Review slides, as needed.

1. Chapter 23

2.  Denial
 “Not me”
 Anger
 “why me?”
 Bargaining
 Bargaining with God
 Depression
 Reality setting in
 Acceptance
 Begin making plan for their departure…getting their
affairs in order

3.  Different responses and viewpoints to death
 Cultural
 Past experiences with death
 Religious beliefs

4.  Even if can’t respond, explain everything you are
doing
 Assume resident can hear you
 Diminished senses
 Mouth and nose care
 Skin care
 Comfort – a priority

5.  Emotional and spiritual support
 Listen.
 Pay attention
 Stop in frequently-do not avoid
 Don’t treat differently than other residents
 Place call light within reach
 Take time to sort out your own feelings about death

6.  Be cared for by competent individuals
 Not to die alone
 Be free from pain
 Able to express feeling in own way about
impending death

7.  Listen, listen, listen!
 Keep resident clean and dry
 Report any c/o pain promptly
 Keep resident comfortable
 Don’t be afraid to communicate
 Respect rights of privacy between resident and
family.

8.  End of Life Care or Comfort Care
 Be understanding and respectful
 Pt has 6 months or less to live. Care focused on
making the resident comfortable
 Be there for the family, as well.

9.  Unfocused eyes…sometimes glazed
 Decreased blood pressure
 Cheyenne-Stokes respirations
 Rattling or gurgling during breathing
 Disorientation

10.  Rigor mortis
 Body stiffens after death
 Post-mortem care – care of body after death
 Bathe body
 Leave tubes in or take out, per RN discretion
 Present for family viewing
 Give family privacy
 Comfort family/Others
 “I’m sorry”
 Just listen