Physical comfortProviding physical comfort is an essential part of nursing care as the patient approaches the end of their life. The patient may feel uncomfortable due to certain factors such as pain, skin irritation, breathing and digestive problems and fatigue. Proper positioning is the most crucial part in relieving the patient’s pain as lying or sitting in one position for a long duration will induce muscles’ aching and back pain.
Indeed, a prolonged and constant pressure on the skin will lead to pressure ulcers. To overcome the pain, nurses need to switch their patient’s position every four hours or turn the patient from side to back and to the other side every few hours to prevent the bed sores. Additionally, nurses may place a foam pad beneath areas of client’s elbow and heels as well as request a special mattress to improve the blood circulation and reduce the risk of recurrent sores (Kolkaba, et al., 2004). Keeping the patient’s skin cleaned and moisturised is also important to avoid infection. Also, serve the pain killer as prescribed by the doctor as the care for someone who is dying should focus on relieving pain without worrying about possible long-term complications of drug dependence or abuse (LaDuke, 1998).
Emotional supportComplete end-of-life care also includes helping the dying person manage mental and emotional distress. Someone who is alert near the end of life might understandably feel depressed or anxious. The simple act of physical contact such as holding hands, a touch, or a gentle massage can make a person feel connected to those he or she loves (Perkins, 2016). It can be very soothing. Meanwhile, some healthcare providers suggest that a low volume music and soft lighting are comforting for a dying patient. It has been proven that music therapy is able to improve a patient’s mood by increasing relaxation and reducing their pain. Or else, just being present with the patient is often enough. Sometimes, your quiet presence can be a meaningful gift for a dying family member or friend.
Spiritual needsWhile an unconscious patient is still able to hear, nurses may suggest that family members invite religious person/s to come and perform certain prayers as it will help the patient with their spiritual needs. Nurses can also encourage families to share their memories of good times with the patient since it is never too late to say how they feel. It is also a good idea for them to make an audiotape or videotape for the family, writing letters, or keeping a journal as it assures the patient that something of their essence will survive past their death (Buckley & Herth, 2004).
Supporting the family memberFamily members require a nurse’s support, guidance, and education as they care for their loved one in their final journey. It is common for patients in their last days of life to have decreased appetite or feel nauseated by food. So, as a nurse, you should educate the family about the symptoms the client will likely experience and the implications for care. Whenever possible, communicate news of a patient’s declining condition or impending death when family members are together so they can provide support to one another (Holmberg, 2006). Give the news in private, and stay with the family as long as needed or desired.
It is a fact that when caring for dying clients and families, nurses, too, experience grief and loss. Before they recover from one loss, they are introduced to another difficult human story. To adapt, you can develop support systems that allow time away from caregiving and focus on pleasant and non-stressful activities. Otherwise, stress management techniques also can help to restore your energy and keep you refreshed. MIMS
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Buckley, J., & Herth, K. (2004). Fostering hopes in terminally ill patients, Nurs Stand. 19(10); 33.
Holmberg, L. (2006). Communication in action between family caregivers and a palliative care team. J Hosp Palliat Nurs. 8(5); 276.
Kolkaba, K. et al. (2004). Efficacy of hand massage for enhancing the comfort of hospice patients. J Hosp Palliat Nurs. 6(2);91.
LaDuke, S. D. (1998). Pain management at the end of life: A critical care perspective. Journal of the New York State Nurses Association. 29(2), 9-12.
Perkins, S. (2016). What Must a Nurse Do to Be Effective When Caring for a Terminally Ill Patient? Retrieved from, http://work.chron.com/must-nurse-effective-caring-terminally-ill-patient-9752.html