Articles to empower you with end-of-life care - Page 25

Compassion Crossing, LLC

Guiding Life's Journey with Care

Compassion Crossing, LLC

Guiding Life's Journey with Care

Detecting Infections in Terminally Ill Geriatric Patients with Dementia

Assessment, Dementia, Hospice, Non-Pharmacological, Nurse Skills, Symptom Management, Terminal Illness

One of the most important roles is detecting and managing infections in terminally ill geriatric patients with dementia. These patients are often at higher risk for infections due to their weakened immune systems, underlying health conditions, and limited mobility. Detecting infections in these patients can be challenging due to their limited communication abilities and other cognitive and physical impairments. However, early detection and management of infections can significantly improve the patient’s quality of life and potentially prolong their life.

What Hospice Nurses should assess every visit

Assessment, Best Practice, Hospice, Hospice Care Team, Nurse Skills, Tips and Tricks, Tips For Nurses

assessment sheet top

Hospice nurses play a vital role in providing quality care and comfort to terminally ill patients and their families. They must make accurate and timely assessments of the patient’s condition, needs, and preferences every visit. This article will outline the key aspects that hospice nurses should assess every visit, in addition to the standard physical assessment.

Ethical Dilemmas in Hospice

Case Studies, Ethical Dilemma, Ethics, Hospice

As a hospice RN case manager, I have seen many ethical dilemmas arise in end-of-life situations. Hospice care is unique because it focuses on providing comfort care to patients no longer seeking curative treatment for their illnesses. As a result, the ethical concerns in hospice care differ from those in other healthcare settings. This article will explore some ethical dilemmas that can arise in hospice care and how they can be addressed.

Before I review several case studies gathered from the sources in the resource section below, please allow me to share a current one of mine that is ongoing as this article is being published.

Should dying patients be on oxygen?

Caregiving Tips, Death and Dying, Dying Process, End of Life, Hospice, Nurse Skills, Palliative Care, Symptom Management, Terminal Illness, Tips and Tricks, Tips For Nurses

I have cared for many terminally ill patients over the years. One question that comes up frequently is should the dying patient be on oxygen at the end of life?

I see it from both sides, from hospice intake personnel as well as the admitting nurse — all had it drilled into them over the years that low oxygen saturation must be treated — to families who see how hospital and nursing home staff rush to put someone on oxygen because of low oxygen saturation.

Contrary to widespread belief, most dying patients do not need oxygen. Here’s why:

Frequency of Changes in Condition as an Indicator of Approaching Death

Assessment, Death and Dying, Dying Process, End of Life, Hospice, How Much Longer, Nurse Skills, Prognostication, Terminal Illness, Tips and Tricks, Tips For Nurses

Recognizing the velocity of changes in a patient's condition is crucial for hospice nurses. By understanding the pace of changes in vital signs, symptoms, functionality, and more, nurses can anticipate needs, adjust care plans, and communicate the prognosis effectively with patients and families. The article provides guidelines on interpreting the velocity to estimate the time a patient has left.

The Hospice Nursing Visit from a Nursing Perspective — Home Patients

Assessment, Best Practice, Compliance, Documentation, Hospice, Hospice Care Team, Nurse Skills, Time Management, Tips and Tricks, Tips For Nurses

This article offers guidance for new visiting hospice nurses struggling with work-life balance. It covers strategies like maintaining a recertification journal, pre-charting before visits, assessing end-of-life status, educating families, and preparing for a "good death." By following these tips, nurses can take less work home while delivering focused, compassionate care.

Best Practices for Approaching Combative Dementia Patients

Best Practice, Caregiving Tips, Dementia, Hospice, Nurse Skills, Terminal Illness, Tips and Tricks, Tips For Nurses

Dementia is a progressive brain disorder that affects a person’s cognitive abilities, memory, and behavior. In the later stages of the disease, some patients can become combative and aggressive, making it difficult for caregivers to provide the necessary care. As a hospice nurse, it’s important to know how to approach and manage combative dementia patients to ensure their comfort and safety. Here are some best practices to consider:

Presentation: Death, Dying, and Comfort Medications in Hospice Care

Comfort Medications, Death and Dying, Hospice, Lorazepam, Medications, Morphine, Nurse Skills, Presentations, Symptom Management

As an experienced hospice nurse, I understand that working in hospice care can be emotionally and physically challenging. In this presentation, I will share my knowledge and expertise on the topics of death and dying, as well as comfort medications including morphine, to help guide you in providing the best care for your patients.

Drowsiness vs. Lethargy vs. Obtunded

Assessment, Death and Dying, Dying Process, End of Life, Hospice, Nurse Skills, Transitioning

Altered Level Of Consciousness

Understanding drowsiness, lethargy, and obtundation is crucial in hospice care. Drowsiness is a normal sleepiness, lethargy is more profound tiredness, and obtundation indicates severe unresponsiveness. Recognizing these levels helps in providing the right care and comfort for terminally ill patients.

Recognizing and Treating Common End of Life Symptoms

Assessment, Caregiving Tips, Comfort Medications, Death and Dying, End of Life, Hospice, Non-Pharmacological, Nurse Skills, Symptom Management, Terminal Illness, Tips and Tricks, Tips For Nurses

Guide to Recognize and Treat Common End of Life Symptoms provides tips on managing symptoms experienced by those at the end of their lives - Topics such as pain, shortness of breath, respiratory distress, and anxiety, and provides suggestions for medications and complementary therapies to help manage these symptoms.

Preparing for a Good Death: Topics to Cover with Hospice Patients and Their Families

Death and Dying, Dying Process, End of Life, Hospice, Hospice Care Team, Nurse Skills

I have worked with countless terminally ill patients and their families. One of the most important aspects of hospice care is ensuring that the patient and their loved ones are prepared for the end of life.

In this article, I will cover the topics that hospice nurses should discuss with patients and caregivers to ensure a good death.

Delirium vs Terminal Restlessness

Assessment, Death and Dying, Dying Process, End of Life, Hospice, Nurse Skills, Symptom Management, Tips and Tricks, Tips For Nurses

delerium vs terminal restlessness

As an experienced hospice nurse, I understand how difficult it can be to distinguish between delirium and terminal restlessness. Both conditions can cause significant distress for the patient and their loved ones, and nurses must be able to tell the difference between them to provide the best possible care. In this article, I will share my knowledge and experience to help new hospice nurses understand the differences between delirium and terminal restlessness and how to rule out delirium.

The Dark Side of Physical Therapy for Geriatric Patients with Dementia

Dark Side, Dementia, Ethics, Hospice, Terminal Illness

Explore the ethical dilemma of physical therapy for terminally ill dementia patients. This article examines the potential harm of aggressive interventions, highlighting the importance of comfort-focused care. Learn why hospice professionals often advocate for gentler approaches in end-of-life dementia care.

Considerations for Increasing Hospice Visit Frequencies

Assessment, Best Practice, Hospice, Hospice Care Team, Nurse Skills, Palliative Care

Hospice care is focused on symptom management, pain relief, emotional support, and spiritual care. It is a privilege to be a part of a patient’s end-of-life journey, and as a new hospice nurse, you may feel overwhelmed, but you can make a difference in a patient’s life. One of the essential skills you need to learn as a hospice nurse is to recognize when to increase the scheduled visit frequency for a terminally ill patient under hospice care.

Hospice Routine Visit Template

Hospice, Templates

I keep the bedside documentation to under 15 minutes (admission visits not included) by creating muscle memory by following consistent templates based on the type of visit (routine, PRN, recertification, death, and admission).

I’ve previously shared my recertification template, so let me share my routine visit template for today. For those new, routine visits are scheduled ahead of time, and while you may arrive to find a crisis before you, the visit itself was scheduled and therefore considered routine. It is regarded as part of the four hospice care levels according to Medicare guidelines.

The Importance of Documenting Hospice Visits at the Bedside

Best Practice, Documentation, Hospice, Hospice Care Team, Nurse Skills, Palliative Care, Tips and Tricks, Tips For Nurses

Our primary focus for our patients is comfort at the end of life as hospice nurses. We work tirelessly to ensure that our patients receive the best possible care during their end-of-life journey. An aspect of that care that is often overlooked, but incredibly important is timely documentation.

Documenting hospice visits at the bedside is crucial for several reasons. Not only does it help ensure that our patients are receiving the best possible care, but it also helps the hospice team as a whole and reduces issues when the caregiver must be involved in triage services. Here are just a few reasons why documenting hospice visits at the bedside is so important:

Hospice Eligibility and Hospice Recertification — information for families and new hospice nurses

About Hospice, Admission, Compliance, Hospice, Hospice Care Team, Hospice Eligibility, Nurse Skills, Recertification

As an experienced hospice nurse, I understand how overwhelming and emotional it can be for terminally ill patients and their loved ones to navigate the hospice process. Hospice care is a compassionate and comprehensive approach to end-of-life care, designed to provide comfort, pain management, and emotional support to patients and their families. However, many people have questions about hospice eligibility and hospice recertification. In this article, I will provide a generalized guide to help you understand these important aspects of hospice care.

Morphine and Lorazepam are not euthanizing agents

Comfort Medications, Hospice, Lorazepam, Morphine, Nurse Skills, Symptom Management

Morphine and Lorazepam do not hasten death

As a hospice nurse with years of experience, I have encountered many situations where family members are hesitant to allow their loved ones to receive medications such as morphine and lorazepam. One of the main reasons for this hesitancy is the belief that these medications will hasten death, leading to euthanasia.

In this article, I want to address this concern and help family members and friends understand the use of morphine and lorazepam in hospice care.