Death, what a fun topic Flashcards
How long does the active dying process usually take?
Hours to days
Sudden death is uncommon
Rarely occurs over weeks
Important (less obvious) Physiologic Changes of death
Decreased appetite
Pain- grimace, moans, etc
Skin molting
Decreased appetite in death
The patient is NOT starving to death
Death is from the underlying disease process
Not eating/drinking is normal
help by Oral care
Keep mouth moist and clean
Pain in death
Warrants trial of Opioids (NO evidence they hasten death)
Undertreated ≥ 50% moderate-severe pain in last few days of life
Communication with the Dying Patient
Distressing to families
This is a time when they want to communicate the most
Assume the patient can hear everything
Talk as if they were fully conscious
After Death: What Do YOU Do
Your role is not to make it all better
Words are NOT what’s most important now
Most important to let the family know you are there for them
After Death: What Do YOU Do 2
Be genuine Say nothing, just be present “I’m so sorry for your loss” “You and your family will be in my thoughts” “I’m here for you”
LISTEN to them
Share memories/stories of the deceased
Don’t talk about yourself
NOT a time to go over medical details
Most important aspects of dying include
Dedicated decision maker Financial affairs in order Knowing what to expect about prognosis Knowing what to expect about physical condition Maintain dignity Pain control
Hospice
Dependent on prognosis
Prognosis ≤ 6 months (days-weeks-months)
Not pursuing curative/disease-modifying therapies
Palliative Care
Specialized care for serious illnesses
Goal improve QOL
Relief of pain, symptoms, stress
Independent of prognosis
Where do most people die
Most patients prefer to die at home…
but actually die in the hospital
_________ ↑ QOL in seriously ill
Palliative care
__________ ↑ QOL at end-of-life
Hospice
