CHAPTER 15: END OF LIFE CARE Flashcards
(17 cards)
Causes of Death in Adults Ages 65 and Older
Diseases of the heart
Malignant neoplasms
Cardiovascular diseases
Chronic obstructive pulmonary disease
Pneumonia and influenza
Diabetes mellitus
Alzheimer disease
Nephritis, nephrotic syndrome, nephrosis
Accidents
Septicemia
The experience of death in ______ is a reflection of an
ethnocultural climate that emphasizes
individualism and self-reliance.
Western cultures
How can specific end-of-life decisions be expressed?
Advance Directives
Physicians’ Orders for Life Sustaining Treatment (POLST)
These documents specify the
type and amount of
intervention desired by
someone.
Advance Directives
Physicians’ Orders for Life Sustaining Treatment (POLST)
The patient must know these information to make an informed decision about end-of-life care
1.the amount of time a treatment will add to life;
2.the quality of life with this treatment;
3.the amount of pain, disability, or risk involved with the treatment;
4.the amount of time involved in the treatment;
5.the cost of treatment and whether it is covered by insurance;
6.the need for and availability of caregivers; and
7. the availability, benefits, and risks of other treatment options.
How many % of people wish to die at home?
90%
Why is death in hospital setting problematic?
because hospitals are focused on curative and restorative care and may not be ideally suited
A philosophical concept of providing palliative or supportive care of dying people
Hospice
focuses on reducing or
relieving the symptoms of a disease
without attempting to provide a cure; it
neither hastens nor postpones death.
Palliative Care
nor postpones death. v Palliative care affirms life while accepting
death as its normal conclusion.
Palliative Care
The four areas that need a particularly careful cultural assessment are:
(1)communication about death;
(2)the decision-making process;
(3)amount and type of intervention that will be accepted; and
(4)the significance of pain and suffering.
Typical physiologic changes observed as death nears include:
fatigue, dyspnea, gastrointestinal changes (dry mouth, anorexia, nausea and vomiting, constipation), anxiety, and delirium (a mental state in which you are confused, disoriented, and not able to think or remember clearly).
What is the ultimate goal as death approaches?
alleviate suffering and provide the dying person with the highest level of comfort possible.
Often the most significant concern of the dying person and his or her loved ones.
Pain
Respiratory rate and oxygen saturation cannot predict the severity of dyspnea.
A dying person may report feeling breathless even though oxygenation levels are satisfactory and typical signs of breathing difficulties are absent.
an acute change in mental status, affects as many as 80% to 85% of older adults in the last days of life.
Delirium
Kubler-Ross Stages of Grief
Denial
Anger
Bargaining
Depression
Acceptance
