Govt. College of Nusing C.R.P. Line Indore (M.P.) : Subject-Advanced Nursing Practice

GOVT.
COLLEGE OF NUSING
C.R.P. LINE INDORE (M.P.)
SUBJECT-ADVANCED NURSING PRACTICE

END OF LIFE CARE
SUBMITTED BY - SMITA SARYAM

INTRODUCTION
 Life and death are the two main stages in a human
beings life , where we come across many challenges,
diseases , and other problems .
 Earlies persons with chronic diseases , terminal illness
and dying is viewed as taboo topics , due to which few
new concepts developed for the care of person who is
their end stage , one of those topic is END OF LIFE.
DEFINITION
 End-of-life care refers to health care for a

person nearing the end of their life or in the
advanced stage of a terminal illness.
Generally speaking, people who are dying
need care in four areas—physical comfort,
mental and emotional needs, spiritual issues,
and practical tasks.
TERMINOLOGIES
 Loss: an aspect of self no longer available to a person
 Death: irreversible cessation of all functions of the entire
brain
 Grief : pattern of physical and emotional responses to
bereavement
 End of life : final phase of a patient's illness when death is
imminent
 Death rattle: a sound that is something heard coming from a
dying person's throat or chest
 Palliative care: it is a specialized medical care for people with
serious illness
 Hospice: a place that provides care for people who are dying
GOALS
 Provide comfort and supportive care during

process.
 Control symptoms and identify patients
need.
 Improve the quality of remaining life.
 Help to ensure dignified death.
PHYSICAL CHANGES AT END OF
LIFE
SYSTEM CHANGES
1. SENSORY 0 Decreased sensation, decreased perception,

blurring of vision, blink reflex absent, eyelids
remain half opened
2. SKIN SYSTEM 0 Mottling on hands, feet,arms and legs;cold,

clammy skin,nail beds,knees;wax like skin
when very near to death.
0 Increased respiratory rate; Cheyne-stokes

3.RESPIRATORY respiration;inability to cough or clear
secretions resulting in
granting,gurgling;irregular breathing
CONT…..
SYSTEM CHANGES
1. URINARY 0 Decreased urinary output, urinary

incontinence, unable to urinate
2.CARDIOVASC 0 Increased heart rate, slower and

-ULAR weakening pulse, irregular rhythm
Decreased in blood pressure, delayed
absorption of drugs
3.GASTROINTE 0 Accumulation of gas, distension and

-STINAL nausea, loss of sphincter control
PSYCHOSOCIAL CHANGES OF
APPROACHING DEATH
 Altered decision making
 Fear of pain
 Helplessness
 Fear of loneliness
 Restlessness
 Anxiety about unfinished business
 Variety of feelings
 Life review
 Unusual communication
PALLIATIVE CARE
Palliative care is any form of care or

treatment that focuses on reducing
the severity of disease symptoms,
rather than trying to delay or reverse
the progression of the disease itself or
provide a cure.
GOALS OF PALLIATIVE CARE
> Provide relief from symptoms
> Regard dying as a normal process
> Affirm life and neither hasten nor postpone death
> Support holistic patient care and enhance quality of life
> Offer support to patients to live as actively as possible until

death
> Offer support to the family

HOSPICE CARE
 Hospice is not a place but a concept of care

that provides compassion, concern and
support for the dying.
HOSPICE ELIGIBILITY REQUIREMENTS:

►Certified as being terminally ill by a physician
and having a prognosis of 6 months or less if
the disease runs its normal course.
GOALS OF HOSPICE CARE
1) To ensure that every moment counts, in the last six

months of life.
2) To make the patient comfortable, ease pain and
other troublesome symptoms and support the
family through a sad and difficult time.
CARE AFTER DEATH
 Documentation of end of life care.
 Cultural aspects of care of body after death.
 Postmortem care
 Procedural guidelines for care of the body after death.
0 DEATH CERTIFICATE
Law requires that a death certificate be prepared for
each person who dies. Death certificate are send to
local health departments and nurse’s responsibility is to
ensure that certificate has been signed by the
physician.
BIBLIOGRAPHY
 Navdeep Kaur Brar “Textbook of advanced
nursing practice”.
 Shebeer. P. Basheer , S. Yaseen Khan “Textbook
of advanced nursing practice”.

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What are the goals of end of life care?

What are the goals of end of life care?

What physical changes occur at the end of life?

What physical changes occur at the end of life?

GOVT.

SUBJECT-ADVANCED NURSING PRACTICE

SUBMITTED BY - SMITA SARYAM

 End-of-life care refers to health care for a

 Provide comfort and supportive care during

1. SENSORY 0 Decreased sensation, decreased perception,

2. SKIN SYSTEM 0 Mottling on hands, feet,arms and legs;cold,

0 Increased respiratory rate; Cheyne-stokes

1. URINARY 0 Decreased urinary output, urinary

2.CARDIOVASC 0 Increased heart rate, slower and

3.GASTROINTE 0 Accumulation of gas, distension and

Palliative care is any form of care or

> Provide relief from symptoms

> Regard dying as a normal process

> Affirm life and neither hasten nor postpone death

> Support holistic patient care and enhance quality of life

> Offer support to patients to live as actively as possible until

> Offer support to the family

 Hospice is not a place but a concept of care

HOSPICE ELIGIBILITY REQUIREMENTS:

1) To ensure that every moment counts, in the last six

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