Unit 12-Caring for Resident When Death is Imminent
of 63
Transcript of Unit 12-Caring for Resident When Death is Imminent
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
1/63
DHSR Approved Curriculum-Unit 12 1
Unit 12
Caring For Resident WhenDeath Is Imminent andFollowing Death
Nurse Aide I Course
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
2/63
DHSR Approved Curriculum-Unit 12 2
Caring for Resident When Death Is
Imminent and Following Death
Introduction
Death is defined as the final stage oflife. The nurse aide will need todevelop a realistic attitude toward thetopic of death to meet the physical andpsychological needs of the resident and
the family as they experience the dyingprocess. This unit also includes careof the body following death.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
3/63
DHSR Approved Curriculum-Unit 12 3
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
4/63
DHSR Approved Curriculum-Unit 12 4
12.0 Explore personal feelings
concerning the concept of death.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
5/63
DHSR Approved Curriculum-Unit 12 5
Caring For Resident When Death Is
Imminent and Following Death
Factors influencing attitudesPersonal experiences
Culture Some fear death Others look forward to
and accept death
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
6/63
DHSR Approved Curriculum-Unit 12 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
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
7/63
DHSR Approved Curriculum-Unit 12 7
Caring For Resident When Death Is
Imminent and Following Death
(continued)
Factors influencingattitudesAge
Children view deathas temporary
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
8/63
DHSR Approved Curriculum-Unit 12 8
Caring For Resident When Death Is
Imminent and Following Death
(continued) Factors influencing attitudes
Age
Adults may develop fears of:pain and sufferingdying alone
separation from lovedones Elderly generally have fewerfears
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
9/63
DHSR Approved Curriculum-Unit 12 9
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
10/63
DHSR Approved Curriculum-Unit 12 10
12.1 Identify the special needs of a
dying resident.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
11/63
DHSR Approved Curriculum-Unit 12 11
Special Needs Of Dying Resident
Visits with family/significant others
Features of residents room:
pleasant as possible
lighting that meets residents
preferenceswell ventilated
odor free
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
12/63
DHSR Approved Curriculum-Unit 12 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
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
13/63
DHSR Approved Curriculum-Unit 12 13
12.2 Identify eight comfort measures
that may be used with the dyingresident.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
14/63
DHSR Approved Curriculum-Unit 12 14
Special Needs Of Dying Resident(continued)
Comfort Measures
Attention to skin care
Good personal hygieneOral hygiene - denturecare
Bedding changed asneeded
Back massages
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
15/63
DHSR Approved Curriculum-Unit 12 15
Special Needs Of Dying Resident(continued)
Comfort MeasuresFrequent position changes
every two hours
P.R.N.
Good body alignment
supportive devices prevention of deformities andpressure ulcers
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
16/63
DHSR Approved Curriculum-Unit 12 16
Special Needs Of Dying Resident(continued)
Comfort Measures
Head of bed elevated to facilitate
breathing Modified diet
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
17/63
DHSR Approved Curriculum-Unit 12 17
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
18/63
DHSR Approved Curriculum-Unit 12 18
12.3 Describe the nurse aides role in
relationship to the to the needs ofthe dying.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
19/63
DHSR Approved Curriculum-Unit 12 19
Caring For Resident When Death Is
Imminent and Following Death
Nurse Aides Role Source of strength and
comfort
Open and receptive Know own feelings about
death and do not project
those feelings ontoresident.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
20/63
DHSR Approved Curriculum-Unit 12 20
Caring For Resident When Death Is
Imminent and Following Death
Nurse Aides Role(continued)
Empathetic
Calm and efficient Normal tone of voice
Good listening skills
Non-judgmental
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
21/63
DHSR Approved Curriculum-Unit 12 21
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
22/63
DHSR Approved Curriculum-Unit 12 22
12.4 Review the various reactions
residents may have as they facedeath.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
23/63
DHSR Approved Curriculum-Unit 12 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
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
24/63
DHSR Approved Curriculum-Unit 12 24
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
25/63
DHSR Approved Curriculum-Unit 12 25
12.5 List and describe the five
stages of grief, death anddying.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
26/63
DHSR Approved Curriculum-Unit 12 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 requestanother opinion
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
27/63
DHSR Approved Curriculum-Unit 12 27
Five Stages of Grief, Death and Dying
as Described
by Dr. Elizabeth Kubler-Ross
DENIAL (continued)
Resident may avoiddiscussion of death
Feeling of, This cant
be happening to me.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
28/63
DHSR Approved Curriculum-Unit 12 28
Five Stages of Grief, Death and Dying
as Described
by Dr. Elizabeth Kubler-Ross
ANGER
Bitterness and turmoilSense of unfairness
Blame of others such
as health care workers
Feeling of, Why me?
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
29/63
DHSR Approved Curriculum-Unit 12 29
Five Stages of Grief, Death and Dying
as Described
by Dr. Elizabeth Kubler-Ross
BARGAINING
Turn to religious andspiritual beliefs
Promises to God andothers
Comfort and hopewhen all seems lost
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
30/63
DHSR Approved Curriculum-Unit 12 30
Five Stages of Grief, Death and Dying
as Described
by Dr. Elizabeth Kubler-Ross
BARGAINING (continued)Generally know this
wont workFrustration and anger
dissolve into
depressionIf only...I will
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
31/63
DHSR Approved Curriculum-Unit 12 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 lifeSleeplessness
I always wanted to
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
32/63
DHSR Approved Curriculum-Unit 12 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 unfinishedbusiness
Helps loved ones accept death
Needs others to validate worth of life
Ive had a good life.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
33/63
DHSR Approved Curriculum-Unit 12 33
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
34/63
DHSR Approved Curriculum-Unit 12 34
12.6 Recognize the signs of
approaching death.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
35/63
DHSR Approved Curriculum-Unit 12 35
Signs Of Approaching Death
Changes in sensory functions andability to speak
Vision
increased secretions in cornerof eyes
blurred vision
failing vision
no eye movement/staring
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
36/63
DHSR Approved Curriculum-Unit 12 36
Signs Of Approaching Death
Changes in sensory functions andability to speak (continued)
Speech
becomes difficult hard to understand
may be unable to speak
Hearing - last function to be lost
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
37/63
DHSR Approved Curriculum-Unit 12 37
Signs Of Approaching Death
Changes in circulation and muscle toneCirculation
fails heat gradually lost from body hands and feet cold to touch andmottled
face becomes pale or gray and
mottled perspiration may increase(diaphoresis)
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
38/63
DHSR Approved Curriculum-Unit 12 38
Signs Of Approaching Death
Changes in circulation and muscletone (continued)Muscle tone
body limpjaw may drop mouth may stay partly open
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
39/63
DHSR Approved Curriculum-Unit 12 39
Signs Of Approaching Death
Changes in Vital SignsRespirations
slower
shallow labored may experience dyspnea, apnea,
Cheyne-Stokes mucous collects in the throat andbronchial tubes (death rattle)
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
40/63
DHSR Approved Curriculum-Unit 12 40
Signs Of Approaching Death
Changes in Vital Signs (continued)Pulse
rapid
weak and irregularBlood pressure drops
Temperature
elevated
subnormal
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
41/63
DHSR Approved Curriculum-Unit 12 41
Signs Of Approaching Death
Urinary and anal incontinence
Decreased peristalsis, abdominal
distention Release of flatus
Decreased pain Loss of consciousness
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
42/63
DHSR Approved Curriculum-Unit 12 42
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
43/63
DHSR Approved Curriculum-Unit 12 43
12.7 Define the role of the nurse aide
in the spiritual preparation fordeath.
12.8 Contrast the spiritual preparation
for death practiced by those ofvarious religions.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
44/63
DHSR Approved Curriculum-Unit 12 44
Nurse Aides Role In Spiritual
Preparation For Death
Priest, rabbi, minister or
other clergy may be
contacted at request ofresident or family
Privacy to be provided
when clergy with resident
N Aid R l I S i it l
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
45/63
DHSR Approved Curriculum-Unit 12 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
Nurse Aides Role In Spiritual
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
46/63
DHSR Approved Curriculum-Unit 12 46
Nurse Aide s Role In Spiritual
Preparation For Death(continued)
Treat religious objectswith care and respect:
medalspictures
statues
bibles Encourage family and
friends to be included
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
47/63
DHSR Approved Curriculum-Unit 12 47
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
48/63
DHSR Approved Curriculum-Unit 12 48
12.9 Identify the needs of the family as
they encounter the dying process.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
49/63
DHSR Approved Curriculum-Unit 12 49
Nurse Aides Role In Meeting
Family Needs
Available for support
Use touch as appropriate
Courteous andconsiderate
Respect right to privacy
Let family assist withcare, if they desire, whereappropriate
Nurse Aides Role In Meeting
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
50/63
DHSR Approved Curriculum-Unit 12 50
Nurse Aides Role In Meeting
Family Needs
(continued) Use good
communication skills
Listen and provideunderstandingthroughout the grief/loss
stages Answer questions orrefer to supervisor
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
51/63
DHSR Approved Curriculum-Unit 12 51
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
52/63
DHSR Approved Curriculum-Unit 12 52
12.10 Discuss the hospice philosophy.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
53/63
DHSR Approved Curriculum-Unit 12 53
Hospice Care
Health care service offered:in hospitals and extended carefacilities
by special facilitiesusually in the individuals home
Continuing care provided by team of
health professionals Designed for residents with terminal
illness
Hospice Care
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
54/63
DHSR Approved Curriculum-Unit 12 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.
Hospice Care
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
55/63
DHSR Approved Curriculum-Unit 12 55
Hospice Care(continued)
Provides counseling for individual andfamily:
Emotional
PsychologicalSpiritual
Financial
Bereavement Family included in all aspects of care
as desired
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
56/63
DHSR Approved Curriculum-Unit 12 56
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
57/63
DHSR Approved Curriculum-Unit 12 57
12.11 Discuss the meaning of
postmortem care.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
58/63
DHSR Approved Curriculum-Unit 12 58
Postmortem Care
Care Of Body After (Post) Death(Mortem)
Begin care when instructed by
supervisorTreat body to privacy, respect and
gentleness
Give care before rigor mortis sets in
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
59/63
DHSR Approved Curriculum-Unit 12 59
12.12 List five reasons for doing
postmortem care.
Postmortem Care
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
60/63
DHSR Approved Curriculum-Unit 12 60
Postmortem Care(continued)
Reasons for Postmortem CarePrevent discoloration and skin
damage
Maintain good appearance of bodyIdentify body and prepare for
transportation
Position body in normal alignmentArrange time family to view the
body
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
61/63
DHSR Approved Curriculum-Unit 12 61
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
62/63
DHSR Approved Curriculum-Unit 12 62
12.13 Demonstrate the procedure for
postmortem care.
-
8/14/2019 Unit 12-Caring for Resident When Death is Imminent
63/63
