Patient Care Fundamentals- Chapter 27: End-of-Life Care (Information from- Nursing Assisting A Foundation in Caregiving)

Anticipatory Grief

a period of mourning when the dying person or his family is expecting the death.

Autopsy

an examination of a body by a pathologist to try to determine the cause of death.

Bereavement

the period following a loss in which mourning occurs.

Complicated Grief

intense, long-lasting grief that does not seem to improve even after time has passed.

Cremation

the process of burning a dead body until it turns to ash.

Death

the end of life; the cessation of all body function.

Grief

a deeply emotional process that is a response to loss.

Grief Counseling

therapy to try to help a person cope after someone has died.

Grief Process

the varying emotional responses to grief.

Mourning

the period in which people work to adapt to a loss; influenced by culture, tradition, and society.

Palliative Care

care that focuses on pain relief, controlling symptoms, preventing side effects and complications, and maintaining quality of life for a person who is very ill and/or is dying.

Pathologist

a doctor with advanced training in the examination of organs and tissues.

Postmortem Care

care of the body after death.

Rigor Mortis

the Latin term for the condition after death in which the muscles in the body become stiff and rigid.

Terminal Illness

a disease or condition that will eventually cause death.

1. What are the goals of palliative care?

To relieve pain, control symptoms, prevent side effects and complications, and maintain the best quality of life possible.

2. Briefly describe each of the five stages of grief (denial, anger, bargaining, depression, and acceptance) as defined by Elisabeth Kubler-Ross.

Stage 1: Denial- People in the denial stage may refuse to believe that they are dying. They may avoid discussion about their illnesses and simply act like it is not happening. (The "No, not me" stage.)

Stage 2: Anger- Once people start to face the possibility of death, they may become angry. Even though it may be upsetting, the caregiver must try not to take anger personally. (The "Why me?" stage)

Stage 3: Bargaining- Once people have begun to believe that they are dying, they may start trying to bargain with God or a higher power in hope to recover. "The "Yes me, but..." stage)

Stage 4: Depression- As dying people become weaker and their symptoms get worse, they may become deeply sad or depressed. It is important for caregivers to listen and be understanding.

Stage 5: Acceptance- Peace or acceptance may or may not come before death. They may make arrangements and prepare for ceremonies like their funerals.

3. List five legal rights to remember when caring for the terminally ill.

1. The right to have visitors.

2. The right to privacy.

3. The right to be free from pain.

4. The right to honest and accurate information.

5. The right to refuse treatment.

4. List 20 physical signs that a person is approaching death.

1. Cyanotic, pale, or darkening skin or mucous membranes

2. Cold skin

3. Skin that looks bruised (mottling)

4. Heavy perspiration

5. Fever

6. Low blood pressure

7. Increased pulse

8. Cheyne-Stokes breathing

9. Gurgling and rattling sound when breathing

10. Difficulty swallowing

11. Decreased appetite and sense of thirst

12. Dry mouth

13. Nausea, vomiting, and diarrhea

14. Decreased sense of touch

15. Loss of feeling, beginning in the legs and feet

16. Extreme weakness and exhaustion

17. Loss of muscle tone

18. Fallen jaw, causing the mouth to stay open

19. Inability to speak

20. Loss of vision

5. What should the nursing assistant do if he observes physical signs such as a dropped jaw after a resident has died?

Report it to the nurse immediately.

6. List four ways that nursing assistants can help families and friends after a loved one has died.

1. Allowing the family and friends to show their feelings.

2. Be available for the family and friends.

3. Do not be afraid to show your feelings for a resident who has died.

4. Do not make inappropriate comments or use cliches.

7. What is bereavement therapy?

Therapy to help staff with grieving.

8. Define Postmortem.

Postmortem care is care of the body after death.

9. When is hospice care usually ordered by a doctor?

C. When a person has approximately six months or less to live.

10. Which sense is usually the last sense to leave the body?

A. The sense of hearing.

11. What may be one of the most important things that a nursing assistant can do to help meet a dying resident's psychosocial needs?

D. Listening to the resident.