End of Life Journal Archives

Content tagged with Clinical Skills

Nursing care of patients at the end of life who are unable to drink

Annie Pettifer

The management of the hydration of dying patients and the subsequent distress of their relatives can be challenging for nurses. This article will analyse a fictitious case scenario in which a student nurse considers how best to care for a dying patient's hydration needs. It will consider best practice surrounding... Read full article

Oral Hygiene In Dying Patients With Diminished Consciousness

Susan Martin

Xerostomia (subjective sensation of oral dryness) and stomatitis (sore mouth) are common in patients with terminal disease and have considerable impact on patients’ wellbeing. Patients with diminished consciousness may still be aware of oral discomfort such as a dry mouth. Therefore, good oral hygiene is an important nursing role when... Read full article

Communication Vignettes: ‘I don’t think I can cope, nurse’

Helen Scott

Dementia is a progressive, life-limiting disease (Jolley, 2010; National End of Life Care Intelligence Network, 2010; Hennings et al, 2013). Over time, people with the condition can decline, both cognitively and functionally (Schneider et al, 1999; DeKosky and Orgogozo, 2001; Tor ti et al, 2004; Hennings et al, 2013). The... Read full article

Communication Vignettes: Talking About Death in Dementia

Helen Scott

In this issue of the journal, Julie Watson highlights how people with dementia often become depersonalised. As dementia progresses, carers may stop seeing the human being behind the condition, attributing all behaviour to pathology. However, despite behavioural change and loss of cognitive function, people who have dementia retain their sense... Read full article

Encouraging/Supporting Dying Parents to Talk to Their Children

Steve Marshall, Julia Manning, Sally Mercer

Communicating with children about the anticipated death of a parent can be very challenging, even for experienced palliative care professionals. It can be particularly difficult for dying parents to discuss the fact that they are dying with their children. Consequently, they may adopt an overly positive stance in order to... Read full article

Communication Vignettes: ‘What if I meet “Old Nick”, Nurse?’

Helen Scott

Regardless of whether or not older people have a life-limiting illness, they are aware that they are in the final stages of their lives. The very end phase of life can be a significant cause of distress (Lloyd-Williams et al, 2007; Gott et al, 2008). Death remains a mystery and,... Read full article

St Christopher’s Hospice Clinical Guidelines: Anticipatory end-of-life care medication for the symptoms of terminal restlessness, pain and excessive secretions in frail older people in care homes

Julie Kinley, Louisa Stone, Jo Hockley

The term ‘frail older people’ has been defined as people over 75 years of age with geriatric syndrome, i.e. the presence of numerous chronic diseases and signs and symptoms such as incontinence, falls, cognitive impairment and reduced mobility (Saavreda Muñoz and Barreto Martín, 2008). However, some older people are ‘frail’... Read full article

Requests for Non-Disclosure of Poor Prognoses to Patients

Kristina Reynolds

For patients who are given information about a life-limiting diagnosis and poor prognosis, it can be very distressing to hear words such as ‘terminal’ and ‘end of life’. These words are also upsetting for patients’ family members/loved ones. In some instances, the family or surrogate decision-makers may ask that health... Read full article

Communication vignettes: ‘Being with’ a patient who is distressed

Helen Scott

Communicating with dying people means more than just imparting information. It is about being physically and emotionally present with patients. The following communication vignette deals with the issue of ‘being with’ dying patients, as defined by Dame Cicely Saunders, the founder of the modern hospice movement. Dame Cicely Saunders wrote... Read full article

Communication vignettes: Telling a child that her dad is dying

Vicky Robinson

Traditionally, palliative care emergencies are associated with physical, often reversible, clinical signs (e.g. spinal cord compression and hypercalcaemia). However, palliative care practitioners can sometimes find themselves in a situation where there is an urgent need to communicate with a family member or friend of a terminally ill patient (Pickering and... Read full article

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