Final Completion Certificate of Marketing Management Internship
CARE FOR THE DYING.pptx
1. CARE FOR THE DYING
ASSESSING THE NEEDS OF LIFE CARE
2. OBJECTIVES:
To make initial assessment to identify actual and potential needs.
To make assessment based on physical and mental changes
To assess patient/client’s condition in order to determine individualized
responses to impending death.
To make assessment as baseline data for providing care and referral
3. The health care industry in which you must operate is client centered.
This means that the client/patient is central in everything that you
do regardless of the care setting
4. Care setting may include:
Residential ( client’s home)
Hospital
Long term facilities
hospices
5. At the time of admission, you as the health
care Assistant are expected to conduct an
initial assessment of the client’s/patient
health status before any care can be
planned. This is one of four types of
assessment, which are:
Initial
Problem focused
Emergence
Time Elapsed Reassessment
6. You should ensure that the area in which this assessment is
carried out is private, quite and relaxing. Unless the client
is unable to communicate clearly or wants to have family
members present, you should assess him/her alone. There.
exceptions to this, such as when your client client/patient
is a child or an older adult, a parent/guardian has to be
present.
7. The initial assessment of a client is used to
create a nursing history. This includes:
Biographic data ( name, age, marital status)
Chief complaint/Reason for visit
History of present illness
Past history (Childhood disease)
Family history of illness
Lifestyle (dietary needs, personal habits)
Social data (religious preferences, beliefs, support system, economic status)
Psychological data (stressors, coping pattern, communi8cation style)
Patterns of health care(usual source of medical care)
Expressed wishes for post mortem care
8. SOURCE OF DATA
You can gather this information from a number of sources such as:
Client
Relatives
Records
Health care professionals
Health care literature
9. MAKE ASSESSMENT BASED ON PHYSICAL
AND MENTAL CHANGES.
Obtain information about the patient’s function abilities
Obtain data that will help you determine the response required and plan the care
Make clinical judgements on the health status and the need to refer
The physical and mental conditions of a dying person vary according to the client’s
general health condition, medication being used to treat the symptoms and other
significant factors, You may observe all the changes, some or no changes in the
patient/client. You may find that some persons respond to impending death based on
their life experiences, some may be very angry and others may remain calm and
peaceful.
The first thing that you must do is record your general impressions f the client’s
overall appearance and health status such as:
10. Assessment based on physical and
mental chances:
The first thing that you must do is record your general impressions f the client’s
overall appearance and health status such as:
Body size
Mental state
Nutritional status
Level of activity
Speech
Appetite
Breathing rate
11. Physical changes that you noticed ay
include the following:
Activity decreases i.e. less movement, less interest in the environment
Interest in food and water diminishes
Body temperature lowers by a degree or more
Blood pressure begins to fall gradually
Circulation to the extremities diminished so that the hands and feet begin to feel cool compared to the rest of the body
Skin colour becomes dull or a greyish blue
The fingernail beds become bluish rather than the normal pink
Communication decreases, i.e. the person ceases to respond to questioning and no longer speaks spontaneously
Coma ensues and may lasts from minutes to hours before death occurs. Persons in a coma may still hear what is said even
though they no longer seem to respond to verbal or even painful stimuli
Pulse may change in regularity from rapid to slow
Blood pressure may fall
Fluid may accumulate in the lungs causing the “roll and rattle”
Breathing changes from a normal rate to an abnormal rate
12. MENTAL CHANGES THAT YOU MAY NOTICE
INCLUDE THE FOLLOWING:
Denial, guilt, despair, feelings of worthlessness, crying and inability to
concentrate
Thoughts of suicide
Delusions and hallucination
Increased respirations, dry mouth, anorexia, difficulty sleeping and
nightmares
Helplessness – may say, “I will never get over this”
Apathy, permission and inability to make decisions
Loss of control – may be manifested by anger, violence, acting out or
depression and passive behaviour
You should note any unusual behaviour demonstrated.
13. SUPPORT DYING PERSON/RELATIVES
Obtain information about patient/relatives regarding beliefs, values and preferences
Secure necessary resource and provide emotional and spiritual support to maintain
client’s/relatives beliefs
Demonstrate respect for patient‘s/relatives
Use knowledge regarding death and dying to support client/relatives
Allow relatives to spend time with dying client
Respect clients rights to privacy
Communicate client’s/relatives’ request for visit of clergy/spiritual leader to nurse in charge
Facilitate the visit of the clergy/spiritual leader/resource personnel
Keep client’s room well lit, ventilated and pleasant
Arrange pictures, flowers, religious objects and other significant items within view and reach
of client.
14. Information that you need to provide the
required support to the patient/relative is:
Religious/cultural affiliation
Who makes the decisions regarding the persons care
How treatment is to be administered
What treatment will be refused
How patient expresses emotion, feelings, spirituality and religious beliefs
How dying, death and grieving are expressed in a culturally appropriate
manner
15. Gathering information about your patient’s
values, beliefs and preferences will enable
you to:
Provide service/care with request for the dying person’s dignity and
uniqueness
Give direction and meaning to life and guide the person’s behaviour
Recognize that the values, beliefs and preferences of the patient and his/her
relatives must precedence when they conflict with those of health care
providers
Values are often taken for granted, but it is important for you to know that they
influence the patient/relatives’ decisions and actions. For e.g
value placed on dying
Your patient’s place in the family
Value placed on being informed
Value placed on the type of care
16. People need personal values to have a sense of individuality, and beliefs to
have a sense of family. I some religions/cultures, persons value treatment
by a folk healer over that by a physician. If you know this then you can
plan, care and ensure that your patient knows that you understand
him/her.
Beliefs and attitudes about death vary. You should determine the
client’s/relatives’ attitudes towards death, illness and health care
providers, then care based on what they expect.
You should be aware of your own beliefs/values and preferences and be
clear on your ability to interact supportively with the patient/relatives.
You should not impose
18. Provide post mortem care
Provide post mortem care
Preparation of body is done after doctor’s written declaration of death.
The deceased person is carefully cleaned and groomed consistent with
policy related to infectious diseases.
Caregiver is appropriately attired according to established procedures for
minimizing risks of infections.
Cleaning and preparation of deceased person is carried out in a manner
that shows sensitivity to the feelings of the deceased person, relatives and
friends.
19. POST MORTEM CARE
The immediate environment is prepared in a manner that respects the
cultural and religious beliefs of the deceased and relatives.
Valuables that are to remain with the deceased person are reported and
recorded accurately, legibly and completely.
Where visible identification is used, it is complete and accurate.
20. POST MORTEM CARE
Disposal of body is done in a timely manner.
Environment is appropriately cleaned after removal of body.
Universal precautions are applied.
21. Care for relatives of the deceased
Impacting situations relating to the deceased person are explained
sensitively in a manner and at a level, appropriate to those concerned.
Viewing of body is confirmed with relatives and friends.
Action is taken to prepare and dispose of body according to relatives
expressed wishes.
Family is supported through the grief process.
22. CARE FOR THE DECEASED CONT’D
Individuals include:
older adults and relatives regardless of
religious/cultural beliefs
children
adults
Care includes:
monitoring dying process
Cleaning
rooming
tagging of body
23. CARE CONT’D
Settings may include:
those dying at home
hospital
long-term facilities
hospices
Health and safety measures relating to:
Infectious and contagious diseases
drainage tubes etc
24. Work activities include:
verify that the person has been certified dead by a physician
Impacting situations include:
cases under jurisdiction of the coroner
financial obligations
25. Personal Protective Equipment may include:
gloves
protective clothing
face mask
Other equipment may include:
tags
body bag
26. Legislation, policies and regulatory bodies may include:
Ministry of Health
National regulations regarding death and dying
Guidelines governing scope of practice
Policies and protocols outlined by facility
Universal precautions guidelines
27. Care of relatives may include:
Provision for emotional and spiritual needs
Support of beliefs etc.
Adherence of wishes regarding the disposal of body