End of Life Care

Question 1

Components of Compassionate Care

Answer 1

Provide pain and symptom management

Maintain quality of life

Question 2

Hospice Care

Answer 2

Family is the primary unit for care and care continues even after the patient’s death
Pain and symptom control is the primary focus
Life life to the fullest without pain and choices with dignity

Question 3

Communicating with the Child

Answer 3

Care for physical and emotional health
Open communication and a trusting relationship
Keep answers short and developmentally appropriate

Question 4

Awareness of Dying: Infant & Toddler

Answer 4

Aware of changes in the routines and reacting to parents
May have a lack of trust if death of a caregiver occurs
Toddlers cannot grasp absence of life
Living is their only time reference
Separation and alterations of routine may be most disruptive
React based on parents actions or feelings

Question 5

Awareness of Dying: Preschool

Answer 5

Preoporational thought – belief that thoughts are powerful, may lead to guilt or feeling that they are being punished
Death is viewed as temporary
No concept of time
See changes and feel effects of medication
Treatments as mutilation to their body
If dying: big fear they will be alone

Question 6

Awareness of Dying: School Aged

Answer 6

Subtle fears and anxiety about seriousness of illnesses
Better ability to understand what is happening to them
Around 8-10 know death is irreversible
Benefits from participation, anticipatory teaching
Death is an absolute loss of control - causing fear, no corporation or anger
May be preoccupied with the funeral

Question 7

Awareness of Dying: Adolescent

Answer 7

Adult understanding
Remnants of magical thinking - some guilt and shame
HARDEST STAGE TO COPE WITH DEATH
Trying to establish their identity- now seen as the “dying person”
Alienation from peers and side effects of chemo are worse than dying to them
Participation in decision making is helpful

Question 8

Symptoms of Death

Answer 8

Increased sleeping
Loss of sensation and movement in the lower extremities progressing to upper body
Sensation of heat altohugh body feels cold
Mottling of the skin
Loss of senses: tactile, sensitivity to light, hearing last to go
Confusion, LOC, slurred speach
Muscle weakness
Decreased urination and more concentrated
Decreased appetite and thirst
Difficulty swallowing
Cheyne Stroke Respitations
Death Rattle sounds