CARE OF THE DYING CLIENT

Terms
Loss occurs when something/someone can no longer be seen, felt, heard, known or
experienced.
Bereavement state of thought, feeling and activity that follows loss. It includes grief
and mourning.
Grief is a form of sorrow that follows the perception or anticipation of a loss of 1 or
more valued of significant objects.
Mourning process that follows a loss and includes working through grief.
Signs of Impending Clinical Death
1. Loss of muscle tone
Relaxation of the facial muscles (the jaw may sag)
Difficulty in speaking
Difficulty in swallowing and gradual loss of the gag reflex
Decrease activity of the GIT
Possible urinary and rectal incontinence
Diminished body movement
2. Slowing of circulation
Diminished sensation
Mottling and cyanosis of the extremities
Cold skin ( first in the feet and later in the hands, ear and nose)
3. Changes in Vital Signs
Decelerated and weaker pulse
Decreased BP
Rapid, shallow, irregular or abnormally slow respirations
4. Sensory Impairment
Blurred vision
Impaired sense of taste and smell

INDICATIONS OF DEATH
1.
2.
3.
4.

Total lack of response to external stimuli lack of responsiveness and receptivity

No muscular movement/breathing for more than 1 hour
No reflexes
Flat EEG this is the most accurate indicator of death
Irreversible cessation of circulatory and respiratory functions
Irreversible cessation of all functions of the entire brain
The physician is the only responsible for pronouncing the person dead.

Care after Death

Body Changes:
1.Rigor Mortis the stiffening of the body that occurs about 2-4 hours after death.
Care of the body
Have the body in normal anatomical position (supine position, the arms at the
sides, palms down)
Before rigor mortis sets in, place dentures in the mouth and close the eyes and
mouth.
Care of Valuables
Identification and proper accounting; all clients valuables are listed and placed in
a safe storage area for the family to take away.
Helping the patiens family
Offering supportive measures
Allow the family to view the patients body
2. Algor Mortis it is the gradual decrease of the bodys temperature after death (about 1
degree celcius per hour until it reaches room temperature.
3. Livor Mortis discoloration of the skin after death after circulation has ceased.
*HELPING TO MEET THE NEEDS OF THE TERMINALLY ILL PATIENT*
1. Assist the client achieve a dignified and peaceful death
Provide relief from loneliness, fear and depression
Maintenance of independence maintain the clients sense of security, self
confidence, dignity and self worth.
Provide physical comfort
Maintain hope
2. Meeting physiologic and psychologic comfort
Nutrition
Elimination
Safety
Hygiene
Pain control (the highest priority)
Relief of respiratory difficulties
3. Provide Spiritual support
Search of meaning
Sense of forgiveness
Need for love
Need for hope

3 PHASES OF GRIEVING PROCESS

1. Shock and disbelief the individual denies the reality of the loss and may
withdraw, sit motionless, or wander aimlessly.
2. Developing Awareness the individual begins to feel the loss acutely and may
experienced desperation. Crying is typical as the individual becomes occupied
with the loss.
3. Reorganization/Restitution inevitability of the loss is acknowledged. The loss is
clear to individual who begins to reorganize life.
STAGES:
1. Stage of Denial
Immediate response to news of loss
Physiological response: tremors, deep sighs, cold and clammy skin,
diaphoresis, discomfort, anorexia
Individuals isolate themselves from sources of accurate information/ reject
offers of comfort and support.
- support emotional needs
- offer to remain with clients
2. Stage of anger individuals may express anger and retaliate against family,
physicians or supreme being
o Do not take anger personally
3. Stage of bargaining individuals make bargains with supreme being.
4. Stage of Depression
Confusion