death and dying practice
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- 1.TIM SPECIFICCONTENT TEACHING LEARNINGE OBJECTIVEA.V. ACTIVITIESEVALU AIDS TEACHER STUDENT ATIONTo introduce INTRODUCTION:TeacherStudents3 the topic.will willminDeath is often referred to as the final stage of growth. Life is a moving Whiteintroduceunderstand process, it begins at birth, but it ends with death.boardthe topic. the topic. Mosbys medical, Nursing & Allied Health Dictionary says Death is: The cessation of life as indicated by the absence of activity in the brain and central nervous system, the cardiovascular system, and the respiratory system as observed and declared by a physician. Nurses are very committed to life and health. The dying patient is a contradiction to a nurses commitment. Occasionally people in the medical field react to the dying person as if they represent a failure in their care, or their skills. Although there is really nothing a human being can do to stop the destiny/ process of another human being. We can help the dying patient and their families in their final hours with our education and compassion. FACTORS AFFECTING GRIEF AND DEATH :To explain Children :children do not understand death as the adults do but its effect TeacherStudents Which9 factorsis tremendous. Both terminally ill children and their siblings are likely to White will will takeare themin affectingask questions about death.they require parental love and support at all boardexplainpart infactorsgrief andstages. The childrens development may be retarded due to death of a by discussion affectingdeath. parent or the child regresses. discussion .grief and..death ?
2. young and middle aged people :They approach death reluctantly. Separation from loved ones is difficultto accept .The elderly person, however, often looks upon death with lessdread. For him death may represent peace and relief from suffering. Forthe person who has always been healthy and suddenly becomes criticallyill,death is often feared.Family :The patients families react to death and dying in a variety of a ways.They feel lost as to what to say, and how to act in an aggressive mannertowards the nurse and the health agency when the patient is critically illor after death. This can be an expression of feelings of helplessness andfrustration.Patient :Patients react to death in many ways.some people frankly express theirfeelings and their fears while fears while others hide them in an air ifsuperficially.some become aggressive , hostile or withdrawn;othersmaintain a composure , which hides many anxieties.Nurse :The nurse also reacts in different ways to the dying patient and to death.Her reactions largely depends on her own past experiences , beliefs andneeds. She has to be very alert with relatives covert or overt actions ofcultural practices during the last stages.Socio economic factors : 3. A bereaved family may suffer more acutely if there is no other earning member in the family. They not only have loss of a loved one , but also economic loss that may further disrupt family life. Cultural influences : Culture also influences an individuals expression of grief. In many families , grief is a private matter shared only with the family. Many individuals internalise their feelings of grief and may not express grief or feelings of loss to others.on the other hand , cultural background may necessitate the family to display emotion and distress with loud weeping and mourning which may disturb the other patients in the ward. MEETING THE NEEDS OF GRIEVINGAND DYING INDIVIDUALS : TeacherTo discuss White willhow will10the needs ofThe clients needs are met by attending the following aspects like : board discuss Studentsyoumin dyingneeds ofwillprovideindividuals. Physical needs :dying participate care to individualindying s bydiscussionperson ? asking Dying may take a few minutes, days or weeks. There is a general questions . slowing down of the bodies processes as a person is dying. They become weak; levels of consciousness may change. It is very important to allow the patient as much independence as possible. As they become weaker or less responsive the nursing team will need to help with basic needs. As the death nears the patient might become totally dependent on the nursing staff for all of their ADLs. Every effort is given to provide the best care, physically and psychological to a dying patient. This person needs be allowed to die in 4. comfort and with DIGNITYVISION, HEARING and SPEECH- Vision may become blurred andgradually fail, this person will automatically turn towards the light, avery dark room may frighten them. Keeping some light in the room isimportant, but not real bright lights. The eyes may stay half-open, thiswill cause dryness and accumulation of secretions in the corners, andfrequent eye care is necessary. Always talk to the patient and let themknow you are there and keep some light in the room. Hearing is the lastsense to go, ALWAYS remember the patient can hear you even whenyou think there is no way they could, they can! So talk to them, continueto explain what you are doing and why, keep your normal tone of voice,offer words of reassurance and comfort. Remember to never offer falsepromises.MOUTH, NOSE and SKIN- oral hygiene is a must! A dying personsmouth many times become very dry and their lips crack. Mouth care isimportant and needs to be done frequently with glycerin swabs, ortoothettes. You do not want to put a lot of water, or fluids in the dyingpersons mouth. Many times they are unable to swallow and too muchfluid can cause them to aspirate. When giving mouth care always havethe head of the bed up and their heads turned to the side. Part of mouthcare is applying lubricant to the patients lips. The nostrils may becomedry or crusted from drainage or oxygen, assess these areas frequently.CIRCULATION decreases and then fails. Body temperature mayincrease as death approaches. Even though the body temperature goes upthe skin becomes cool, pale, and mottled. Perspiration increases, manytimes profusely. Good skin care, bathing, and prevention of decubitisulcers are very important nursing measures.Positioning the patient frequently and keeping them comfortable as 5. possible, you may use pillows to help with positioning and to avoid skinto skin contact.ELIMINATION- the dying person may become incontinent of boweland bladder. Remember DIGNITY. Bed protectors or attends may beneeded. Perineal care is very important.Psychological needs :Patients insight into their condition should be assessed. Issues relatingto dying and death should be explored appropriately and sensitively.Clients differ in their emotional responses when recognizing that deathis inevitable. some person speak of their fears of death. Responsesinclude fear of the unknown , separation , pain of leaving loved ones,loss of dignity and so on. .nurse should be involved in giving hope,while helping the client to deal with reality. No matter what thebehaviour of client is,it should be accepted by the nursing staff. A fearof isolation of having to face the death alone is a primary fear of thedying person . yhe nurse supports the client by providing her/him fullattention.presence of members of the family needs to be encouraged.Social needs :The familys insight into the patients condition should be assessed andissues relating to dying and death explored appropriately and sensitively.The family should be told that the clinical expectation is that the patientis dying and will die. Use of ambiguous language such as may not getbetter can lead to misinterpretation and confusion. A constant source of 6. frustration and anger voiced by bereaved relatives is that no one satdown and discussed the fact that their loved one was dying. If relativesare told clearly that the patient is dying they have the opportunity to askquestions, stay with the patient, say their goodbyes, contact relevantpeople, and prepare themselves for the death. Relatives of patients dyingin the community should be given contact telephone numbers so thatthey have access to help and advice on a 24 hour basis.Spiritual needs :Sensitivity to the patients cultural and religious background is essential.Formal religious traditions may have to be observed in the dying phaseand may also influence care of the body after death. After the patientsdeath, relatives should be dealt with in a compassionate manner. Aleaflet explaining issues related to grieving can be helpful.Hospice care :Hospice care is end-of-life care provided by health professionals and.volunteers. They give medical, psychological and spiritual support. Thegoal of the care is to help people who are dying have peace, comfort anddignity. The caregivers try to control pain and other symptoms so aperson can remain as alert and comfortable as possible. Hospiceprograms also provide services to support a patients family.Usually, a hospice patient is expected to live 6 months or less. Hospicecare can take place At home 7. At a hospice centerIn a hospitalIn a skilled nursing facilitySTAGES OF DYING :To describe Teacher StudentsWhich7 stages of Clients reaction to impemding death is unique to everyone,Dr .elizabethwillwillare themin dying.kubler-ross studied responses to death and her findings have been usedlcd explain verbalise stages ofusing a.v stages of dying ?extensively by nursing and other professionals. According to kubleraids. dying.ross, the stages of dying are (1) Denial and isolation (2) Anger (3)Bargaining (4) Depression (5) Acceptance1. Denial and IsolationThe first reaction to learning of terminal illness or death of a cherishedloved one is to deny the reality of the situation. It is a normal reaction torationalize overwhelming emotions. It is a defense mechanism thatbuffers the immediate shock. We block out the words and hide from thefacts. This is a temporary response that carries us through the first waveof pain.2. AngerAs the masking effects of denial and isolation begin to wear, reality andits pain re-emerge. We are not ready. Th