Death, Dying and Dementia Flashcards
What are Kubler-Ross’ Five Stages of Grieving?
Denial Anger Bargaining Depression Acceptance
What are the physiological needs of the dying person?
- maintain clean skin and bed linens
- use a slide sheet to turn the patient as often as required to keep them comfortable
- positioning for comfort and protection of bony parts
- incontinence pads or catheter (if appropriate/ordered)
- gentle massage to reduce anxiety, improve circulation and shift oedema
- small sips of fluids or ice chips
- oral care with soft moist brush or swabs
- clean secretions from eyes and nose
- pain meds
- oxygen to relieve dyspnoea
What are the last offices provided after death?
- IV/drains removed
- wounds covered with simple dressings
- bodily orifices packed with gauze to prevent leakage
- teeth/dentures cleaned and replaced
- hair groomed
- fingernails cleaned
- men are shaved
- eyes are close
- lower jaw supported with bandage
- limbs positioned and tied in place
- ID tags attached
- body shrouded and in body bag
What are loss, grief, bereavement and mourning?
- Loss is an actual or potential situation in which something that is valued is changed or is no longer available (can be actual or perceived)
- Grief is the total response to the emotional experience related to loss.
- Bereavement is the subjective response experienced by the surviving loved ones after the death of a person with whom they have shared a significant relationship.
- Mourning is the behavioural process through which grief is eventually resolved or altered
What nursing diagnoses may surround grieving?
Complicated grieving/Risk of complicated grieving:
Interrupted family processes
Risk-prone health behaviour
Risk of loneliness
What is involved in a home care assessment surrounding grieving?
Individual knowledge Individual self-care strategies Individual coping Current manifestations of the grief response Role expectations: Family knowledge Support people’s availability and skills: Family role expectations Community resources
What is involved in active (attentive) listening?
silence, open and closed questioning, paraphrasing, clarifying and reflecting feelings and summarising
What are the signs of “circulatory death?”
immobility
apnoea
absent skin perfusion
absence of circulation (evidenced by absent arterial pulse for a minimum of 2 minutes)
What is the definition of “brain death”?
brain death is defined as the cessation of circulation to the brain resulting in the entire brain (including the brainstem) dying. must be confirmed by two medical practitioners
Signs of impending clinical death:
-Loss of muscle tone, difficulty speaking/swallowing, diminished movement, possible incontinence
-Slowing of the circulation, cool skin, slow weak pulse, decreased blood pressure
Changes in respirations - Cheyenne-Stokes, loud, laboured breathing
- Sensory impairment
What are rigor mortis, Algor mortis and livor mortis?
Rigor mortis - the contraction of muscles and stiffening of joints after death. Begins at 2-4 hours, ends at 96 hours. Caused by lack of ATP in the body post death.
algor mortis - gradual cooling of the body, 1 degree per hour until reached room temperature
livor mortis - haemoglobin discolouration in the dependant areas of the body
What is dementia?
an umbrella term that is used to describe impairment of brain function, including language, memory, perception, personality and cognitive skills
What are the different types of dementia?
Alzheimer’s
dementia with Lewy bodies,
dementia due to Parkinson’s disease,
dementia due to Huntington’s disease and
dementia due to progressive supranuclear palsy
What does FICA mean?
Faith (or belief)
Implications/influence
Community
Address (support)
What are the common causes of altered consciousness towards the end of life?
Decreased cerebral perfusion hypoxaemia metabolic acidosis sepsis accumulation of toxins from renal and liver failure medications disease-related factors
