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Approaching Death

The document discusses approaching death and what constitutes a good death. It outlines signs that death is near such as weakness, sleeping, and decreased intake. It also discusses how nurses can support a good death through communication to address cultural, spiritual, and emotional factors and clarify goals of care. Finally, it lists five domains of quality end of life care such as pain management, avoiding prolonging dying, and strengthening relationships.

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Bhawna Pandhu
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54 views14 pages

Approaching Death

The document discusses approaching death and what constitutes a good death. It outlines signs that death is near such as weakness, sleeping, and decreased intake. It also discusses how nurses can support a good death through communication to address cultural, spiritual, and emotional factors and clarify goals of care. Finally, it lists five domains of quality end of life care such as pain management, avoiding prolonging dying, and strengthening relationships.

Uploaded by

Bhawna Pandhu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Pall 9016: Understanding death

Approaching Death
Approaching Death

“When you were born, you cried and the world


rejoiced.
Live your life in a manner so that when you die
the world cries and you rejoice”

Indian proverb
Reflection

 What do you want your end of life to look


like?

 What is a “good death” in your estimation?

 How do you think your experiences have


shaped this?
A Good Death:
What the literature says

 Free from avoidable stress

 In general accord with patient’s and family


wishes

 Reasonably consistent with clinical, cultural,


and ethical standards
Stages of Impending death

There are a number of predictable signs that


death will occur in the near future:
Signs that death is coming

• Progressive weakness
• Bedbound state
• Sleeping much of the time
• Decreased intake food and fluid
• Darkened and/or decreased urine output
• Difficulty swallowing (dysphagia)
Signs that death is coming
Signs that death is coming

 http://ltctoolkit.rnao.ca/sites/default/files/res
ources/AppF_ESAS_EndofLifeBPG2011_pg10
6to107.pdf
Signs and Symptoms Con’t

• Delirium not related to reversible causes


• Decreased level of consciousness not related
to other causes
• Noisy respiration/excessive respiratory tract
secretion
• Change in breathing pattern (Cheyne-Stokes
respiration periods of apnea)
• Mottling and cooling of the extremities
CHCA Domains of Care

Canadian Hospice Care Association (CHCA)Domains


of Care, include the following:
1. Disease management
2. Physical
3. Psychological
4. Spiritual
5. Social
6. Practical
7. End-of-life care/death management
8. Loss and Grief
CHCA Domains of Care
Approaching Death

How do nurses support a good death?


Supporting a Good Death

Nurses use effective communication to facilitate end of life


decisions related to:
 Cultural and spiritual values, beliefs, and practices
 Emotions and fears
 Past experiences with death and loss
 Clarifying goals of care
 Family preferences related to direct care involvement
 Practical needs
 Informational need;
 Supportive care needs;
 Loss and grief; and
 Bereavement planning
Five Domains of Quality End of Life Care

1. Receiving adequate pain and symptom


management
2. Avoiding inappropriate prolongation of dying
3. Achieving a sense of control
4. Relieving burden
5. Strengthening of relationships with loved
ones

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