End-of-Life Nursing Care: A Guide for Best Practice

2013 ◽  
Author(s):  
Joanna De Souza ◽  
Annie Pettifer
Keyword(s):  
End Of Life ◽  
Nursing Care ◽  
Best Practice

Symptom management at the end of life

2019 ◽  
pp. 569-574
Author(s):  
Susi Lund
Keyword(s):  
End Of Life ◽  
Nursing Care ◽  
Symptom Management ◽  
Best Practice ◽  
Service Providers ◽  
National Guidelines ◽  
Mouth Care ◽  
Death Rattle ◽  
Syringe Driver ◽  
Need Support

At the end of life, it is important to review all medications, and those required may be continued via a syringe driver if the person is unable to take them orally. The anticipation of needs and forward planning are important, having medications and resources available, ensuring all service providers are aware of the patient 24 hours a day and families have relevant contact numbers. Effective communication with the patient and family is essential, to manage expectations and ensure they understand what is being done and why. Care should always be planned in accordance with local and national guidelines in best practice in palliative and end-of-life care. Anticipatory prescribing of as-required medications for symptoms can help avoid distress. Respiratory secretions (death rattle) can cause noisy, rattling breathing that occurs when the dying person is unconscious and close to death and is unable to cough or clear secretions. This can be distressing to family members, and they will need support and information about the condition. Nursing care involves repositioning to aid drainage of secretions, frequent mouth care, and review of fluid input, and drugs may be used to reduce secretions. Terminal agitation is a state of agitation and distress at the end of life. This is a distressing experience, and it is most important to communicate effectively with the patient and family, maintaining dignity and privacy and providing a comforting professional presence. Sedation should be used with care and discretion, taking the wishes of the patient and family into account.

scholarly journals Nursing care at end of life: a UK-based survey of the deaths of people living in care settings for people with intellectual disability

2018 ◽  
Vol 24 (6) ◽  
pp. 366-382 ◽  
Author(s):  
Ruth Northway ◽  
Stuart Todd ◽  
Katherine Hunt ◽  
Paula Hopes ◽  
Rachel Morgan ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
End Of Life ◽  
Nursing Care ◽  
End Of Life Care ◽  
Life Care ◽  
Care Providers ◽  
Nursing Support ◽  
Respiratory Problems ◽  
The Uk ◽  
The Impact

Background People with intellectual disability are believed to be at risk of receiving poor end-of-life care. Nurses, given their advocacy role and duty to provide compassionate end-of-life care, have the potential to change this situation but research regarding this aspect of their role is limited. Aims This paper thus seeks to answer the question ‘How and when are nurses involved in providing care at end of life for people with intellectual disability?’ Methods A total of 38 intellectual disability care providers in the UK providing support to 13,568 people with intellectual disability were surveyed. Data regarding 247 deaths within this population were gathered in two stages and subsequently entered into SPSSX for analysis. Results Findings revealed that the majority of deaths occurred between the ages of 50 and 69 years, the most commonly reported cause of death being respiratory problems. Both community and hospital-based nurses were involved in supporting individuals during their final 3 months of life, and sometimes more than one type of nurse provided support to individuals. Generally nursing care was rated positively, although room for improvement was also identified. Conclusions Nurses are involved in supporting people with intellectual disability at end of life and appropriate education is required to undertake this role. This may require change in curricula and subsequent research to determine the impact of such change on nursing support to this population.

scholarly journals General practitioners’ perceptions of best practice care at the end of life: a qualitative study

BJGP Open ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. bjgpopen19X101660 ◽  
Author(s):  
Anne Herrmann ◽  
Mariko Carey ◽  
Alison Zucca ◽  
Lucy Boyd ◽  
Bernadette Roberts
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Best Practice ◽  
Qualitative Content Analysis ◽  
Care Delivery ◽  
Natural Extension ◽  
Family Needs ◽  
Qualitative Interview Study ◽  
Wide Range ◽  
Practice Care

BackgroundGPs can play a central role in palliative care delivery. However, little is known about their views on what constitutes best practice care at the end of life.AimTo explore, in a sample of Australian GPs, their perceptions of best practice palliative care and their ideal role in its delivery.Design & settingA qualitative interview study of 25 GPs practising in metropolitan and non-metropolitan locations in New South Wales, Australia.MethodSemi-structured telephone interviews were conducted. Data were analysed using qualitative content analysis.ResultsParticipants had a mean age of 51 years, and had practised between 3 and 38 years (mean 19 years). Best practice palliative care was perceived to be proactive and responsive to a wide range of patient and family needs. Many participants indicated a need for relational continuity, which involves GPs establishing a care pathway from diagnosis to palliation, coordinating care across the pathway, and collaborating with other healthcare providers. A number of participants perceived palliative care as a natural extension of primary care and indicated that best practice palliative care mainly requires experiential knowledge and good communication skills, rather than specialised medical knowledge. Participants listed a number of communication strategies to offer patients and their families choice and ongoing negotiation about the recommended treatments.ConclusionThis study provides novel in-depth insights into GPs’ perceptions of best practice palliative care. Future research should further investigate the identified features of care, and whether they can maximise the outcomes of patients and their families.

Rehabilitation and palliative care

2015 ◽  
pp. 777-787
Author(s):  
Donna J. Wilson ◽  
Kathleen Michael
Keyword(s):  
Physical Activity ◽  
Palliative Care ◽  
End Of Life ◽  
Nursing Care ◽  
Human Dignity ◽  
Disease Process ◽  
Life Care ◽  
Level Of Functioning ◽  
Self Confidence ◽  
Tailored Program

This chapter applies the concept of physical activity to palliative care across settings. A physical activity program for each patient should be presented at the time of diagnosis and extend to end-of-life care. Even when it is not possible to cure or reverse a disease process, or to restore a previous level of functioning and independence, a rehabilitative approach to nursing care adds quality to the experience of living until life’s completion. The language of rehabilitation nursing is a language shared with those who practice palliative care. Feelings of self-confidence, independence, hope, human dignity, and autonomy are all influenced by an individually tailored program of rehabilitation.

P-149 Nurse led hospice beds – improving access to specialist hospice nursing care for all patients at the end of life

2015 ◽  
Vol 5 (Suppl 3) ◽  
pp. A53.2-A54 ◽  
Author(s):  
Carina Saxby ◽  
Jill Ellerington ◽  
Susan Watson ◽  
Sarah Locker
Keyword(s):  
End Of Life ◽  
Nursing Care
Sign in / Sign up

Export Citation Format

Share Document