Week 9: Death and dying Flashcards
Attitudes towards death and dying
- Living in a death avoidant society (avoid talking about death)
- Death literacy (normalizing it)
- Healthcare’s relationship w death (death is failure of health care system)
How has dying changed since the 1900s?
- People used to die in their homes but now 65% of people die in facilities
- People live longer
- 10% of people die suddenly, 20-% experience steady decline and 70% experience slow decline
Hospice palliate care - WHO
An approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual
Hospice palliative care- Ontario
Holistic care- comfort, meaning and support for people facing the end of life and their families
Importance of palliative care
- Compassionate and upholds patients right to die w dignity
- Provides relief from pain and other distressing symptoms
- Regards dying as a normal process
- Applicable early in the course of illness
Where do people receive hospice palliative care?
- At home
- In community
- In hospitals
- In long-term care
- In residential hospices
Who is on a palliative care team?
- Family physician
- Physio
- Spiritual counsellor/religious leader
- PSW
- Palliative nurses
- Palliative physician
- Traditional medicine worker
- Nutritionist
- Social worker
- Death doula
- Occupational therapist
- Pharmacist
What does dying look like- SOCIALLY
- Social withdrawal
- Talking to or seeing people and things who aren’t there
- Excessive fatigue and sleep
- Temporary dramatic improvement
What does dying look like- DIGESTIVE
- Less interest in food
- Odd cravings
- No longer eating and drinking
- Incontinence
What does dying look like- MUSCULAR
- Loss of movement, muscle tone, and sensation
- Jaw drops, mouth stays open
- Face looks peaceful and relaxed
What does dying look like- CIRCULATORY
- Pulse is fast, weak, and irregular
- Blood pressure falls
- Skin is mottled or blush
- Cold hands and feet
What does dying look like- RESPIRATORY
- Cheyne- Stokes breathing (stopping and starting)
- Gurgling sound
FINAL signs of death
Absence of pulse, respirations and blood pressure
Fixed, dilated pupils
What care does a dying person need?
- Listening
- Gentle touch
- Compassion
- Pain relief
- Physical comfort
- Vision support
- Hearing support
- Communication adaptations
- Mouth care
- Incontinence care
- Nutritional support
What happens after death- POSTMORTEM SUPPORT
- Positioning the body before rigor mortis develops (2-3 hrs after death)
- Personal care
- Rituals
