Category: Tips For Nurses

Articles for nurses caring for terminally ill patients including how to manage challenging situations.

Understanding and Managing 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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How to Use the Beers Criteria for Medication Reconciliation and Deprescribing in Hospice Care: 10 Case Studies

thoughtful prescribing and deprescribing
In this article, we will discuss how to use the Beers Criteria to identify PIMs and potential prescribing omissions (PPOs) in hospice patients. PPOs are medications that are indicated but not prescribed for a specific patient or population, or that are prescribed at a suboptimal dose or duration. We will also present 10 case studies to illustrate the medication reconciliation and deprescribing process and the outcomes of medication changes in different scenarios.
Read MoreHow to Use the Beers Criteria for Medication Reconciliation and Deprescribing in Hospice Care: 10 Case Studies

How to Care for People with Dementia: The Importance of Patience, Compassion and Empathy

Caring for someone with dementia requires understanding and a heart full of compassion. This guide highlights the importance of patience and empathy and their profound impact on enhancing the lives of those with dementia.
Read MoreHow to Care for People with Dementia: The Importance of Patience, Compassion and Empathy

Managing Shortness of Breath in Hospice Care: Non-Pharmacological Methods for Comfort

Discover effective non-pharmacological methods to manage shortness of breath in hospice care. Learn about positioning techniques, breathing exercises, and environmental adjustments that can comfort and relieve patients experiencing dyspnea, enhancing their quality of life during end-of-life care.
Read MoreManaging Shortness of Breath in Hospice Care: Non-Pharmacological Methods for Comfort

How to Support a Dementia Patient Who Tries to Escape from a Memory Care Facility

patients escaping
Elopement is when a person with dementia leaves a safe area, like their home or care facility, without supervision. This can be intentional or unintentional, and it's important to address to ensure the safety of the patient. If your loved one is attempting to escape from a memory care facility, there are steps you can take to support both them and the facility.
Read MoreHow to Support a Dementia Patient Who Tries to Escape from a Memory Care Facility

Coping with a Loved One’s Placement in a Nursing Home: Supporting Patients with Dementia

women using a rollator walking down a hallway
This article will try to help you cope with this challenge. We will give you some information and advice on how to: Prepare for the transition to a nursing home Support your loved one during and after the move Take care of yourself and your family.
Read MoreCoping with a Loved One’s Placement in a Nursing Home: Supporting Patients with Dementia

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

Understanding Normal Pressure Hydrocephalus (NPH): A Guide for Families

Normal Pressure Hydrocephalus
Normal Pressure Hydrocephalus (NPH) is a condition that occurs when cerebrospinal fluid (CSF) builds up inside the skull and presses on the brain. This can lead to various impairments in brain functions, such as thinking, memory, movement, and bladder control. NPH can also affect the quality of life, mood, and behavior of the person with NPH and their caregivers. The cause of NPH is often unknown, but it may be due to injury, bleeding, infection, brain tumor, or surgery on the brain. This article aims to provide a guide for families to understand NPH, its symptoms, diagnosis, treatment, and management, as well as how to cope with the challenges and uncertainties of living with NPH.
Read MoreUnderstanding Normal Pressure Hydrocephalus (NPH): A Guide for Families

Understanding Hospice Eligibility for Terminally Ill Patients with Non-Alzheimer’s Dementia

Navigating hospice eligibility for non-Alzheimer's dementia patients demands a personalized approach. Unlike Alzheimer's, there's no definitive scale, necessitating assessments of functional decline, mobility, communication, incontinence, weight loss, overall condition, and comorbidities. Effective documentation, clinical judgment, and compassionate care are crucial for supporting these patients and families.
Read MoreUnderstanding Hospice Eligibility for Terminally Ill Patients with Non-Alzheimer’s Dementia

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

This article 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.
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Understanding the Patient’s Question: When Will I Die?

Wirlpool
Navigating the tender journey of hospice care, Compassion Crossing offers guidance on addressing the pivotal question of “when?”—a beacon for caregivers seeking solace and understanding in life’s final chapter.
Read MoreUnderstanding the Patient’s Question: When Will I Die?

Considerations of Care — Related and Unrelated Diagnoses for a Terminally ill Patient Receiving Hospice Services

Icd 10 Codes For Terminally Ill Patients
Explore the complexities of hospice care for terminally ill patients with multiple diagnoses. Learn how to distinguish between related and unrelated conditions, understand Medicare coverage, and navigate the challenges of providing comprehensive care while adhering to hospice regulations and ethical standards.
Read MoreConsiderations of Care — Related and Unrelated Diagnoses for a Terminally ill Patient Receiving Hospice Services

Identifying Patients Who May Benefit from Hospice Care: A Visual Observation Guide for Personal Care Facilities

Identifying when a patient may benefit from hospice care is a critical yet often challenging task. For caregivers, including Certified Nursing Assistants (CNAs) and Medical Technicians (Med Techs), visual observation can be a powerful tool for recognizing signs that suggest a hospice referral might be appropriate. This guide is tailored to assist caregivers in personal care facilities in identifying these signs through visual observation methods, helping provide compassionate and timely end-of-life care.
Read MoreIdentifying Patients Who May Benefit from Hospice Care: A Visual Observation Guide for Personal Care Facilities

How to Use the START/STOPP Criteria for Medication Reconciliation and Deprescribing in Hospice Care: 10 Case Studies

thoughtful prescribing and deprescribing
If you are caring for a terminally ill patient in hospice, you know how challenging it can be to manage their medications. You want to make sure they are getting the best possible care, but you also want to avoid unnecessary or harmful drugs that may worsen their quality of life or cause adverse effects. That’s where medication reconciliation and deprescribing come in. Medication reconciliation is the process of reviewing and updating the patient’s medication list to ensure accuracy and completeness. Deprescribing is the process of reducing or stopping medications that are no longer needed, effective, or appropriate for the patient’s condition and goals of care.
Read MoreHow to Use the START/STOPP Criteria for Medication Reconciliation and Deprescribing in Hospice Care: 10 Case Studies

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

Paidad Scale To Assess For Pain Observationally
The PAINAD scale is a comprehensive tool that assesses and manages pain in older adults with dementia and delirium. It focuses on observable signs of pain rather than patient self-report, making it particularly useful for individuals who cannot communicate their discomfort
Read MoreUnderstanding the Importance of the PAINAD Scale in Pain Assessment for Terminally Ill Patients

Understanding Changes in Palliative Performance Scale in the Last Six Months of Life

Palliative Performance Scale Ppsv2
Explore the Palliative Performance Scale (PPS) and its crucial role in end-of-life care. Learn how this tool helps hospice professionals assess patient decline, predict life expectancy, and provide tailored care. Understand the significance of PPS changes in the final six months and how they guide compassionate care decisions.
Read MoreUnderstanding Changes in Palliative Performance Scale in the Last Six Months of Life

Four Case Studies About External Oxygen on Hospice

It is common for family members and caregivers who are not trained in end-of-life topics to be concerned about their loved one's oxygen concentration (SpO2 and sometimes also abbreviated SPaO2) reading from a pulse oximeter. Suppose their loved one refuses external oxygen or takes off the external oxygen. In that case, this often causes distress to the family and caregivers because they are focused on the numbers vs. the patients themselves. Hospice is about patient-centered care, and I would like to present four case studies to demonstrate how hospice manages this situation with compassion.
Read MoreFour Case Studies About External Oxygen on Hospice

How to Respond to a Dementia Patient Asking About a Deceased Family Member

Son Trying To Console Teary Eyed Mother
When a dementia patient inquiries about a family member who has passed away but still believes them to be alive, it's essential to respond with empathy and understanding. Here are some tips on how to handle such situations with compassion and sensitivity:
Read MoreHow to Respond to a Dementia Patient Asking About a Deceased Family Member

The Benefits of Deprescribing Medications in Hospice: A Guide for Patients, Families, and Hospice Nurses

Common Medications That May No Longer Be Needed For Terminally Ill Patients
I know how important it is to provide comfort and support during this challenging journey. One aspect of hospice care that often raises concerns is deprescribing medications. In this article, we'll explore what deprescribing is and why it can benefit patients nearing the end of life.
Read MoreThe Benefits of Deprescribing Medications in Hospice: A Guide for Patients, Families, and Hospice Nurses

Managing Terminal 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

Documenting Observational Signs of Discomfort: A Guide for Hospice Nurses and Families

Person Writing In A Journal
As a hospice nurse, I understand the importance of documenting observational signs of discomfort in terminally ill patients. This guide covers recognizing physical and behavioral cues indicating discomfort, even if patients don't express it. It also highlights the benefits of journaling for families and nurses, with tips for effective documentation to enhance patient comfort and care.
Read MoreDocumenting Observational Signs of Discomfort: A Guide for Hospice Nurses and Families

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