Tag: End Of Life Symptoms

Article about common end-of-life symptoms of the terminally ill.

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.
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Best Practices for Oral Care in Hospice Patients: A Guide for Families

oral mouth swabs
Caring for a loved one who is comatose during their hospice journey requires special attention, particularly when it comes to oral care. In this guide, we'll explore best practices for oral care, considering the unique needs of comatose patients, and provide you with valuable resources for further guidance.
Read MoreBest Practices for Oral Care in Hospice Patients: A Guide for Families

Understanding Terminal Illness Progression: Observable Signs and Symptoms

how people die trajectory
When a loved one receives a terminal diagnosis, it's natural to wonder about the journey ahead. Terminal illnesses follow a unique path, and understanding the signs and symptoms at various stages can help you provide the best care and support. This article aims to guide you through the general progression of terminal illnesses, focusing on observable signs and symptoms as the patient approaches the end of life. The progression of a terminal illness can vary depending on the type of illness, the person’s age, health, and treatment options. However, there are some common signs and symptoms that indicate that the illness is advancing, and the person is approaching the end of life. These signs and symptoms can help you and your loved one prepare for what is to come and make the most of the remaining time together.
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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.
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The Death Rattle

Death Rattle
As a caregiver, witnessing a loved one nearing the end of life can be a challenging and emotional experience. One symptom that you may encounter during this time is known as the death rattle. Understanding what the death rattle is, how to recognize it, and how to manage its symptoms can help you provide comfort and support to your loved one in their final days. In this guide, we'll explore the death rattle, its significance, and practical tips for managing it.
Read MoreThe Death Rattle

Breathing Patterns Before End of Life: Critical Clues for the Last Hours!

Breathing Patterns
This article is intended for family members, caregivers, as well as nurses new and old. As an experienced hospice nurse, I've learned that when a family member or caregiver tells me their loved one is or has "goldfish breathing" or "fish out of water breathing" or "taking guppy breaths" that the patient is now at the end of their life.
Read MoreBreathing Patterns Before End of Life: Critical Clues for the Last Hours!

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

Should 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:
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Drowsiness vs Lethargy vs Obtunded

Altered Level Of Consciousness
As a hospice registered nurse case manager, you will encounter patients who experience various degrees of altered consciousness. It is essential to understand the difference between drowsiness, lethargy, and obtundation, as they can indicate different underlying medical conditions and require different interventions. For example, drowsiness is common and often expected, but lethargy and obtundation are more profound changes of condition which may mean the patient is closer to death than further way. Here’s a guide to help new hospice nurses distinguish between the three:
Read MoreDrowsiness vs Lethargy vs Obtunded

Recognizing 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 Symptoms

Delirium vs Terminal Restlessness

delerium vs terminal restlessness
As an experienced hospice nurse, I understand how difficult it can be to distinguish between delirium and terminal restlessness. Both conditions can cause significant distress for the patient and their loved ones, and it’s crucial for nurses to be able to tell the difference between the two to provide the best possible care. In this article, I will share my knowledge and experience to help new hospice nurses understand the differences between delirium and terminal restlessness along with ways to rule out delirium.
Read MoreDelirium vs Terminal Restlessness

Morphine and Lorazepam are not euthanizing agents

Morphine and Lorazepam do not hasten death
As a hospice nurse with years of experience, I have encountered many situations where family members are hesitant to allow their loved ones to receive medications such as morphine and lorazepam. One of the main reasons for this hesitancy is the belief that these medications will hasten death, leading to euthanasia. In this article, I want to address this concern and help family members and friends understand the use of morphine and lorazepam in hospice care.
Read MoreMorphine and Lorazepam are not euthanizing agents

Understanding PRN Medications for Comfort Care

Hey there, my friend! As an experienced hospice nurse, I understand that managing symptoms for comfort is crucial for terminally ill patients. One of the ways we do this is through PRN medications. Today, I want to help you understand PRN medications and how they can be used in conjunction with scheduled medications.
Read MoreUnderstanding PRN Medications for Comfort Care

Air 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 properly. Air hunger is exceedingly rare in my firsthand experiences, but it can happen.
Read MoreAir hunger management at end-of-life

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 the realm of 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 shed light on the different types 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 the terminally ill individual experiences comfort and dignity in their final days.
Read MoreUnderstanding Terminal Restlessness

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