NATCEP Day Thirty Six
 Discuss attitudes of American society about death
 Identify the stages of dying & grieving
 Recognize the emotional ne...
Attitude toward own death is influenced by
age, cultural background and past
experience
Talking about death is frequentl...
 Society is more accepting of the dying’s wishes
• Hospice
 Palliative Care
 Care that involves relieving or reducing t...
When does grieving begin?
• Immediately when someone is diagnosed with a
terminal illness
• Anticipatory grief: mourning ...
 Stage 1: Denial
• “The lab tests can’t be right – I don’t have cancer”
• Behaviors
 Unrealistically cheerful
 Asks lot...
 Stage 2: Anger
• “This food is terrible – it’s not fit to eat!”
• Behaviors
 Complaining
 Unreasonable requests
 Ange...
Stage 3: Bargaining
• “If only God would spare me this, I’ll go to church
every week.”
• Behaviors
 May be difficult to ...
 Stage 4: Depression
• “There just isn’t any reason to go on.”
• Behaviors
 Person may separate themselves from the worl...
Stage 5: Acceptance
• “I feel so alone.”
• Behaviors
 Person may be serene, calm & accepting
 May be apathetic
 Behavi...
Social interaction
Self-expression
Control over one’s life
Privacy
Spiritual support, if appropriate
Empathy, unders...
Encourage prayer
Encourage visits from person’s clergy
Respect person’s religious beliefs
whether or not they are compa...
Allow the person to express feelings
Allow the person as much control over
situation as possible
Respect need for priva...
Circulation slows
Feet & hands cold, pale, “mottling”
Perception of pain reduced
Eye movement reduced or absent
Perspiration, even though body is cold
Loss of muscle tone
• Body limp
• Jaw may drop op...
Respirations slow &/or may be difficult
• “Rattling” due to mucus collecting
Pulse weak, rapid &/or irregular
B/P falls...
Physical care to meet needs
Keep warm
Consider their wishes = honor them
• Unable to communicate, involve family
Provi...
Special attention to mouth care (comfort)
Speak to person in normal tone; assume
they can always hear you (one of last
s...
Family may also experience the 5 stages
Help the family identify the person’s
functioning level
If present, assure time...
Purpose
• Family viewing
• Transfer to morgue or funeral home
Care involves
• Bathing body
• Closing eyes & mouth
• Plac...
Allows staff and residents to grieve
Helps reassure residents person is not
forgotten
Memorial Service
Journaling
Let...
NATCEP Day 36 Presentation
of 22

NATCEP Day 36 Presentation

Nurse Aide Care of the Dying Resident
Published on: Mar 3, 2016
Published in: Healthcare      
Source: www.slideshare.net


Transcripts - NATCEP Day 36 Presentation

  • 1. NATCEP Day Thirty Six
  • 2.  Discuss attitudes of American society about death  Identify the stages of dying & grieving  Recognize the emotional needs of the dying person  Identify the physical signs of approaching death  Caring for persons when death is imminent  Recognition and consideration for the family  Describe spirituality and the impact of these beliefs on the emotional needs of the dying  Define post-mortem care and the steps involved in providing  List possible response of others to the death (other residents, staff)  Acknowledge the death of a person
  • 3. Attitude toward own death is influenced by age, cultural background and past experience Talking about death is frequently avoided Dying person may become institutionalized and cared for by strangers
  • 4.  Society is more accepting of the dying’s wishes • Hospice  Palliative Care  Care that involves relieving or reducing the intensity of uncomfortable symptoms without producing a cure.  “Keeping them comfortable” • Advanced Directives  Document stating a person’s wishes about health care when that person cannot make their own decisions  Living Will: speaks for you when you cannot speak for yourself  Outlines the measures that a person wishes to be taken to support or maintain their life when death is likely and they are not able to communicate their wishes  DNR Orders – do not resuscitate  No action should be taken should death come or to prevent death
  • 5. When does grieving begin? • Immediately when someone is diagnosed with a terminal illness • Anticipatory grief: mourning that begins before someone dies. • Roles and responsibilities within a family may begin to change • Friends and family may begin to separate themselves from the dying person in an attempt to deal with the loss • Losses are many. . . . . . .
  • 6.  Stage 1: Denial • “The lab tests can’t be right – I don’t have cancer” • Behaviors  Unrealistically cheerful  Asks lots of questions  Disregards medical orders  NA Response • Listen, be accepting • Be available and open but do not probe • Be honest; do not encourage denial • “It must be difficult for you to learn the results of your test.”
  • 7.  Stage 2: Anger • “This food is terrible – it’s not fit to eat!” • Behaviors  Complaining  Unreasonable requests  Anger at family, physician & nursing staff  NA Response • Listen • Remain open and calm • Don’t try to place blame • “Let me see if I can find something that you would like more.”
  • 8. Stage 3: Bargaining • “If only God would spare me this, I’ll go to church every week.” • Behaviors  May be difficult to observe  Person vacillates between doubt & hope NA Response • Listen, do not contradict plans • Promote a sense of hope • Promote a sense of acceptance • “Would you like a visit from your clergy?”
  • 9.  Stage 4: Depression • “There just isn’t any reason to go on.” • Behaviors  Person may separate themselves from the world  Person may turn their face away from people  Person may not speak, or speak in an expressionless voice  NA Response • Stay with person as much as possible • Avoid cheery phrases and behaviors • Encourage person to express their feelings • “I understand you are feeling very sad/depressed.”
  • 10. Stage 5: Acceptance • “I feel so alone.” • Behaviors  Person may be serene, calm & accepting  May be apathetic  Behavior may be dependent on how well the former stages were resolved  Some may not reach this stage NA Response • Listen, show acceptance • “I am here with you. Would you like to talk?”
  • 11. Social interaction Self-expression Control over one’s life Privacy Spiritual support, if appropriate Empathy, understanding Respect Finalization of relationships
  • 12. Encourage prayer Encourage visits from person’s clergy Respect person’s religious beliefs whether or not they are compatible with the beliefs of the staff/facility Respect & encourage the use of religious symbols
  • 13. Allow the person to express feelings Allow the person as much control over situation as possible Respect need for privacy Allow for spiritual support Touch shows caring & concern
  • 14. Circulation slows Feet & hands cold, pale, “mottling” Perception of pain reduced
  • 15. Eye movement reduced or absent Perspiration, even though body is cold Loss of muscle tone • Body limp • Jaw may drop open • Loss of control of feces & urine
  • 16. Respirations slow &/or may be difficult • “Rattling” due to mucus collecting Pulse weak, rapid &/or irregular B/P falls Urine output may decrease Swallowing ability may decrease May have periods of confusion &/or anger Physician must certify death
  • 17. Physical care to meet needs Keep warm Consider their wishes = honor them • Unable to communicate, involve family Provide for skin cleanliness • perspiration or incontinence Change positions to prevent skin breakdown
  • 18. Special attention to mouth care (comfort) Speak to person in normal tone; assume they can always hear you (one of last senses to go) Provide for spiritual support respecting their personal wishes Communicate through touch Continue to explain procedures when performing
  • 19. Family may also experience the 5 stages Help the family identify the person’s functioning level If present, assure time with the person before and after death Be a good listener
  • 20. Purpose • Family viewing • Transfer to morgue or funeral home Care involves • Bathing body • Closing eyes & mouth • Placing body in position of rest  Do not put pressure on skin, cause visible bruising • Follow facility policy for dentures, prothesis • Account for personal belongings
  • 21. Allows staff and residents to grieve Helps reassure residents person is not forgotten Memorial Service Journaling Letter to family

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