Category: Symptom Management
Articles relating to managing symptoms of terminally ill patients with the goal of maintaining comfort through the natural dying process.
Liquifying Ativan pills for easier delivery
Ativan, generically called Lorazepam, pills can be easily melted into liquid, and given to your loved one in a syringe. This is typically done vs. putting the pill under the tongue if your loved one has a dry mouth, and the Ativan pills are not melting under the tongue.
The process of melting lorazepam into a liquid will require the following resources:
Validation Therapy: A Valuable Tool for Families and Healthcare Teams
Naomi Feil is an expert in gerontology and the creator of validation therapy, which is a means of communicating and acknowledging the internal reality of patients with dementia. When properly utilized, validation therapy can enhance the quality of life of patients with dementia as well as reduce stress on the family and caregivers.
While Naomi Feil and her followers (of which the writer of this article may be considered one, at least in form) focus on using this method of communication to maintain health with the potential for a level of restorative health, I want to share how the concepts of this method can be used during times of crisis.
The D.O.G.I. at the window case study
As nurses, when we see an acute change of condition, part of what we should be doing in our assessment is determining if there are reversible or treatable elements that are causing the change. In RN school, Dr. Dagen taught the students about using the D.O.G. mnemonic to help us remember that if a patient has an acute change of condition to check whether there were new medications the patient is taking, their O2 saturation level and their glucose level.
I would further add that as a hospice nurse dealing with mainly geriatric patients that if there is an altered level of consciousness (LOC)/personality change, to also consider the patient may have an infection. For any of you dealing with geriatric patients add “I” for infection, hence “D.O.G.I.” While this mnemonic is typically used for acute changes of level of consciousness, the thought process behind it can be used for other acute change of patient condition as well.
Coughing Up Blood (hemoptysis) Symptom Management
Hemoptysis, or coughing up blood, can be a distressing symptom for patients at the end of their life journey. As a hospice nurse, your expertise in managing this symptom is crucial in ensuring a peaceful and comfortable experience for your patients and their families.
Buccal vs Sublingual for Liquid Medications
Your dying patient has lost their gag reflex as part of the dying process. One of the questions I implore you to ask yourself is what’s the safest route to administer liquid medications? Well, before even going to answer this question, unless contraindicated, make sure the patient’s head of the bed is at least at a 30 to 45-degree angle (I prefer the latter).
The buccal route is the safest route to administer liquid medications at the end of life in my experience. In practice, I strongly encourage you as well as the families we mutually teach to give any liquid medications on the side of the mouth least likely to have spillage — this depends on the position of the patient — and slowly over time giving the medication in 0.25 ml increments allowing for the absorption of the medication switching cheeks as applicable.
Understanding Terminal Restlessness
Navigating the final days of a loved one's life can be a challenging and emotional journey. One of the signs that can be observed during this time is known as terminal restlessness. As someone deeply rooted in hospice care, I have witnessed various manifestations of this restlessness. Understanding its types, causes, and management strategies is crucial for providing compassionate end-of-life care. This article aims to illuminate the different kinds of terminal restlessness, identify reversible causes, and discuss effective management techniques. By equipping caregivers, families, and healthcare professionals with this knowledge, we can ensure that terminally ill individuals experience comfort and dignity in their final days.
Common Misconceptions about Morphine and End-of-Life Medications
Morphine is a crucial medication in end-of-life care, but it's often misunderstood. This article debunks common myths about morphine use in hospice, addressing concerns about addiction, hastening death, and sedation. Learn the truth about morphine's role in providing comfort and dignity for terminally ill patients.