Category: Symptom Management

Articles relating to managing symptoms of terminally ill patients with the goal of maintaining comfort through the natural dying process.

Managing Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State at End of Life: A Comfort-Based Approach

Dka Vs Hhs For Diabetes
As an experienced hospice nurse, I understand that managing diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) at end of life can be challenging, especially when patients choose to stop taking their diabetic medications or when those medications are no longer an option. In this article, I will provide information on recognizing the signs and symptoms of hyperglycemic crises and outline comfort-based treatment options that align with hospice goals of care.
Read MoreManaging Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State at End of Life: A Comfort-Based Approach

Understanding and Managing Contractures

dementia patient with contractures
I know that the journey you and your loved one are on can be challenging, especially when facing a terminal illness. As an experienced hospice nurse caring for terminally ill patients, I want to provide you with some valuable insights on a common issue that may arise during this time: contractures.
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Managing Shortness of Breath in Hospice Care: Non-Pharmacological Methods for Comfort

Using A Small Fan To Help Reduce Shortness Of Breath
Shortness of breath, or dyspnea, is a common symptom that affects many patients in hospice care. It can make breathing difficult and uncomfortable, and cause anxiety and distress. As a hospice nurse, I know how hard it can be to see your loved one's struggle with breathlessness. That’s why I want to share with you some non-pharmacological methods that can help ease their breathing and improve their comfort. Non-pharmacological methods are techniques that do not involve taking any medicine. They are safe, easy, and effective ways to manage shortness of breath. They can also help patients feel more relaxed and calmer and improve their quality of life. In this article, I will explain five non-pharmacological methods that have worked well for many hospice patients.
Read MoreManaging Shortness of Breath in Hospice Care: Non-Pharmacological Methods for Comfort

Best Practices for Managing Hallucinations

Flow Chart For Managing Hallucinations And Delusions
As an experienced hospice nurse, I understand the challenges faced by terminally ill patients and their families when dealing with hallucinations, especially in conditions like Lewy Body Dementia, Parkinson's disease, and other neurodegenerative diseases. Hallucinations can be distressing and confusing for patients and their loved ones, but with the right approach and a combination of pharmacological and non-pharmacological methods, we can help manage these symptoms to improve comfort and quality of life.
Read MoreBest Practices for Managing Hallucinations

How to Use Pursed Lip Breathing to Manage Shortness of Breath

Pursed Lip Breathing
Dealing with shortness of breath can be challenging for terminally ill patients, but there are techniques that can help manage this symptom and improve their overall comfort. One such technique is pursed lip breathing. Pursed lip breathing is a simple and effective breathing technique that can help reduce shortness of breath and improve oxygen exchange in the lungs. As an experienced hospice nurse with years of experience, I will guide you through the steps of pursed lip breathing in a compassionate and easy-to-understand manner.
Read MoreHow to Use Pursed Lip Breathing to Manage Shortness of Breath

Dementia Care for loved ones who are habitually restless

habbitually restless lady
Caring for a loved one with dementia can be both rewarding and challenging. If your loved one has been restless throughout their life, this restlessness may continue as a symptom of their dementia. As an experienced hospice nurse, I understand the difficulties you may face in managing habitual restlessness while ensuring the safety and welfare of your loved one. In this article, I'll provide you with practical tips and evidence-based practices to create a calming environment for your loved one, even if they have trouble with fine motor control due to arthritis or other factors.
Read MoreDementia Care for loved ones who are habitually restless

Managing Infections in the Geriatric Population

elderly patient blowing her nose with medications nearby
Infections remain a significant contributor to mortality among older adults, even with advancements in antibiotic treatments. Managing infections in this population poses unique challenges, necessitating early detection and treatment due to the increased risk of morbidity and mortality. In this article, we will delve into common infections in geriatric patients, encompassing early, middle, and late-stage symptoms, preventive measures, and prevalent treatment approaches, particularly for patients facing a terminal illness prognosis of six months or less.
Read MoreManaging Infections in the Geriatric Population

Understanding the Importance of the PAINAD Scale in Pain Assessment for Terminally Ill Patients

Paidad Scale To Assess For Pain Observationally
As experienced hospice nurses, our primary goal is to provide the best possible care and comfort to our terminally ill patients during their final journey. Pain management is a crucial aspect of hospice care, and it becomes even more challenging when dealing with patients who may have difficulty expressing their pain due to cognitive impairments or other factors. In such situations, the PAINAD scale emerges as a valuable tool for pain assessment. Let's explore why and when using the PAINAD scale is essential, particularly when patients consistently over or underreport their pain.
Read MoreUnderstanding the Importance of the PAINAD Scale in Pain Assessment for Terminally Ill Patients

Managing Terminal Restlessness

Exhausted Patient From Restlessness
Losing a loved one is an incredibly challenging experience, and witnessing changes in their behavior and well-being can be distressing. As a hospice nurse, I've supported many families and caregivers through this grim time. One common symptom that may arise towards the end of life is restlessness. In this article, I will explain the different types of restlessness and offer guidance on how to manage them. Understanding these distinctions can provide valuable insights into your loved one's condition and help you navigate the final stages of their life with compassion and care.
Read MoreManaging Terminal Restlessness

Caring for a Loved One with a History of Diverticulitis

diverticulitis
Caring for a loved one with a history of diverticulitis requires a combination of preventive measures, early detection of warning signs, and understanding the common signs and symptoms of this condition. Your role as a caregiver is crucial in providing support and assistance to ensure their well-being. In this comprehensive guide, we will explore essential aspects of caring for someone with diverticulitis, including prevention, early warning signs, and treatment options.
Read MoreCaring for a Loved One with a History of Diverticulitis

Unlocking the Power of Validation Therapy in Compassionate End-of-Life Care

In the realm of hospice care, where empathy and compassion are paramount, a remarkable approach called Validation Therapy has emerged as a beacon of hope and comfort for individuals facing dementia and cognitive disorders in their final journey. As an experienced hospice registered nurse case manager, I've witnessed the transformative impact of Validation Therapy on patients, allowing them to find solace, regain their self-worth, and experience a sense of dignity during their end-of-life phase.
Read MoreUnlocking the Power of Validation Therapy in Compassionate End-of-Life Care

Understanding Discomfort: Distinguishing it from Pain While Caring for Your Terminally Ill Loved One

An Elderly Woman Who Is Uncomfortable
Caring for a terminally ill loved one is a profound and challenging journey that requires compassion, understanding, and a willingness to alleviate any discomfort they may experience. In this guide, we will explore the concept of discomfort, its distinction from pain, and the importance of recognizing and addressing discomfort in addition to pain. By the end, you'll be better equipped to provide holistic care that focuses on enhancing your loved one's quality of life during this sensitive time. Throughout the course of your loved one's illness, you might find yourself thinking that they don't require "pain medication" because they don't seem to be in pain. They might even respond with a direct "no" when asked about their pain. However, are you aware that most types of pain medication can alleviate discomfort? Did you also know that your loved one could be feeling uncomfortable without necessarily being in severe pain? Nonetheless, it's important to recognize that their discomfort requires the same treatment as if they were in pain.
Read MoreUnderstanding Discomfort: Distinguishing it from Pain While Caring for Your Terminally Ill Loved One

Clues for terminal restlessness often missed for facility patients

Exhausted Patient From Restlessness
One of the hardest portions of the job of a hospice nurse is to identify when a patient has two weeks of life left to live; this can be especially difficult at facilities going through staffing shortages leading to inconsistent caregivers with little to verbally report on a patient’s change of condition. Since being aware of the velocity of declines is extremely important, let’s cover an area that we in hospice (nurses, families, and caregivers alike) can keep an eye on in terms of identifying terminal restlessness which is often a key indicator for one week or less of life.
Read MoreClues for terminal restlessness often missed for facility patients

Effectiveness of topicals for pain and anxiety management

I have seen firsthand the benefits and drawbacks of different medications for managing pain and anxiety in terminally ill patients. Fentanyl patches and Ativan gel are two commonly used medications, but their effectiveness can vary depending on a patient’s build and weight, particularly for very thin or cachexic individuals.
Read MoreEffectiveness of topicals for pain and anxiety management

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