Chapter 29: Caring for Older Adultsat the End of Life

Question 1

What are the 3 trajectories of death?

Answer 1

1) expected death

2) mixed death

3) unexpected death

Question 2

what is death?

Answer 2

cessation of all biological functions

Question 3

what are the 4 different values of aging?

Answer 3

1) Chronic illness and disability associated with end of purpose and loss of productivity

2) Denial of aging and death in 21st century

3) Advances in technology to manipulate/control aging and death

4) Transferring of responsibility of death from religious leader to physicians who are responsible for curing illness and prolong life

Question 4

What are OA perspective on dying?

Answer 4

Older adults are more aware and accepting of the inevitability of death

Question 5

what is dignifies death?

Answer 5

A sacred passage, time of honouring, time for goodness, time for compassion, peace, dignity and gentle release

Question 6

what is rehumanizing in end of life care?

Answer 6

recognizes and respects the process of death and dying as important

Question 7

what does hospice treat?

Answer 7

the person not the disease

Question 8

what is hospice care vs palliative

Answer 8

hospice: philosophy of care that seeks to support dignified dying for the person and their families and caregivers. cost effective too.

palliative: patient and family-centred care optimizing quality of life by anticipating, preventing and treating suffering. stepping stone to hospice care.

Question 9

what are the interventions given to those who are dying?

Answer 9

Tylenol suppository PRN for elevated temperature

Mouth care, eye drops

Hydration

NPO

Nozinan ,Versed, analgesics

Scopolamine s/c and transdermal
patch

Oxygen therapy

Foley catheterization

Question 10

when does a doctor pronounce death?

Answer 10

doctors can make orders for the RN or RPN to pronounce the death if its EXPECTED

if the death is UNEXPECTED, the doctor has to pronounce the death

if the patient dies from an accident, leave everything and dont move anythng until doctor comes onto the unit and gives the okay

Question 11

what documentation is included in end of care?

Answer 11

• Vital signs ceased (pulseless at the apex and absent respirations ) and the pupils fixed and dilated
• Mindfulness of cultural, religious beliefs, values and treatment of the body after death
• Notification of POA when client dies (time and name)
• Considerations if necessity for coroner involvement
• Contact most responsible physician for signing the “ Medical Certificate of Death”