Category: Caregiving Tips
Articles for caregivers of terminally ill patients including how to manage challenging situations.
Preventing Friction and Shear Injuries in Elderly Care: A Guide for Non-Health Professionals
Taking care of an elderly fragile person at home can be both rewarding and challenging. One crucial aspect of caregiving is preventing friction and shear injuries, which can be painful and detrimental to the person's well-being. In this article, we'll explore what friction and shear injuries are, how they can be avoided, and some practical tips to ensure your loved one's safety and comfort.
Read MorePreventing Friction and Shear Injuries in Elderly Care: A Guide for Non-Health ProfessionalsThe Life of Least Regrets
The longer I work in hospice, the more I'm reminded about two critical pieces of wisdom: 1) Hospice is about living, and 2) we should all do our best to live a life of least regrets.
While this article is geared towards family members with a terminally ill loved one, as well as my fellow workers in the fields of palliative and hospice care, I believe the thoughts that I will share apply to everyone alive near and far.
Read MoreThe Life of Least RegretsThe Ins and Outs of Hospice Patients Seeing Their Regular Doctor and Specialists
When it comes to hospice care, one common question that arises is whether terminally ill patients should continue seeing their regular doctor or specialists. As an experienced hospice nurse, I have witnessed the benefits and challenges of maintaining these relationships. In this article, we’ll explore the pros and cons of hospice patients still visiting their general practitioners and specialists from the perspective of patients and their families.
Read MoreThe Ins and Outs of Hospice Patients Seeing Their Regular Doctor and SpecialistsShould dying patients be on oxygen?
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:
Read MoreShould dying patients be on oxygen?Best Practices for Approaching Combative Dementia Patients
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:
Read MoreBest Practices for Approaching Combative Dementia PatientsRecognizing and Treating Common End of Life Symptoms
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.
Read MoreRecognizing and Treating Common End of Life SymptomsEducating families on reporting changes in condition
When someone you love is sick and may not get better, you want to do everything possible to make them comfortable and happy. Sometimes, you may notice that they are acting differently or feeling worse. This is called a change of condition. Some changes in condition are very serious and need to be reported to the hospice provider right away. Other changes in condition are less urgent and can be written down in a journal until the next nursing visit. This article will help you learn how to tell the difference and what to do.
Read MoreEducating families on reporting changes in conditionThe importance of caregiver journaling for the patient and family
Caring for a loved one in hospice is rewarding yet challenging. Keeping a caregiver journal benefits the patient, family, and hospice provider. It enhances care, coping, and creating memories. Get tips on starting and maintaining a meaningful journal to improve your caregiving experience.
Read MoreThe importance of caregiver journaling for the patient and familyAir hunger management at end-of-life
I can count the times I’ve run into air hunger at the end of life as a visiting RN Case Manager for going on five years on one hand. Over the years, I’ve managed patients with pulmonary fibrosis, lung cancers (diverse types), breast cancer, COPD, congestive heart failure, B-cell lymphoma, leukemia, and other diseases that can impact one person’s ability to breathe correctly. Air hunger is rare in my firsthand experiences, but it can happen.
Air hunger often sounds like the person is gasping for breath without regard to the actual respiratory rate (how fast they are breathing); it can also sound like stridor (YouTube videos below where you can hear the difference).
Read MoreAir hunger management at end-of-lifeLiquifying 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:
Read MoreLiquifying Ativan pills for easier deliveryValidation 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.
Read MoreValidation Therapy: A Valuable Tool for Families and Healthcare TeamsFall Reduction – Reducing Falls in Personal Care Homes and Private Homes
Falls among the elderly can have severe consequences, including hip fractures, which can be life-threatening. As an experienced hospice registered nurse case manager, I understand the importance of fall prevention, especially in private homes, personal care homes, and assisted living facilities. This article aims to provide practical tips for reducing falls in these settings by following the nursing process: assessment, diagnosis, planning, implementation, and evaluation.
Read MoreFall Reduction – Reducing Falls in Personal Care Homes and Private HomesAssessing pain in non-verbal patients
Pain is a subjective sensation that can affect a person’s physical, emotional, and spiritual well-being. While pain can be measured objectively by using vital signs such as temperature, pulse, blood pressure, and respiration count, these indicators may not reflect the true intensity of pain that a person is experiencing. This is especially true for non-verbal patients, who cannot communicate their pain verbally. Non-verbal patients may include those with advanced dementia, terminal illness, or other conditions that impair their speech. In this article, I will discuss the importance of assessing pain in non-verbal patients, the tools and methods that can be used to do so, and the benefits of providing adequate pain relief for these patients.
Read MoreAssessing pain in non-verbal patientsBuccal 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.
Read MoreBuccal vs Sublingual for Liquid MedicationsUnderstanding 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.
Read MoreUnderstanding Terminal Restlessness