CARE OF THE DYING CLIENT

CARE OF THE DYING CLIENTTermsLoss occurs when something/someone can no longer be seen, felt, heard, known or experienced.

Bereavement state of thought, feeling and activity that follows loss. It includes grief and mourning.

Grief is a form of sorrow that follows the perception or anticipation of a loss of 1 or more valued of significant objects.

Mourning process that follows a loss and includes working through grief.

Signs of Impending Clinical Death

1. Loss of muscle tone

Relaxation of the facial muscles (the jaw may sag)

Difficulty in speaking

Difficulty in swallowing and gradual loss of the gag reflex

Decrease activity of the GIT

Possible urinary and rectal incontinence

Diminished body movement

2. Slowing of circulation

Diminished sensation

Mottling and cyanosis of the extremities

Cold skin ( first in the feet and later in the hands, ear and nose)

3. Changes in Vital Signs

Decelerated and weaker pulse

Decreased BP

Rapid, shallow, irregular or abnormally slow respirations

4. Sensory Impairment

Blurred vision

Impaired sense of taste and smell

INDICATIONS OF DEATH

1. Total lack of response to external stimuli lack of responsiveness and receptivity

2. No muscular movement/breathing for more than 1 hour

3. No reflexes

4. Flat EEG this is the most accurate indicator of death

Irreversible cessation of circulatory and respiratory functions

Irreversible cessation of all functions of the entire brain

The physician is the only responsible for pronouncing the person dead.Care after Death

Body Changes:

1.Rigor Mortis the stiffening of the body that occurs about 2-4 hours after death.

Care of the body

Have the body in normal anatomical position (supine position, the arms at the sides, palms down)

Before rigor mortis sets in, place dentures in the mouth and close the eyes and mouth.

Care of Valuables

Identification and proper accounting; all clients valuables are listed and placed in a safe storage area for the family to take away.

Helping the patiens family Offering supportive measures

Allow the family to view the patients body

2. Algor Mortis it is the gradual decrease of the bodys temperature after death (about 1 degree celcius per hour until it reaches room temperature.

3. Livor Mortis discoloration of the skin after death after circulation has ceased.

*HELPING TO MEET THE NEEDS OF THE TERMINALLY ILL PATIENT*

1. Assist the client achieve a dignified and peaceful death

Provide relief from loneliness, fear and depression

Maintenance of independence maintain the clients sense of security, self confidence, dignity and self worth. Provide physical comfort

Maintain hope

2. Meeting physiologic and psychologic comfort

Nutrition

Elimination

Safety

Hygiene

Pain control (the highest priority)

Relief of respiratory difficulties

3. Provide Spiritual support

Search of meaning

Sense of forgiveness

Need for love

Need for hope

3 PHASES OF GRIEVING PROCESS

1. Shock and disbelief the individual denies the reality of the loss and may withdraw, sit motionless, or wander aimlessly.

2. Developing Awareness the individual begins to feel the loss acutely and may experienced desperation. Crying is typical as the individual becomes occupied with the loss.

3. Reorganization/Restitution inevitability of the loss is acknowledged. The loss is clear to individual who begins to reorganize life.

STAGES:

1. Stage of Denial

Immediate response to news of loss

Physiological response: tremors, deep sighs, cold and clammy skin, diaphoresis, discomfort, anorexia

Individuals isolate themselves from sources of accurate information/ reject offers of comfort and support. support emotional needs

offer to remain with clients

2. Stage of anger individuals may express anger and retaliate against family, physicians or supreme being

Do not take anger personally

3. Stage of bargaining individuals make bargains with supreme being.

4. Stage of Depression

Confusion