End of Life

Question 1

Living Will

Answer 1

may contain information about life sustaining measures that the client does or does not wish to have in specific circumstances. This is a legal document signed by the client when they were able to make those choices.

Question 2

Power of Attorney

Answer 2

a person legally appointed by the client when they were able to make decisions on their behalf. This can be further specified to include medical decision or not (the person may simply be POA for finances)

Question 3

Advanced Directive

Answer 3

This applies only to medical treatments that a client may or may not wish to have that is often completed by the client or their substitute decision maker (if the client is unable) upon entry to a LTCF. It might include whether or not the client would like to receive ICU care, for example.

Question 4

Substitute decision maker (SDM)

Answer 4

a person appointed to make decisions on behalf of a client when the client is no longer able. Laws state who can be appointed if the client is unable to appoint a person themselves, but it is generally the closest next of kin.

Question 5

DNR

Answer 5

simply means that if a persons heart stops beating or they stop breathing that no measures will be taken to restart these functions. The client or their representative decides this, it does not need to be ordered by a doctor.

Question 6

5 stages of grief

Answer 6

Denial: inability to accept the prognosis
Anger: the ‘Why me?’ stage
Bargaining: may be seeking more time alive in exchange for a promise to a higher power
Depression: profound sadness about the loss of impending loss
Acceptance: coming to terms with the death or impending death

Question 7

supporting dying client

Answer 7

Promoting pain and symptom management, psychological (emotional) support and maintaining dignity are crucial.

As death approaches, increasing physical support will be required. Some types of physical support will depend on the disease that is leading to death, but eventually most people will require full physical care, including repositioning, incontinence care, oral care and more.

Question 8

post mortem care

Answer 8

1. ensure the client is as presentable as possible for the family who may be visiting
2. continue to treat the client with dignity and respect and allowing privacy following death.
3. If possible, complete post-mortem care prior to rigor mortis (stiffening of skeletal muscles) setting in (usually 2-3 hours after death, but varies)
4. Provide family privacy, a place to sit and fluids at the minimum