Certified Nurse Assistant, Module 16, Death and Dying. Key Terminology. Review the terms listed in the Terminology section.
Spell the listed terms accurately. Pronounce the terms correctly. Use the terms in their proper context.
The five stages of grieving, according to Dr. Kubler-Ross. Denial, anger, bargaining, depression, and acceptance. Approaches to meet common emotional and spiritual needs of terminally ill patients and residents, and their families. A.
Emotional needs of the dying. Contact with loved ones. Encourage family members to visit.
Provide privacy. Communication. Listening.
And provide privacy. Expressions of emotions, i.e. guilt, anger, frustration, anxiety, depression, reminiscence, recalling, b. Cultural and spiritual needs of the dying.
Beliefs are communicated and respected. Rights and rituals are encouraged. Respect of solitude. Beliefs and wishes regarding autopsy, funeral, and post-modem care are respected.
C. Approaches. Respect for religious and cultural practices. Provide physical, emotional, and spiritual comfort to patient or resident, and family. Accept patient emotions.
Report to licensed nurse any emotional, social, or spiritual needs. Objective 4. List the rights of the dying patient or resident. A. I have the right to be treated as a living human being until I die. B.
I have the right to maintain a sense of hopefulness, however changing its focus may be. C. I have the right to be cared for by those who can maintain a sense of hopefulness.
D. I have the right to express my feelings about my approaching death. E.
I have the right to participate in decisions concerning my care. F. I have the right to expert continuing medical care and nursing attention, even though care goals must be changed to comfort goals. G. I have the right to not die alone.
H. I have the right to be free from pain. I.
I have the right to have my questions answered honestly. J. I have the right not to be deceived.
K. I have the right to have help from and for my family in accepting my death. L.
I have the right to die in peace and dignity. M. I have the right to retain my individuality and not be judged for my decisions which be contrary to the beliefs of others.
N. I have the right to discuss and enlarge my religious and spiritual experiences, whatever these may mean to others. O. I have the right to expect that the sanctity of the human body will be respected after death.
P. I have the right to be cared for by caring, sensitive, knowledgeable people who will attempt to understand my needs and will be able to gain some satisfaction in helping me face my death. Section 5. Differentiate between common signs of approaching death and biological death.
A. Impending signs of death. Decreasing level of consciousness. Cold hands and feet. Diaphoresis.
Pale skin. Loss of muscle tone. Labored or chain-stokes respirations. Death rattle.
Weak, irregular, or slow pulse. Blank, staring expressions. Jaw drops.
Mottling of skin. Pertistalsis slows. Loss of sensation. pain decrease, signs of biological death, no pulse, no berating, no blood pressure, pupils may be fixed, hearing is the best sense of disappear. Be professional in all conversations, talk to the patient, and explain procedures.
Section 6. Identify and comfort measures. of the dying patient or resident. monitor the patient or resident, observe for signs and change of status, care and comfort measures. Section 7. Identify the philosophy and goals of hospice, and the nurse assistant's role when the patient is cared for by a licensed hospice nurse. The first modern hospice, St. Christopher's Hospice, began in London in the 1960s.
Philosophy Goals. Nurse Assistant's Role. Attitudes and Skills Useful in Hospice Care.
Role of the Hospice Nurse. Section 8. Describe Procedures and Responsibilities for Postmortem Care. Assist the postmortem care as directed by a licensed nurse. Follow facility procedures.
Provide privacy, support, and comfort. Respect family members' beliefs with regard to post-mortem care.