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HCA > Long Term Care Final Exam > Flashcards

Long Term Care Final Exam Flashcards

1
Q

Define rehabilitation

A
  • process by which people who have been disabled by injury or illness are helped to recover as much of their original abilities or replace lost abilities with new ones
  • process of restoring a person to the highest possible level of functioning through exercise, therapy
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2
Q

What is the main goals of rehabilitation?

A
  • patient independence
  • physical strength and conditioning
  • effective use of retained abilities
  • a productive and meaningful life
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3
Q

Identify members of the rehabilitation team.

A

-patient (main focus)
-physician
-nursing team
-physical therapist
-occupational therapist
-pharmacist
-physiotherapist
-activities director
-respiratory therapist
-dietician
-social worker
-family members
-spiritual advisor
speech-language pathologist

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4
Q

How can you promote the highest level of movement possible and the strengthening of body muscles and joints?

A
  • maintenance of good body alignment
  • frequent turning and repositioning
  • exercises
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5
Q

Identify assistive devices which increase independence when performing ADLs: eating

A
  • easy-grip mugs
  • food guards on plates
  • swivel spoon
  • knives with rounded blades
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6
Q

Identify assistive devices which increase independence when performing ADLs: hygiene

A
  • electronic toothbrush
  • suction nail brush
  • long-handled hairbrush, comb, bath sponge
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7
Q

Identify assistive devices which increase independence when performing ADLs: toileting

A
  • grab bars beside the toilet
  • built-up toilet seat
  • commode chair
  • long-handled tongs for self-wiping
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8
Q

Identify assistive devices which increase independence when performing ADLs: dressing

A
  • long-handled shoe horns
  • button hooks
  • sock and zipper pullers
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9
Q

Identify assistive devices which increase independence when performing ADLs: walking and movement

A
  • cane
  • walker
  • crutches
  • wheelchair
  • transfer board
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10
Q

Discuss the role of the health care aide when using assistive devices

A
  • devices are in safe working order
  • readily available when needed
  • patient has been taught the proper use of the device
  • patient is offered encouragement when learning how to use device
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11
Q

Differentiate between prosthesis and orthotic

A

prostheses: artificial body part that may be functional or cosmetic
orthotic: device which aligns and supports a body part and help prevent deformity

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12
Q

Name the psychological and social aspects on a patient going through rehabilitation.

A
  • feel inadequate,
  • conspicuous (stand out)
  • depression
  • apathy
  • hopelessness
  • anger
  • irritability
  • hostility
  • acting out
  • hyperactivity
  • withdrawal
  • pessimism
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13
Q

The most important determinants of a patient’s successful rehabilitation is

A

attitude, patience, persistance

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14
Q

Care providers can help by being

A

supportive, patient, empathetic, encouragement

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15
Q

Discuss the responsibilities of the health care aide in the rehabilitative process.

A
  • safe environment
  • know how all the mechanical devices work
  • observe status and progress of patient and inform rehabilitative team
  • provide emotional support and encouragement
  • motivate the patient
  • encourage to participate in social and recreational activities
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16
Q

Define mental health.

A
  • a state of well being in which the individual realizes his or her own abilities to cope with normal stresses of life and able to make contributions to the community
  • ability to cope and manage life stresses in a positive way
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17
Q

Which three factors influence mental health?

A
  • inherited characteristics
  • childhood nurturing
  • life circumstances
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18
Q

Identify characteristics of mentally healthy individuals.

A
  • feel comfortable about themselves
  • cope with own emotions
  • take life’s disappointments in stride
  • easy-going attitude
  • don’t under or overestimate their abilities
  • accept own shortcomings
  • have self-respect
  • deal with most situations that come their way
  • get satisfaction from simple everyday pleasures
  • able to give love
  • consider interests of others
  • have personal lasting and satisfying relationships
  • like and trust others
  • respect differences in others
  • don’t push people around
  • feel part of a group
  • feel sense of responsibility
  • do something about their problems
  • accept responsibilities
  • shape their environement
  • plan ahead
  • welcome new experiences and ideas
  • use natural capacities
  • set realistic goals
  • make their own decisions
  • put best effort into everything that they do
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19
Q

Define stress

A
  • an everyday fact of life and can’t be avoided
  • the ability to adapt to stress is a measure of an individual’s mental health
  • the emotional, behavioural, or physical response to an event or situation
  • anything that threatens to destroy us, keep us from satisfying basic needs
  • interferes with growth, development and productivity
  • throw us off balance
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20
Q

Identify common stressors

A
  • environmental (weather, noise, traffic)
  • social (deadliness, loss of loved one, relationship problems)
  • physiological (chronic illness, aging, poor nutrition)
  • emotional (meaning given to life experiences)
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21
Q

What happens to our body when we are stressed out?

A
  • fight or flight response

- hormones released into bloodstream causing increased heart rate, rapid breathing, sweaty palms, butterflies

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22
Q

List common physical and psychological effects of prolonged stress: physical symptoms

A
  • headaches
  • dizzy
  • tired
  • muscle aches
  • back pain
  • wight loss/gain
  • diarrhea/constipation
  • frequent illness
  • loss of sexual drive
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23
Q

List common physical and psychological effects of prolonged stress: Emotional Symptoms

A
  • mood swings
  • frustration
  • anger and hostility
  • unrealistic guilt
  • feeling blue
  • depression
  • feeling helpless or hopeless
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24
Q

List common physical and psychological effects of prolonged stress: Behavioural Symptoms

A
  • difficulty sleeping
  • eating too much or too little
  • nail biting
  • increased alcohol or smoking
  • overreacting
  • avoiding work and responsibilities
  • no interest in social activities
  • decline in personal hygiene
  • frequent crying spells
  • increased conflict with family and friends
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25
Q

List common physical and psychological effects of prolonged stress: Cognitive Symptoms

A
  • forgetfulness
  • difficulty concentrating
  • poor self-esteem
  • preoccupied with unreasonable thoughts
  • rambling thoughts and speech
  • inability to adapt
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26
Q

Discuss stress-reduction techniques

A
  • have a good lifestyle
  • take care of yourself
  • balance work with play
  • use relaxation techniques like deep breathing
  • exercise
  • be realistic
  • quit worrying
  • prioritize responsibilities
  • talk with others
  • avoid self-medication
  • laugh
  • give yourself time
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27
Q

Define mental illness.

A
  • affect and interfere with everyday life
  • opposite of mental health
  • unable to function effectively within the family or society
  • alterations in thinking, mood, or behaviour
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28
Q

Facts about mental illness

A
  • 1 out of 8 Canadians can expect to be hospitalized for a mental illness causing suffering and disablement
  • second leading reason for hospitalization among 20-44 year olds
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29
Q

Myth: People with mental illness are violent and dangerous.

A

Reality: no more violent than any other group, far more likely to be victims of violence

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30
Q

Myth: People with mental illness are poor and less intelligent

A

Reality: have average or above average intelligence, not the same as mental retardation, mental illness can affect anyone no matter the class or income level

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31
Q

Myth: Mental illness is caused by poor parenting or personal weakness

A

Reality: not anyone’s fault nor a character flaw, people do not choose to become ill, not lazy, result of chemical imbalance in the body

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32
Q

Myth; Mental illness is a single, rare disorder

A

Reality: not a single disease but a broad term applied to a variety of disorders

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33
Q

True or false? In the elderly, mental health problems are sometimes mistaken for normal changes associated with old age.

A

True

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34
Q

Anxiety disorder: Facts

A
  • subject to intense, prolonged feelings of fright and distress for no obvious reason
  • most common of all mental health problems
  • includes phobias, panic disorders, obsessive-compulsive disorders, PTSD
  • accompanied by depression, eating disorders or substance abuse
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35
Q

Anxiety disorder: Signs and Symptoms

A
  • uneasy feeling
  • sense of dread
  • sense of danger
  • sense of harm
  • extreme anxiety
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36
Q

Anxiety disorder: Treatment

A

counseling and medication

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37
Q

Anxiety disorder: Role of the health care aide

A
  • remain calm
  • use simple instructions
  • provide quiet atmosphere
  • stay with patient to show support
  • use touch if appropriate
  • report to supervisor
  • do not label
  • be patient
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38
Q

Schizophrenia: Facts

A
  • not split personality
  • biochemical disease of the brain
  • one of the more serious mental health illnesses
  • affects 1% of Canadians in late teens or twenties
  • inherited behaviour
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39
Q

Schizophrenia: Signs and symptoms

A
  • mixed up thoughts
  • delusions
  • hallucinations
  • paranoia
  • bizarre behaviour
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40
Q

Schizophrenia: Treatment

A
  • not curable

- use of antipsychotic medication and psychotherapy

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41
Q

Schizophrenia: Role of the health care aide

A
  • keep environment stimuli at minimum
  • maintain calm approach
  • patient
  • do not be offended by client’s remarks or actions
  • be accepting
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42
Q

Mood disorders: Facts

A
  • affect 10% of population
  • experience high and lows with greater intensity for longer periods of time
  • most common mood disorder is major depression, especially common in elderly
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43
Q

Mood disorders: Bipolar disorder

A

brain disorder that causes unusual shifts in a person’s mood, energy and ability to function
-extreme shifts in mood, energy and ability to function

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44
Q

Mood disorders: Signs and symptoms of depression

A
  • very sad
  • hopelessness
  • changes in eating patterns
  • disturbed sleep
  • constant tiredness
  • inability to have fun
  • thoughts of death or suicide
  • anxiety
  • paranoia
  • weight loss
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45
Q

Mood disorders: Factors that play a role in development of depression

A
  • trauma
  • prolonged stress
  • physical or viral illness
  • hormonal or chemical imbalance
  • family history
  • sensitivity to reduced sunlight
  • use or abuse of drugs
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46
Q

Mood disorders: Role of the health care aide

A
  • assist with ADLs
  • provide time for patient to complete tasks
  • offer encouragement and praise
  • be positive
  • encourage rest
  • ensure safety
  • follow the care plan
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47
Q

Mood disorders: Treatment

A
  • referred to psychiatrist or psychologist for evaluation and treatment
  • counseling or drug therapy
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48
Q

Mood disorders: Suicide Facts

A
  • 1 in 13 Canadians affected by suicide
  • responsible for 25% of deaths in in youth and second leading cause of death behind motor vehicle accidents
  • attempt suicide due to unbearable psychological pain and see suicide as the only option
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49
Q

Mood disorders: Suicide risk factors

A
  • history of suicidal behaviour
  • presence of physical or mental illness
  • substance abuse
  • social isolation
  • significant loss
  • access to the means of killing oneself
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50
Q

Mood disorders: Suicide danger signs

A
  • repeated expressions of hopelessness, helplessness or desperation
  • behaviour out of character
  • signs of depression
  • sudden change to cheerful attitude
  • giving away prized possessions
  • taking out life insurance or making a will
  • making remarks related to death and dying
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51
Q

Mood disorders: If you are concerned someone may be suicidal what should you do?

A
  • encourage them to express feelings
  • listen attentively
  • do not downplay feelings
  • reassure the person
  • ask if there is anything you can do
  • let them know you care about them
  • help them contact someone who can help like Canadian Mental Health Association
52
Q

True or false? Talking about suicide decreases the likelihood that someone will attempt it.

A

True

53
Q

Eating disorders: Facts

A
  • little to do with food and more to do with psychological and emotional factors
  • food obsessions, distorted body image, being thin
  • 90% occurs in women
54
Q

Eating disorders: Anorexia nervosa

A
  • serious, chronic life-threatening eating disorder
  • refusal to maintain minimal body weight within 15% of normal weight
  • intense fear of gaining weight, distorted body image and amenorrhea
  • recurrent binge eating and purging episodes
  • starvation, weight loss can result in death
55
Q

Eating disorders: Bulimia

A

-psychological eating disorder characterized by episodes of binge eating followed by inappropriate methods of weight control (purging)

56
Q

Eating disorder: Binge eating disorder

A
  • excessive intake of calories without any effort to prevent weight gain
  • eating rapidly, eating until uncomfortably full, eating excessive amounts of food, eating alone
  • guilty, disgusted, depressed, embarrasses, self-loathing
57
Q

True or false? Everyone who is obese engages in binge eating and everyone with a binge eating disorder is obese.

A

False. Not everyone is obese and have binge eating disorders

58
Q

Substance abuse

A
  • use alcohol and drugs as a way of coping with stress
  • alter a person’s mood and provide a temporary sense of well-being
  • extremely harmful
  • very costly for society
  • causes behavioural, health and social problems
59
Q

Substance

A

drug or chemical that is self-administered

60
Q

Abuse

A

substance use that is outside the limits acceptable by society and that has a negative effect on the psychological, physiological and social functioning of the individual

61
Q

Misuse

A

drug use for purposes other than which it is intended

62
Q

Dependence

A

reliance on a substance that has reached the level that absence of it will cause an impairment in function

63
Q

Tolerance

A

decreased effect of a substance caused by repeated use

64
Q

Addiction

A

compulsive use of a substance

65
Q

Withdrawal

A

physiological and psychological responses that occur when there is abrupt cessation or reduced intake of a substance on which an individual is dependent

66
Q

Define crisis

A
  • an acute emotional upset that develops when an individual is faced with a stressful event that is insurmountable through the use of usual coping mechanisms
  • temporary immobilization of the individual
  • rise in anxiety
  • illogical and confused thoughts
  • sudden or unpredictable events or can be anticipated
67
Q

Define crisis intervention

A
  • technique for helping individuals resolve a particular immediate stress problem
  • not an in-depth analysis of a situation
  • goal is to restore persona s quickly as possible to precrisis level of functioning
68
Q

Stressful events classifications

A

1) maturational/ developmental

2) situational

69
Q

Identify the variety of crises

A
  • catastrophic diagnosis
  • fearful of an impending surgery
  • serious motor vehicle accident
  • given bad news in personal life
  • aggressive or combative
  • death of family member
70
Q

Identify indicators of a person who is in crisis

A
  • tension
  • anxiety
  • disorganization
  • depression
  • helplessness
  • inadequacy
  • fear
  • confusion
  • emotional shock
  • decreased energy level
  • increased fatigue
  • altered sleeping patterns
  • loss of appetite
  • changes in temperament
  • social withdrawal
71
Q

True or false? A stressful event alone is a crisis.

A

False. It does not count as a crisis unless the individual’s view of the event and their response to it is significant and threatening to them, has also exhausted all usual coping strategies without effect

72
Q

Identify the roles of the health care aide when caring for a patient in crisis.

A
  • recognize a crisis
  • remain calm and confident
  • provide general crisis support to patients and families
  • seek out appropriate intervention services
  • participate in team approach to crisis intervention
73
Q

Briefly discuss interventions associated with non-violent crisis intervention (ex-aggressive behaviours)

A
  • be alert
  • do what you can to protect the patient
  • try to isolate the situation
  • have a pre-arranged signal for help
  • be calm and confident
  • maintain direct eye contact
  • avoid sudden or nervous gestures
  • do not stand above or over the patient
  • do not face the patient head on
  • do not cross your arms or put your hands on your hips
  • do not whisper
  • do not touch the patient or invade his personal space
  • listen empathetically
74
Q

Define critical incident

A
  • situation that can interfere now or later in an individual’s ability to function
  • most at risk is emergency personnel like health care workers, police officers, fire fighters, paramedics
75
Q

Define critical incident stress (CIS)

A
  • term used to describe the extreme emotional reactions common with critical incidents
  • PTSD=refers to CIS that lasts more than 30 days
76
Q

What kind of situations can a health care aide find themselves in that could lead to huge amounts of stress for themselves and their peers?

A
  • serious injury or death of colleague
  • multiple casualty incidents
  • natural disasters
  • suicide of patient or colleague
  • intensive media coverage and scrutiny
77
Q

Define critical incident stress debriefing (CISD)

A
  • structured intervention designed to reduce and control the negative impact of critical incidents and promote a fast and positive recovery
  • initiate grief process and reduce the fallacy of uniqueness and abnormality
  • encourages additional assistance after the debriefing and provides referrals for follow-up
78
Q

Identify reasons for the increased need for informal caregivers

A
  • outpatient treatments
  • shorter hospital stays
  • improved life prolonging interventions
  • significant commitment
  • intense and time consuming
79
Q

Define caregiver

A
  • anyone who provides assistance to someone who needs it
  • provide full time care or part time and not paid for their efforts
  • parent, spouse, child, friend, mostly women
80
Q

How do people become caregivers?

A
  • rarely by conscious decision
  • gradual
  • in a crisis
  • many do the job out of guilt
81
Q

Caregivers are responsible for what kind of care needs?

A
  • personal care (bathing, dressing)
  • instrumental tasks (making meals, yard work)
  • emotional support
  • 18 hours of care per week
82
Q

Discuss the effects of informal caregiving on the care provider

A
  • increased expenses
  • restrictions on time and freedom
  • social isolation
  • conflict with chronically ill
  • interference with lifestyle and social activities
  • stress and anger
  • sleep patterns disrupted
  • affects their work
  • having to move closer to the person needing care
  • anxiety, frustration, resentment, guilt
83
Q

Identify ways to relieve caregiver stress.

A
  • change routine as much as possible
  • recognize limitations
  • recognize that you are doing the best you can
  • accept your feelings
  • be patient
  • keep fit
  • make time for your own physical and emotional needs
  • avoid burnout
  • join a support group or speak to a counselor
84
Q

List common reasons for admission to a personal care home.

A

-inability to perform ADLs independently
-mood disturbances
-difficult behaviours
-memory and cognitive impairment
tendency for falls
-need for constant supervision
-stroke, hip fracture, arthritis
-urinary incontinence
-lack of family support

85
Q

What is an example of an institution.

A
  • a personal care home where the people residing are called residents
  • meant to be like their home environment
  • only 9% of Canadian seniors live in this
  • remain here until they die or transferred to acute care setting (few return home)
86
Q

Name the different levels of an individual’s degree of dependency on nursing staff for ADLs.

A

Level 1: minimal dependency for either bathing, dressing, feeding, treatments, elimination (remain in community)
Level 2: partial dependence on nursing time for bathing, dressing, feeding, treatments, elimination (in personal care homes)
Level 3: maximum dependency on nursing for two of the three-bathing, dressing, feeding, treatments, elimination
maximum dependency for one and moderate dependence for two
Level 4: maximum dependency for four or more
Level 5: Chronic care, individuals who need more professional care (Deer Lodge Centre or Riverview Health Centre0

87
Q

How is the cost of institutionalization determined?

A
  • based on income level

- resort to institutionalization after exhausting their resources

88
Q

Discuss the impact of institutionalization on the resident.

A
  • well-being
  • quality of life
  • mortality
  • adjusting to life in institution
  • loss of independence
  • separation from spouse and friends
  • stress
  • depression
  • withdrawal
  • loss of appetite
  • loneliness
89
Q

Discuss the impact of institutionalization on the family

A
  • painful decision
  • guilt
  • sadness
  • relief
  • grief
  • fear
  • anger
  • disagreement among family members
90
Q

Why do some believe that the quality of life in a personal care home is diminished?

A
  • loss of privacy
  • loss of choice and decision-making
  • decreased stimulation, boredom, loneliness
  • lack of contact with other age groups
  • separation from family, home and possessions
91
Q

Best Friends Model of Alzheimer’s Care

A
  • emphasize and understand the experience of Alzheimer’s disease
  • know the basics of the medical and scientific aspects
  • invest time in an initial and ongoing strengths-based assessment
  • support basic rights for the person with dementia
  • know the person’s life story very well
  • apply the qualities and lessons of friendship
  • recast relationships
  • learn the knack
92
Q

Eden Alternative Long Term Care Model

A
  • loneliness, helplessness and boredom account for the majority of suffering for elderly
  • pets, plants and children the axis around which daily life revolves
  • easy access to companionship
  • encourage and create opportunities that promote the resident’s participation
  • varied and spontaneous environment where unexpected or unpredictable interactions can take place
93
Q

Discuss the role of the health care aide in minimizing the effects of institutionalization.

A
  • orient the resident and his family to the facility on admission
  • provide a bright warm stimulating physical environment
  • individualize the environment
  • treat the elderly residents as adults
  • allow for privacy
  • courteous and respectful
  • offer flexibility to the daily routine
  • encourage visits and socialization by family and friends
  • listen to residents as they talk
  • show genuine interest
94
Q

Identify the framework for the care of residents created by North Eastman Health Association, Residents’ Bill of Rights

A

1) every resident has the right to be treated with courtesy and respect
2) right to be properly sheltered, fed, clothed, groomed and cared for
3) right to be told who is responsible for their care
4) right to privacy
5) right to keep and display personal possessions
6) right to give or refuse consent to treatment, informed of medical condition

95
Q

What are the advantages of being institutionalized?

A
  • staff on hand to provide 24 hour care, 7 days a week
  • increased social contact
  • accessible social activities
  • rehabilitation services
  • relief from the stress of caregiving on family
96
Q

Which fears are encountered when someone is dying?

A
  • not necessarily focused on death
  • pain
  • suffering
  • dying alone
97
Q

Ideas about death is influenced how?

A
  • life experiences
  • culture
  • religion
  • age
  • spiritual belief
98
Q

How do some health care professionals see death?

A
  • uncomfortable dealing with it
  • goal is to assist patients to eventually becoming well
  • death is seen as a failure on their part
99
Q

Briefly describe Kubler-Ross’s 5 stages of dying

A

1) Denial: refuse to believe that anything is wrong
2) Anger: they may strike at anything or anybody
3) Bargaining: they try to postpone the loss and hope the loss can be prevented
4) Depression: feel overwhelmed and lonely and may withdraw from others
5) Acceptance: acceptance of loss
* don’t necessarily pass through all these stages or may skip over some or go back

100
Q

Define euthanasia

A

act of assisting or permitting the death of a dying person in a painless, merciful manner

101
Q

What are the two forms of euthanasia

A

passive: refers to the witholding or withdrawing of medical treatment in order to hasten death
active: situation in which a dying person’s death is hastened by a physician or nurse practitioner = assisted suicide

102
Q

Define medical assistance in dying (MAID)

A
  • federal legislation now permits medical practitioners to provide medical assistance in dying
  • pharmacists, health care providers and others can provide requested assistance
  • must be provided with reasonable knowledge, care and skill and in accordance with any applicable provincial laws, rules or standards
103
Q

How are patients able to do advance care planning?

A
  • legally able to identify in advance what health care interventions they want before they are unable to
  • can name a proxy who makes health care decisions on their behalf=living will
104
Q

Which three categories are included in the goals of care policy?

A

1) comfort care
2) medical care
3) resuscitation

105
Q

What are health care directives?

A

legally binding documents, when existence is known then instructions must be followed

106
Q

Describe palliative care

A

-special kind of care for critically or terminally ill individuals
-improves quality of life of clients and their families facing terminal illness
-no respirators or resuscitators
-a few attempts to prolong the dying process
-focus is on the whole person
-ensure patient’s comfort and dignity
-relief of suffering
-closely associated with cancer and AIDS
-no age limit
at home, hospitals, long-term care facilities and hospices

107
Q

Which physiologic changes happen at the end of life: death likely within weeks or days

A
  • bed-bound state
  • significant progressive weakness
  • sleeping almost continuous
  • loss or ability to close eyes
  • loss of interest in food or fluids
  • difficulty swallowing
  • low blood pressure
  • urinary incontinence
  • references to going home or travel
  • seeing previously deceased individuals
  • disorientation
  • delirium
  • dehydration
108
Q

Which physiologic changes happen at the end of life: death likely within hours

A
  • changes in respiratory rate and pattern
  • noisy breathing
  • mottling and cooling of skin
  • dropping blood pressure and weak pulse
  • change in mental status
109
Q

True or false? Dehydration is considered predictable and experts argue it may have both positive or negative effects on the dying individual.

A

True

110
Q

Define delirium

A

temporary state of mental confusion

111
Q

Discuss the role of the health care aide when caring for a dying person.

A

1) pain relief and comfort: massages, soft music, relaxation techniques
2) comfort and positioning: frequent position changes and support devices, semi fowler position for easing breathing problems
3) vision and eye care: ensure room well lit, follow care plan
4) hearing: continue to introduce yourself and give explanations and reassurance
5) speech: ask yes or no questions
6) mouth care: ensure oral mucous membranes are moist and intact, report any changes
6) nostril care: apply lubricant and clean nostrils according to care plan
7) skin care: bathing, frequent position changes, fresh garment and linens
8) elimination: keep client dry and clean, give perineal care

112
Q

How can the health care aide meet the client’s needs?

A
  • touching: touch and silence is a powerful and compassionate way to communicate
  • listening: just being there and listening can be very helpful
  • respect: be respectful when client shares thoughts about religious and spiritual beliefs
  • always be honest
  • support realistic hope
  • accept the patient’s reactions and feelings
  • disclose accurate and appropriate information
  • accept silence
113
Q

True or false? Being with a person in the final moments can be very traumatic for the family.

A

False. It can be very therapeutic and may facilitate the grieving process.

114
Q

How can a health care aide include the family with the dying process?

A
  • encourage them to sit with the dying person
  • talk and touch as much as possible
  • let the family provide as much care as they would like
  • offer contact to hospital chaplain or spiritual leader
  • encourage family members yo express their feelings
115
Q

The dying person’s bill of rights

A
  • right to be treated as a living human being
  • right to maintain a sense of hopefulness
  • right to be cared for by those who can maintain a sense of hopefulness
  • right to express feelings and emotions about approaching death
  • right to participate in decisions concerning their care
  • right to expect continuing medical and nursing attention even though cure goals changes to comfort goals
  • right not to die alone
  • right to be free of pain
  • right to have questions answered honestly
  • right not to be deceived
  • right to have help from and for family in accepting death
  • right to die in peace and with dignity
  • right to retain individuality and not to be judged for decisions
  • right to discuss and enlarge religious and spiritual experiences
  • right to expect that sanctity of the human body will be respected after death
  • right to be cared for by caring, sensitive, knowledgeable people
116
Q

Discuss the role of the health care aide when caring for the loved ones of a dying person.

A
  • showing your concern
  • being helpful
  • providing privacy
  • checking the patient frequently
  • carrying out activities quickly, quietly and efficiently
  • allow family to be involved in care
  • be courteous to spiritual care providers, providing privacy for their visits
117
Q

List the signs of approaching death.

A
  • loss of movement, muscle tone, and sensation
  • slowing of peristalsis and other digestive functions
  • failure of circulation
  • failure of the respiratory system
  • excessive fatigue and sleep
  • changes in eating
  • social withdrawal
  • coolness in the tips of fingers and toes
118
Q

Define do not resuscitate (DNR)

A

-patient or physician requests/orders that no resuscitative measures be taken when the patient’s heart and lungs cease to function

119
Q

What signs are shown after death?

A
  • pupils become permanently dilated
  • blood pools in the lower areas of the body, giving a purple tinge to those areas
  • heat is gradually lost from the body
  • patient may urinate, defecate or release flatus
  • within 2 to 4 hours, body rigidity sets in
120
Q

Who pronounces the patient dead? Who tells the family? What if you are the first person to notice the death?

A
  • the physician, sometimes the nurse
  • doctor or nurse
  • go get the doctor to tell the family
121
Q

Discuss the role of the health care aide in postmortem care.

A
  • family not present when patient died, body must be prepared for viewing
    1) pull blankets up to the shoulders, leaving the face exposed
    2) put dentures back in the mouth
    3) close the eyelids
    4) clean up any blood, urine or feces
    5) tidy the room
  • should be positioned so that he looks like he is resting comfortably
  • treat body with dignity and respect
  • all care should be done gently and often requires two people
122
Q

Define postmortem care.

A

care of the body after death

123
Q

Explain the specific traditions for Judaism about the care of the body after death.

A
  • burial takes place within 24-48 hours
  • body not to be left unattended until burial
  • family sit Shiva (mourn) for 7 days with friends and relatives bringing gifts of food
  • family may withdraw socially for 30 days and mourn officially for one year
  • hold four services of remembrance for the deceased every year and on the anniversary of the death
124
Q

Explain the specific traditions for Muslim about the care of the body after death.

A
  • body is positioned on its right side facing southeast or on its back with feet in a southeasterly direction with head slightly raised all in order to face Mecca
  • body must not be touched by a non-muslim
  • precise rules apply to washing the body
125
Q

Explain the specific traditions for Indigenous about the care of the body after death.

A
  • deceased person’s personal belongings are given away at a special ceremony four days following burial so gather things and give to family
  • family usually stays at home to pray until funeral
  • distant relatives make funeral arrangements
  • fire is lit at the wake of night before the funeral in order to warm the soul for its transformation to the next dimension
  • pipe ceremony may be held the morning of the funeral with a traditional burial later in the day
  • bereaved persons may cut their hair to express grief and put hair in casket as an offering to the spirits to assist the soul in its journey
126
Q

What are some coping strategies with dealing with care provider grief?

A
  • be self aware and participate in self monitoring
  • pay attention to stress level
  • share thoughts
  • attend bereavement debriefings or Palliative Care rounds when possible
  • utilize facility’s Pastoral Care Providers as personal resource or to facilitate grief or debriefing sessions
  • develop personal or team orientated rituals that are planned opportunities to acknowledge losses or patients who died
  • make time for enjoyable personal activities
  • exercise regularly
  • treat yourself
  • work through your grief gradually
  • advocate for change in areas that are changeable

HCA (13 decks)

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