident When Death Is Imminent and Following DeathNurse Aide’s Role(continued)
  • Empathetic
  • Calm and efficient
  • Normal tone of voice
  • Good listening skills
  • Non-judgmental

DHSR Approved Curriculum-Unit 12

slide21

Individual Resident's

Reaction to Death

DHSR Approved Curriculum-Unit 12

slide22

Objective

12.4 Review the various reactions residents may have as they face death.

DHSR Approved Curriculum-Unit 12

individual resident s reaction to death
Individual Resident’s 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

DHSR Approved Curriculum-Unit 12

slide24

Five Stages Of

Grief, Death And

Dying As Described

By Dr. Elisabeth Kubler-Ross

DHSR Approved Curriculum-Unit 12

slide25

Objective

12.5 List and describe the five stages of grief, death and dying.

DHSR Approved Curriculum-Unit 12

five stages of grief death and dying as described by dr elizabeth kubler ross
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

DHSR Approved Curriculum-Unit 12

five stages of grief death and dying as described by dr elizabeth kubler ross1
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 can’t be happening to me.”

DHSR Approved Curriculum-Unit 12

five stages of grief death and dying as described by dr elizabeth kubler ross2
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?”

DHSR Approved Curriculum-Unit 12

five stages of grief death and dying as described by dr elizabeth kubler ross3
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

DHSR Approved Curriculum-Unit 12

five stages of grief death and dying as described by dr elizabeth kubler ross4
Five Stages of Grief, Death and Dying as Described by Dr. Elizabeth Kubler-Ross
  • BARGAINING (continued)
    • Generally know this won’t work
    • Frustration and anger dissolve into depression
    • “If only...I will”

DHSR Approved Curriculum-Unit 12

five stages of grief death and dying as described by dr elizabeth kubler ross5
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”

DHSR Approved Curriculum-Unit 12

five stages of grief death and dying as described by dr elizabeth kubler ross6
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
    • “I’ve had a good life.”

DHSR Approved Curriculum-Unit 12

slide33

Signs of

Approaching

Death

DHSR Approved Curriculum-Unit 12

slide34

Objective

12.6 Recognize the signs of approaching death.

DHSR Approved Curriculum-Unit 12

signs of approaching death
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

DHSR Approved Curriculum-Unit 12

signs of approaching death1
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

DHSR Approved Curriculum-Unit 12

signs of approaching death2
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)

DHSR Approved Curriculum-Unit 12

signs of approaching death3
Signs Of Approaching Death
  • Changes in circulation and muscle tone (continued)
    • Muscle tone
      • body limp
      • jaw may drop
      • mouth may stay partly open

DHSR Approved Curriculum-Unit 12

signs of approaching death4
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)

DHSR Approved Curriculum-Unit 12

signs of approaching death5
Signs Of Approaching Death
  • Changes in Vital Signs (continued)
    • Pulse
      • rapid
      • weak and irregular
    • Blood pressure drops
    • Temperature
      • elevated
      • subnormal

DHSR Approved Curriculum-Unit 12

signs of approaching death6
Signs Of Approaching Death
  • Urinary and anal incontinence
  • Decreased peristalsis, abdominal distention
  • Release of flatus
  • Decreased pain
  • Loss of consciousness

DHSR Approved Curriculum-Unit 12

slide42

Nurse Aide's

Role In

Spiritual Preparation

For Death

DHSR Approved Curriculum-Unit 12

slide43

Objectives

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.

DHSR Approved Curriculum-Unit 12

nurse aide s role in spiritual preparation for death
Nurse Aide’s 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

DHSR Approved Curriculum-Unit 12

nurse aide s role in spiritual preparation for death continued
Nurse Aide’s Role In Spiritual Preparation For Death(continued)
  • Support resident’s 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

DHSR Approved Curriculum-Unit 12

nurse aide s role in spiritual preparation for death continued1
Nurse Aide’s 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

DHSR Approved Curriculum-Unit 12

slide47

Nurse Aide's

Role In

Meeting Family

Needs

DHSR Approved Curriculum-Unit 12

slide48

Objective

12.9 Identify the needs of the family as they encounter the dying process.

DHSR Approved Curriculum-Unit 12

nurse aide s role in meeting family needs
Nurse Aide’s 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

DHSR Approved Curriculum-Unit 12

nurse aide s role in meeting family needs continued
Nurse Aide’s 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

DHSR Approved Curriculum-Unit 12

slide51

Hospice Care

DHSR Approved Curriculum-Unit 12

slide52

Objective

12.10 Discuss the hospice philosophy.

DHSR Approved Curriculum-Unit 12

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

DHSR Approved Curriculum-Unit 12

hospice care continued
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.

DHSR Approved Curriculum-Unit 12

hospice care continued1
Hospice Care(continued)
  • Provides counseling for individual and family:
    • Emotional
    • Psychological
    • Spiritual
    • Financial
    • Bereavement
  • Family included in all aspects of care as desired

DHSR Approved Curriculum-Unit 12

slide56

Postmortem Care:

Care Of The Body

After (Post) Death (Mortem)

DHSR Approved Curriculum-Unit 12

slide57

Objective

12.11 Discuss the meaning of postmortem care.

DHSR Approved Curriculum-Unit 12

postmortem care
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

DHSR Approved Curriculum-Unit 12

slide59

Objective

12.12 List five reasons for doing postmortem care.

DHSR Approved Curriculum-Unit 12

postmortem care continued
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

DHSR Approved Curriculum-Unit 12

slide61

Demonstration

and

Return Demonstration

DHSR Approved Curriculum-Unit 12

slide62

Objective

12.13 Demonstrate the procedure for postmortem care.

DHSR Approved Curriculum-Unit 12

slide63

The End

DHSR Approved Curriculum-Unit 12