Chapter 3 Flashcards
Holistic care
Caring for the whole person- the mind as well as the body.
Caring for a person holistically is part of providing person-centered care promotes their individual preferences, choices, dignity and interests.
Example: taking the time to talk with residents while helping them bathe
Changes in residents that need to be reported to the charge nurse
Signs of depression Suicidal thoughts Loss of ability to think logically Poor nutrition Shortness of breath Incontinence
Guidelines to caring for a resident with an intellectual disability
Treat them as adults
Praise and encourage often, especially positive behavior
Help teach activities of daily living by dividing a task into smaller units
Promote independence. Assist residents with activities and motor functions that are difficult
Encourage social interaction
Repeat what you say to make sure they understand
Be patient
Schizophrenia
A psychotic disorder that affects a person’s ability to think and communicate clearly. It also affects the ability to manage emotions, make decisions and understand reality. Affects the person’s ability to interact with others. Symptoms include hallucinations and delusions
Observing and reporting mental health disorders
Note:
Changes in ability
Positive or negative mood changes, especially withdrawal
Comments, even jokes about hurting oneself or others
Failure to take medicine or proper use of medicine
Real or imagined physical symptoms
Events, situations or people that seem to upset or excite residents
Advanced directives
Legal documents that allow people to decide what kind of medical care they wish to have if they are unable to make those decisions themselves.
Living will
Outlines the medical care a person wants, or does not want, in case they become unable to make those decisions
Durable power of attorney for healthcare
(Sometimes called healthcare proxy)
is a signed, dated and witnessed legal document that appoints someone else to make medical decisions for a person in the event that they become unable to do so. This can include instructions about medical treatment that the person does not want
Guidelines for caring for the dying resident
Reduce glare and keep room lighting low
Census begin to diminish and vision May fail. Hearing is usually the last sense to leave the body. Speak in a normal tone. Tell the resident about care that is being done or what is happening in the room. Do not expect an answer. Ask You questions. Observe body language to anticipate a residents needs
Give mouth care often
If the resident is unconscious, give mouth care every 2 hours. Apply lubricant, such as lip balm to the lips and nose
Skin care
Give bed baths and incontinence care is needed. Dave perspiring residents often. Skin should be kept clean and dry. Change sheets and clothes for comfort. Keep sheets wrinkle free. Careful skin care to prevent pressure injuries is important.
Pain control and comfort
Observe body language and watch for other signs of pain. Report them. Frequent changes of position, back massage skin care, mouth care and proper body alignment may help
Environment
Put favorite objects and photographs where the resident can easily see them. Make sure the room is comfortable, appropriately lit and well ventilated.
Emotional and spiritual support
Listening maybe one of the most important things you can do for a resident who is dying. Pay attention to these conversations. Report any comments about fear to the nurse. Touch can also be important. Holding the residence hand as you sit quietly can be very comforting.
Guidelines for treating residents who are dying with dignity
Respect the residence wishes and all possible ways
Communication is extremely important at this time so that everyone understands what the residents wishes are. Listen carefully for ideas and how to provide simple gestures that may be special and appreciated
Do not isolate or avoid a resident who is dying
Enter the room regularly
Be careful not to make promises that cannot or should not be kept
Continue to involve the resident and his care and in facility activities
Be person centered. Do not talk with other staff members about your personal life when caring for the resident
Listen
If a resident wants to talk do not offer advice. Do not make judgmental comments.
Be professional
Don’t act especially cheerful or sad
Keep the resident as comfortable as possible
Help with the families physical comfort
Honor their requests to the best of your ability
Common signs of approaching death include:
Blurred and failing vision
Unfocused eyes
Impaired speech
Diminished sense of touch
Loss of movement, muscle tone and feeling
Arising or below normal body temperature
Decreasing blood pressure
Weak pulse that is abnormally slow or rapid, shallow respirations, along with short periods of not breathing called Cheyne-stokes respirations
A rattling or gurgling sound as the person breathes (which does not cause discomfort for the dying person)
Cold, pale skin
Mottling (bruised appearance) spotting or blushing of skin caused by poor circulation
Perspiration
Incontinence
Disorientation or confusion
Guidelines to postmortem care
Faith the body. Be gentle to avoid bruising. Place drainage pads underneath the head and perineum follow standard precautions
Do not remove any tubes or other equipment attached to the body. Leave this to the nurse
If instructed, put dentures back in the mouth. Close the mouth. If not possible place dentures in a denture cup near the residence head
Close the eyes carefully
Position the body on the back with legs straight and arms folded across the abdomen. Put a small pillow underneath the head
Final facility policy about personal items. Check to see if you should remove jewelry. Always have a witness of personal items I removed or given to a family member. Document what was given to whom.
Strip the bed after the body has been removed. Open Windows to air the room is needed. Straighten up.
Document according to your facilities policy
Hospice care
Return for the special care of the dying person needs. it uses a holistic, person-centered approach. The resident is encouraged to participate in family life and decision making as long as possible
Palliative care
Is given in hospice where the goals shift from person-centered care to focusing on the comfort and dignity of the resident.
Pain relief, comfort and managing symptoms, rather than teaching residents to care for themselves becomes the focus
Hospice Care guidelines
HCG
Be a good listener
Acknowledge that some will not want to confide in their caregivers. Never push someone to talk
HCG
Respect privacy and Independence
HCG
Be sensitive to individual needs
Ask family members of friends how you can help
HCG
Be aware of your own feelings
Know your limits and respect them
HCG
Recognize the stress
Talk with a counselor support group while keeping specific information confidential
HCG
Administer self-care
Talk about an acknowledge your feelings. Take time to do things for yourself. Take a break when needed
HCG
Allow yourself to grieve. You will develop close relationships with some residents. Know that is normal to feel sad, angry or lonely when residents die
