The five priorities focus on: recognising that someone is dying; communicating sensitively with them and their family; involving them in decisions; supporting them and their family; and creating an individual plan of care that includes adequate nutrition and hydration.
Generally speaking, people who are dying need care in four areas: physical comfort, mental and emotional needs, spiritual needs, and practical tasks. Of course, the family of the dying person needs support as well, with practical tasks and emotional distress.
The following are the nursing priorities for patients in hospice care: Provide symptom management and comfort measures. Facilitate open and honest communication. Support decision-making and advance care planning.
In Palliative Care, Comfort Is the Top Priority.
The five priorities focus on: recognising that someone is dying; communicating sensitively with them and their family; involving them in decisions; supporting them and their family; and creating an individual plan of care that includes adequate nutrition and hydration.
Nursing Care Plan Considerations
The highest priority needs are at the bottom of the pyramid and include physiological needs such as air, nutrition, and sleep. The nurse must prioritize physical needs over those closer to the top of the pyramid, such as the need for a sense of connection.
Decisions about care at the end of a person's life often involve quality-of-life considerations. Nurses are obligated to provide care that includes the promotion of comfort, relief of pain and other symptoms, and support for patients, families, and others close to the patient.
The nurse should offer support by encouraging reminiscence, calming music, touch, light massage, presence, and prayer (according to family preferences) as the patient begins their transition. The dying process is variable for each individual. Families often ask for a definitive time frame when death will occur.
The role of the nurse during the active dying phase is to support the patient and family by educating them on what they might expect to happen during this time, addressing their questions and concerns honestly, being an active listener, and providing emotional support and guidance.
A person-centered approach. Our healthcare system is designed to treat illness and prolong life. But near the end of life, people generally benefit most from care that addresses their mind, body, and spirit. That can mean spending one's final days at home rather than in a hospital.
Comfort care as palliative care addresses physical, intellectual, emotional, social, and spiritual needs. The goal is to give the patient autonomy, access to information, and choice. Keep in mind that comfort care can be provided in a hospital, nursing home or private home.
For many, a good death is simple. It means remaining at the place you call home, being physically comfortable, and experiencing things you love until the very end. Hospice care makes these important aspects at the end-of-life possible.
Speak respectfully.
Use terms the patient can understand, avoiding medical jargon. But be careful not to speak down to the person. Be sympathetic and patient. Listen to their concerns, and answer them honestly.
Often the best way to process death is by talking to someone. After a patient dies, consider leaning on your nursing peers for support. Unlike a friend outside of work, a nurse colleague will understand the situation and may offer objective insight.
Nursing tasks include assessing for pain and other distressing symptoms, providing evidence-based interventions to alleviate them, and preventing initiation of interventions that may not improve comfort and quality of life.
While diagnosis and treatment is no longer the goal, medical monitoring is still important to keep patients content and relaxed. Blood pressure, body temperature, heart rate, and other vital signs are still important to keep track of, even when the patient is not longer being treated.
Prioritization strategies often reflect the foundational elements of physiological needs and safety and progress toward higher levels. Airway, breathing, and circulation. Pieces of clinical information that direct the nurse toward a potential “actual problem” or a change in condition.
The first-level priority problems are health issues that are life-threatening and require immediate attention. These are health problems associated with ABCs; airway, breathing, and circulation, such as establishing an airway, supporting breathing, and addressing sudden perfusion and cardiac issues.
There is much common ground based on the application of the four major principles of medical ethics: nonmaleficence, beneficence, autonomy, and justice. The goal of end-of-life care for elderly people is to improve their quality of life, helping them cope with illness, disability, death, and an honorable death process.
Assess the patient for pain and provide pain relief measures based on their preferences. Assess the patient for fears related to death. Assist the patient with life review and reminiscence. Provide music of the patient's choosing.