Caring For Resident When Death Is Imminent and Following Death

Unit 12
Caring For Resident When

Death Is Imminent and
Following Death
Nurse Aide I Course
DHSR Approved CurriculumUnit 12
Caring for Resident When Death Is

Imminent and Following Death
Introduction
Death is defined as the final stage of
life. The nurse aide will need to
develop a realistic attitude toward the
topic of death to meet the physical and
psychological needs of the resident and
the family as they experience the dying
process. This unit also includes care
of the body following death.
12.0 Explore personal feelings

concerning the concept of death.
Caring For Resident When Death Is

Factors influencing attitudes
Personal experiences
Culture
Some fear death
Others look forward to
and accept death

(continued)

Religion
Belief in life after death
Reunion with loved ones
Reincarnation
Punishment for sins
No afterlife

(continued)
Factors influencing
attitudes
Age
Children view death
as temporary

(continued)

Age
Adults may develop fears of:
pain and suffering
dying alone
separation from loved ones
Elderly generally have fewer
fears
12.1 Identify the special needs of a

dying resident.
10
Special Needs Of Dying Resident

Visits with family/significant others
Features of residents room:
pleasant as possible
lighting that meets residents
preferences
well ventilated
odor free
11

(continued)
Features of residents room:

Contains personal items which
provide comfort and reassurance
Pictures
Mementos
Cards
Flowers
Religious objects
12
12.2 Identify eight comfort measures

that may be used with the dying
resident.
13

(continued)
Comfort Measures
Attention to skin care
Good personal hygiene
Oral hygiene - denture
care
Bedding changed as
needed
Back massages
14

(continued)
Comfort Measures
Frequent position changes
every two hours
P.R.N.
Good body alignment
supportive devices
prevention of deformities and
pressure ulcers
15

(continued)
Comfort Measures
Head of bed elevated to facilitate
breathing
Modified diet
16
17
12.3 Describe the nurse aides role in

relationship to the to the needs of
the dying.
18

Nurse Aides Role

Source of strength and
comfort
Open and receptive
Know own feelings about
death and do not project
those feelings onto
resident.
19

Nurse Aides Role

(continued)
Empathetic
Calm and efficient
Normal tone of voice
Good listening skills
Non-judgmental
20
21
12.4 Review the various reactions

residents may have as they face
death.
22
Individual Residents Reaction

To Death
Accept or be resigned to death
Open and receptive
Communicate about
uncertainties
Fearful or angry
Despairing and anxious
Hostile
Thoughtful and meditative
23
24
12.5 List and describe the five
stages of grief, death and

dying.
25
Five Stages of Grief, Death and Dying

as Described
by Dr. Elizabeth Kubler-Ross
DENIAL
Defense mechanism
Buffer against reality
Emotional escape hatch
Resident may request
another opinion
26

as Described
DENIAL (continued)
Resident may avoid
discussion of death
Feeling of, This cant
be happening to me.
27

as Described
ANGER
Bitterness and turmoil
Sense of unfairness
Blame of others such
as health care workers
Feeling of, Why me?
28

as Described
BARGAINING
Turn to religious and
spiritual beliefs
Promises to God and
others
Comfort and hope
when all seems lost
29

as Described
BARGAINING (continued)
Generally know this
wont work
Frustration and anger
dissolve into
depression
If only...I will
30

as Described
DEPRESSION
Belief that hope is lost
Overwhelming despair
Introverted and withdrawn
Reminiscing and reviewing life
Sleeplessness
I always wanted to
31

as Described
ACCEPTANCE
Calm and subdued interest in life
Strives to complete unfinished
business
Helps loved ones accept death
Needs others to validate worth of life
Ive had a good life.
32
33
12.6 Recognize the signs of

approaching death.
34
Signs Of Approaching Death

Changes in sensory functions and
ability to speak
Vision
increased secretions in corner of
eyes
blurred vision
failing vision
no eye movement/staring
35

Changes in sensory functions and
ability to speak (continued)
Speech
becomes difficult
hard to understand
may be unable to speak
Hearing - last function to be lost
36

Changes in circulation and muscle tone
Circulation
fails
heat gradually lost from body
hands and feet cold to touch and
mottled
face becomes pale or gray and mottled
perspiration may increase (diaphoresis)
37

Changes in circulation and muscle
tone (continued)
Muscle tone
body limp
jaw may drop
mouth may stay partly open
38

Changes in Vital Signs
Respirations
slower
shallow
labored
may experience dyspnea, apnea,
Cheyne-Stokes
mucous collects in the throat and
bronchial tubes (death rattle)
39

Changes in Vital Signs (continued)
Pulse
rapid
weak and irregular
Blood pressure drops
Temperature
elevated
subnormal
40

Urinary and anal incontinence
Decreased peristalsis, abdominal
distention
Release of flatus
Decreased pain
Loss of consciousness
41
42
12.7 Define the role of the nurse aide

in the spiritual preparation for
death.
12.8 Contrast the spiritual preparation
for death practiced by those of
various religions.
43
Nurse Aides Role In Spiritual

Preparation For Death
Priest, rabbi, minister or
other clergy may be
contacted at request of
resident or family
Privacy to be provided
when clergy with resident
44

(continued)
Support residents religious/spiritual

practices even if different from that of
nurse aide
Listen respectfully to religious/spiritual
beliefs
Participate in religious practices if
asked and acceptable
45

(continued)
Treat religious objects

with care and respect:
medals
pictures
statues
bibles
Encourage family and
friends to be included
46
47
12.9 Identify the needs of the family as

they encounter the dying process.
48
Nurse Aides Role In Meeting

Family Needs
Available for support

Use touch as appropriate
Courteous and considerate
Respect right to privacy
Let family assist with care,
if they desire, where
appropriate
49
Nurse Aides Role In Meeting

Family Needs
(continued)
Use good communication

skills
Listen and provide
understanding throughout
the grief/loss stages
Answer questions or refer
to supervisor
50
51
12.10 Discuss the hospice philosophy.
52
Hospice Care
Health care service offered:
in hospitals and extended care facilities
by special facilities
usually in the individuals home
Continuing care provided by team of
health professionals
Designed for residents with terminal
illness
53
Hospice Care
(continued)
Acceptance of death as imminent (6

months or less)
Assures that individual dies with dignity
and comfort
Not concerned with cure or life-saving
procedures
Emphasis on pain relief
Trained volunteers and professionals
make regular visits.
54
Hospice Care
(continued)
Provides counseling for individual and
family:
Emotional
Psychological
Spiritual
Financial
Bereavement
Family included in all aspects of care as
desired
55
56
12.11 Discuss the meaning of

postmortem care.
57
Postmortem Care
Care Of Body After (Post) Death
(Mortem)
Begin care when instructed by
supervisor
Treat body to privacy, respect and
gentleness
Give care before rigor mortis sets in
58
12.12 List five reasons for doing

postmortem care.
59
Postmortem Care
(continued)
Reasons for Postmortem Care

Prevent discoloration and skin
damage
Maintain good appearance of body
Identify body and prepare for
transportation
Position body in normal alignment
Arrange time family to view the body
60
61
12.13 Demonstrate the procedure for

postmortem care.
62
63

Caring For Resident When Death Is Imminent and Following Death

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Unit 12

Caring For Resident When

DHSR Approved CurriculumUnit 12

Caring for Resident When Death Is

DHSR Approved CurriculumUnit 12

12.0 Explore personal feelings

DHSR Approved CurriculumUnit 12

Caring For Resident When Death Is

DHSR Approved CurriculumUnit 12

Caring For Resident When Death Is

Factors influencing attitudes

Caring For Resident When Death Is

DHSR Approved CurriculumUnit 12

Caring For Resident When Death Is

Factors influencing attitudes

DHSR Approved CurriculumUnit 12

12.1 Identify the special needs of a

DHSR Approved CurriculumUnit 12

Special Needs Of Dying Resident

Special Needs Of Dying Resident

Features of residents room:

12.2 Identify eight comfort measures

DHSR Approved CurriculumUnit 12

Special Needs Of Dying Resident

Special Needs Of Dying Resident

Special Needs Of Dying Resident

DHSR Approved CurriculumUnit 12

DHSR Approved CurriculumUnit 12

12.3 Describe the nurse aides role in

DHSR Approved CurriculumUnit 12

Caring For Resident When Death Is

Nurse Aides Role

Caring For Resident When Death Is

Nurse Aides Role

DHSR Approved CurriculumUnit 12

12.4 Review the various reactions

DHSR Approved CurriculumUnit 12

Individual Residents Reaction

DHSR Approved CurriculumUnit 12

12.5 List and describe the five

stages of grief, death and

DHSR Approved CurriculumUnit 12

Five Stages of Grief, Death and Dying

Five Stages of Grief, Death and Dying

DHSR Approved CurriculumUnit 12

Five Stages of Grief, Death and Dying

Five Stages of Grief, Death and Dying

Five Stages of Grief, Death and Dying

Five Stages of Grief, Death and Dying

Five Stages of Grief, Death and Dying

DHSR Approved CurriculumUnit 12

12.6 Recognize the signs of

DHSR Approved CurriculumUnit 12

Signs Of Approaching Death

Signs Of Approaching Death

Signs Of Approaching Death

DHSR Approved CurriculumUnit 12

Signs Of Approaching Death

DHSR Approved CurriculumUnit 12

Signs Of Approaching Death

Signs Of Approaching Death

Signs Of Approaching Death

DHSR Approved CurriculumUnit 12