death and dying

Death

Is the cessation of all biological function that sustain a living organism.

Dying

On the point of death.

Causes of Death

Aging, Poisoning, Malnutrition, Disease, Suicide, Homicide, Drug Intoxication, Starvation, Dehydration, Accident or major trauma resulting in fatal injury.

Psychological Stages of Dying

Stages of Grief as defined by Kubler-Ross.

Denial/Isolation

Shock and disbelief.

Anger

Hostility and resentment.

Bargaining

Looking for a way out.

Depression

No longer able to deny, patient's experience, sadness and loss.

Acceptance

Acceptance of the inevitability of death with peace and detachment.

Indications of Death

Total lack of response to external stimuli, No muscular movement, especially breathing, No reflexes, Flat encephalogram (brain waves).

Signs of Impending Clinical Death

Loss of Muscle Tone, Slowing of the Circulation, Changes in Respirations, Sensory Impairment.

Loss of Muscle Tone

Relaxation of the facial muscles (e.g., the jaw may sag), Difficulty speaking, Difficulty swallowing and gradual loss of the gag reflex.

Slowing of the Circulation

Diminished sensation, Mottling and cyanosis of the extremities, Cold skin, slower and weaker pulse, Decreased blood pressure.

Changes in Respirations

Rapid, shallow, irregular, or abnormally slow respirations, Noisy breathing, referred to as the death rattle, Mouth breathing, dry oral mucous membranes.

Sensory Impairment

Blurred vision, Impaired senses of taste and smell.

Views on Death in Christianity

There is life after death. They favored burial of the dead body but cremation is also practiced.

Views on Death in Islam

Present life is only a preparation for the next realm of existence.

Views on Death in Hinduism

Death is very spiritual, and believes in the rebirth and reincarnation of souls.

Views on Death in Buddhism

They believe in reincarnation, Family members and monks recite scriptures and mantras.

Hispanic Culture of Death

Care of the dying relative, the bulk of care provided for a terminally ill family member is performed by female relatives.

Muslim Funeral

The body should be buried as soon as possible from the time of death.

Organ donation

Generally acceptable for Muslims.

Routine autopsies

Not acceptable in Islam as they are seen as a desecration of the body.

Embalming and cosmetology

Not allowed unless required by state or federal law.

Death Rituals in Africa

Smearing of ash in all of the windows, turning all pictures in the house around, and covering all mirrors and televisions and any other reflective objects.

Burial animal sacrifice

Some kill an ox at the burial to accompany the deceased; others kill another animal some time after the funeral.

Body removal

Removing a dead body through a hole in the wall of a house, and not through the door.

Zigzag path to burial

A zigzag path may be taken to the burial site, or thorns strewn along the way, or a barrier erected at the grave itself.

Pallor Mortis

Paleness of death that occurs almost immediately, within 15-25 minutes, after death due to a lack of blood in the capillary region.

Algor Mortis

Cool of death; 1 hour after death, temperature decreases around 2 degrees Celsius, continuing to decrease one degree Celsius until it reaches the temperature of the environment.

Rigor Mortis

Death stiffness that occurs about 2 to 4 hours after death, beginning in the involuntary muscles and progressing to the extremities.

Livor Mortis

Red-purplish discoloration of the skin caused by the breakdown of red blood cells, appearing in the lowermost or dependent areas of the body.

Organ or tissue donation

Check for waiver or consent after death.

Autopsy

Post-mortem examination that requires family consent and may be mandated by law if death results from foul play.

Death documentation

Certifying and documenting the occurrence of a death provides a legal record of the event.

Postmortem care

Respect the person and their beliefs while maintaining the dignity of the dead person.

Post Mortem Care Supplies

Includes a body bag, name tag, patient labels, fitted and flat sheet, hospital gown, and supplies for bed bath.

Nursing Responsibilities

Nurses need to analyze their own feelings about death to effectively help others with terminal illness.

Patient care

Provide relief from illness, fear, and depression while helping clients maintain a sense of security.

Family support

Explain procedures and equipment, prepare them about the dying process, and encourage communication.

Post Mortem Care Procedures

Needs to be done promptly, quietly, efficiently, and with dignity, including straightening limbs and placing the head on a pillow.

Time of death documentation

Note time of death and chart, notify attending physician, and notify family members.

Body identification

Tag or provide body identification as per policy and note personal artifacts released with the body.