Category: Tips For Nurses
Articles for nurses caring for terminally ill patients including how to manage challenging situations.
Dementia Care for loved ones who are habitually restless
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.
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.
Abdominal Aortic Aneurysm: A Life-Threatening Condition for Hospice Patients
The purpose of this article is to provide you with some information and guidance about AAAs and how they can be managed in hospice patients.
Understanding the Patient’s Question: When Will I Die?
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.
Considerations of Care — Related and Unrelated Diagnoses for a Terminally ill Patient Receiving Hospice Services
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.
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.
How to Use the START/STOPP Criteria for Medication Reconciliation and Deprescribing in Hospice Care: 10 Case Studies
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.
How to Talk to Families About End-of-Life: A Guide for Hospice Nurses
This article provides hospice nurses with practical and evidence-based strategies to discuss end-of-life care with families
Understanding the Importance of the PAINAD Scale in Pain Assessment for Terminally Ill Patients
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
Understanding Changes in Palliative Performance Scale in the Last Six Months of Life
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.
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.
How to Respond to a Dementia Patient Asking About a Deceased Family Member
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:
The Benefits of Deprescribing Medications in Hospice: A Guide for Patients, Families, and Hospice Nurses
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.
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.
Documenting Observational Signs of Discomfort: A Guide for Hospice Nurses and Families
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.
Minimizing Dementia Progression in Loved Ones: Beyond Medications
Dementia is a progressive disease that affects memory, thinking, and behavior. While there is no cure for dementia, there are ways to minimize its progression and improve the quality of life for those living with the disease. Here are some activities to do, activities to avoid, dietary changes to make, and activities to perform to minimize the progression of dementia.
Statins Increase the Risk of Dementia or Worsening Dementia
Pharmaceutical advertisements often highlight the benefits of a particular drug, including its ability to reduce the risk of various health conditions. However, the actual risk reduction these drugs provide may differ from what is portrayed in the advertisements. It is the opinion of the author that if cardiologists and other providers told their patients the absolute risk reduction of statins is 0.8% for all-cause mortality, 1.3% for myocardial infarction and 0.4% for stroke and the side effects of going on a statin include dementia, worsening dementia, confusion, muscle problems, such as aches, pains, weakness, muscle breakdown, falls, nausea, constipation, diarrhea, and increase the risk of type 2 diabetes, would you or anyone else ever agree to take a statin?
Avoiding Problematic Language in Hospice Nursing Narratives
Proper documentation is crucial for hospice nurses to ensure Medicare compliance and maintain the patient's eligibility for services. Auditors, who may not have a healthcare background, review these documents to determine if the patient's condition is terminal. To avoid having the patient removed from service due to improper documentation, hospice nurses should be mindful of the words and phrases they use in their nursing narratives and progress notes. This article will guide what to avoid and why it is essential to paint a picture of a terminally ill patient.
Understanding Heart Failure Stages and Assessment
Heart failure is a complex medical condition that can impact the quality of life of patients, especially those in hospice care. As a hospice nurse, assessing the heart failure stage is crucial to providing appropriate care accurately. This article will explore the New York Heart Failure Classification System, its stages, and how to assess patients for their stages. Additionally, we will emphasize the importance of documentation in compliance with Medicare guidelines for terminally ill patients with heart failure.
Understanding Functional Decline in the Natural Dying Process
Explore the journey of functional decline in the natural dying process. This article provides insight for caregivers and families, emphasizing the importance of documenting changes to enhance care and decision-making in life’s final chapter.
Importance of Medication Reconciliation in Hospice Care
Medication reconciliation plays a pivotal role in hospice care, ensuring terminally ill patients receive safe medication regimens. This process involves maintaining an accurate medication list to prevent adverse drug events. It's essential at various stages, including admission, recertification, and changes in condition. Healthcare professionals should be familiar with tools like the Beers Criteria and STOPP/START criteria to identify potentially inappropriate medications and prescribing omissions in older adults.
Understanding Serotonin Syndrome: A Comprehensive Guide
Hospice nurses assess the status of the patient's journey towards the end of life every nursing visit. Situations where a reversible condition can drastically impact the patient and the hospice assessment can occur. If it is not caught, it is potentially mistreated, leading to increased discomfort and a faster death, often involving increased suffering. One of the common clues that someone is getting closer to dying is increased agitation and restlessness.
Are you aware of Serotonin Syndrome?
Trigger Words for Hospice Nurses: Assessing End-of-Life in Two Weeks or Less
Discover key indicators for end-of-life care in hospice. This guide highlights ‘trigger words’ that signal a patient’s final days, aiding nurses and caregivers in providing compassionate support during the most critical moments.
Understanding and Avoiding Caregiver Burnout when Caring for a Loved One with Dementia
Caring for a loved one with dementia can be a rewarding experience, but it can also be physically, emotionally, and mentally exhausting. Family caregivers often neglect their own well-being while focusing on the needs of their loved ones, leading to burnout. Caregiver burnout is a state of physical, emotional, and mental exhaustion that can happen when caregivers don't get the help they need or try to do more than they are able to do. In this article, we will discuss how family caregivers of a loved one with dementia can avoid burnout and recover if they are already experiencing burnout.