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					Running head: END OF LIFE AND PALLIATIVE CARE           1




                                Donna Hummer

                          Thomas Edison State College

                                   3/4/2011
END OF LIFE AND PALLIATIVE CARE                                                                     2


                                       ABSTRACT



        No matter how healthy a person is in life, no matter how much he or she exercises and

eats a healthy diet no one will live forever. No matter what your age is or the age of your loved

one the time to prepare for death is now. There is so much ignorance about death and for those

who love and care for them. To many people wait until it is too late to determine how they wish

to spend their final days. End of life care needs to be discussed so they can make decisions on

how they wish to die. And what they want their final decision to be .Palliative care focuses on

alleviating patient’s symptoms and delivering humane medical care to patients whether they live

or die, Patients facing a protracted, fatal illness can spend their last days in comfort, saying

goodbye, imparting their wisdom, healing wounded relationships. And expressing their love and

appreciation to family and friends ( brody 2009) Easing their way through the journey of grief by

admitting the reality of loss, expressing emotions, and allowing the transition between life and

death
END OF LIFE AND PALLIATIVE CARE                                                               3




        For each person the journey is unique. You may experience some or all of these changes’

        Months before Passing:

        Withdrawal and Reflection.

        Decreased appetite, changes in food preferences.

        Decreased energy.

        Increase need for sleep.

        Vivid dreams.

        Assistance with personal care.



 Weeks Before Passing.

        Minimal appetite, prefer easily digested foods.

        Increase need for sleep.

        Increased need for sleep.

        Increased need for assistance with care.



 Days before Passing;

         Decreased level of consciousness.

         Pauses in breathing.

         Decreased urine volume

         Murmuring to people others cannot see.

         Reaching in the air or picking at covers.

         Further assistance needed with personal care.
END OF LIFE AND PALLIATIVE CARE                                               4




        Days to Hours before Passing;


        Decreased level of consciousness or comatose state.


        Inability to swallow.


        Pauses in breathing become longer.


        Shallow breaths.


        Knees, feet, and or hands becoming cool or cold.


        Knees, feet, and or hands discoloring to purplish.


        Skin coloring becoming pale, waxen.( Bell )




        What Will Happen? The Physical Journey

        What Can I do ?

        Review medications with the hospice nurse.

        Reposition every two hours.

        Swab inside of mouth gently. Maintain a quiet peaceful environment.

        Keep comfortable and pain free. ( Bell )




                                               Hospice
END OF LIFE AND PALLIATIVE CARE                                                                  5




             The goals of hospice are to manage pain and other symptoms that cause

              discomfort or distress.

             Create a comfortable environment for the patient.

             Allow the patient to be close to family and loved ones during the dying process.

             Give relief to the patients caregivers.

             Offer counseling for the patient and those close to the patient.(Brody)




                                    The Kubler Ross Grief Cycle




                                                 Stages

      Shock,Denial, Anger, Bargaining, Depression, Testing, and finally Acceptance.

        How we change what others think, feel, believe and do. ( Ross )Journey. No matter

 how healthy a person is in life, no matter how much he or she exercises an

                                           References
END OF LIFE AND PALLIATIVE CARE                                                               6


Brody (2009). And Expressing Their Love And Appreciation To Family And Friend. ( Brody

       2009). In Guide to the Great Beyond. : Random House.

Brody, J. (Ed.). (2009). Guide to the Great Beyond.

The Journey. (2010). In K. W. Bell (Ed.), Living at the End of Life. : Sterling Publishing

       Company, INC.

Ross, K. (2002-2011). The Kubler- Ross grief cycle. In Changing Minds (p. ). Retrieved from

       http://changingminds.org/disciplines/change_management/kubler_ross/kubler_ross.htm
END OF LIFE AND PALLIATIVE CARE   7

				
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