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Nursing Assistant UNIT 4 CHAPTER 22: CARING FOR PEOPLE WHO ARE TERMINALLY ILL.

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Presentation on theme: "Nursing Assistant UNIT 4 CHAPTER 22: CARING FOR PEOPLE WHO ARE TERMINALLY ILL."— Presentation transcript:

1 Nursing Assistant UNIT 4 CHAPTER 22: CARING FOR PEOPLE WHO ARE TERMINALLY ILL

2 Caring for the Terminally Ill  People die from many different causes at many different ages  Terminal Illness  Illness or condition for which there is no cure  AIDS  Cancers  Certain heart conditions  Chronic respiratory disorders  Kidney disorders  Liver disorders

3 Caring for the Terminally Ill  In the past, most people with a terminal illness received care at home  All caregivers could do was make patient comfortable  We must allow person to live and die with dignity  When taking care of a dying person you should be aware of the power of listening and touch

4 Stages of Grief  Grief  Mental anguish, specifically associated with loss  Dr. Elisabeth Kubler-Ross ( )  Psychiatrist  Wrote famous book, On Death and Dying  Worked specifically with terminally ill people  Identified distinct stages of grief

5 Stages of Grief  Stage I: Denial  Occurs when the person is told they have a terminal illness  Person refuses to accept the diagnosis or feels a mistake has been made  Denial helps protect a person emotionally from overwhelming grief  This stage may last only a few minutes or until the person actually dies  Not your place to convince the patient that the illness exists  Be honest but neutral

6 Stages of Grief  Stage II: Anger  Occurs when the person realizes that they are actually going to die  People may feel angry for different reasons  Each person handles anger differently  Some people are angry with themselves, and some make take it out on others  Do not take anger personally

7 Stages of Grief  Stage III: Bargaining  Typically done on a very private basis by the patient  Person wants to “make a deal” with someone who has control over their fate  Person may want to live long enough to accomplish a goal or witness a specific event  The will to live can be a very powerful life force and may extend the persons life for many months  Allow the person to experience the feeling of hope that comes with this stage

8 Stages of Grief  Stage IV: Depression  When the person fully realizes that death will be the end result  Person will be sad and may have regrets about things they were not able to do  Some are quite withdrawn and quiet  Normal part of process  Be supportive  Some people require medical intervention

9 Stages of Grief  Stage V: Acceptance  When a person comes to terms with the reality of their own death  Is at peace with this knowledge  Complete unfinished business  Says goodbyes  Plan funeral service  Usually want to talk about their death  Some people gain acceptance months or years before it happens

10 Wills  A will is a legal statement that expresses a person’s wishes for the management of their affairs after death  Person must be deemed competent when will is made to be valid  Many health care facilities offer assistance  You may witness wills  By signing you are just saying you watched the person sign

11 Dying with Dignity  Advance Directives  Allows a person to make wishes know about health care decisions  Many pertain to “end of life issues”  May elect to avoid “life sustaining treatments”  Respiratory ventilation  CPR  Feeding Tubes

12 Dying with Dignity  Advance Directives  May elect to have supportive care only  Will not prolong life but will make person more comfortable  Oxygen  Pain medication  ROM  Grooming  Hygiene

13 Dying with Dignity  Advance Directives  DNR (do not resuscitate)  Also called a no-code  Only means CPR will not be performed to save a persons life

14 Dying with Dignity  Hospice Care  Hospice organizations have the mission of offering the terminally ill person the best quality of life possible  Care is provided by a multidisciplinary care team  Doctors  Nurses  CNA’s  Clergy  Social Workers  Mental Health Professionals

15 Dying with Dignity  Hospice Care  Team not only takes care of the patient, but takes care of family as well  After patient’s death, hospice provides grief counseling and other types of assistance to the family  Available to patient’s and families 24 hours a day 7 days a week  Care provided in patient’s home, long term care center, hospital, and hospice houses

16 Dying with Dignity  Hospice Care  Care given is palliative care  Focused on relieving uncomfortable symptoms  Pain medications  Chemotherapy  Radiation  Oxygen  Surgery  In no way is a terminally ill person is told to give up hope for recovery

17 Dying with Dignity  Hospice Care  Can also assist with equipment  Hospital bed  Bedside commode  Mechanical lifts  Focus of hospice team is to honor the wishes of the patient and family

18 Effects of Caring for the Terminally Ill on the Caregiver  Caring for a terminally ill person will affect you  We actually go through the grief process  May feel inadequate when we watch others grieve  Make sure to take time for yourself  Use clergy and counseling services available  Openly talk about your feelings on death with friends and family


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