Final Hours最后几个小时.pptVIP

* * * * Family Members Will Always Remember “The Final Hours” Nurses have a unique opportunity to be invited to spend these precious moments with Veterans and their families and to make those moments memorable in such a positive way. We only get one chance to do this well Respect the Dying Veteran and the Family/Comrades They Leave Behind Conclusion * * * * * * * * * * * * * * * * * * * * * * * * * * * * * E L N E C For Veterans Curriculum End-of-Life Nursing Education Consortium Palliative Care For Veterans ELNEC- For Veterans Module 8:Final Hours The Nurse, Dying and Death Nurses provide support to Veterans, families, staff Interpersonal competence Being present “Bearing witness” Interdisciplinary care Dying is an Individualized Personal Experience for the Veteran There is no typical death Less likely to be fearful of dying alone vs. non-Veterans Nurses advocate for choices Setting of death Support Open, Honest Communication Convey caring, sensitivity, compassion Recognize their helplessness Provide information in simple terms Veteran awareness of dying Maintain presence What About Artificial Nutrition and Hydration at End of Life? “Starving to death” Enteral feeding does not reduce risk of aspiration or mortality Hydration does not decrease dry mouth Patients who fasted to end their lives experienced peaceful death Gabriel et al., 2010; HPNA, 2003a What About CPR? Discuss futility when death is expected Poor outcome of CPR predictors Advanced terminal illnesses Dementia Poor functional status Honoring Veterans:Dignity Conserving Care The A, B, C, D of dignity conserving care Attitude Behavior Compassion Dialogue Chochinov, 2007 The Dying Older Veteran Do not assume that a dying older Veteran has addressed his/her mortality Positive influences facing mortality Negative influences facing mortality Two Roads to Death Ferris et al., 2003 Psychological and Emotional Considerations Fear of the dying process Fear of abandonment Fear of unknown Nearing death a