Hospice Palliative Care

Hospice/Palliative care for a dying patient needs to be well planned and managed to ensure that all aspects of care giving are taken care of. The plan provides a reference for nurses and other practitioners who are involved in giving care to the patient. This is so as to ensure that they all know what needs to be done and does not. The plan also includes the relatives or family of the patient who need to be involved in the process not only to give emotional support but also physical support to the patient. However, this is just a plan and the nurse’s actions are independent and governed by the scope of practice of the state and specific country as well as the comfort levels of the nurse. The common management needs for a dying patient are comfort,

Providing comfort – In most instances, the dying patient in need of palliative care is often in pain. It is thus important to ensure that the pain is controlled and managed.

• Provide a continuous dosage of opioids for the pain. The dosage should be given round the clock. It should also be administered in intervals to the patient in order to alleviate their pain. The opioids can be administered via a PCA pump. Other than that, the patient should be given boluses as an additional dosage in cases when the patient is experiencing pain whilst their opioids dosage has already been administered. The boluses need to be given to the patient as needed.

• In case of renal failure, the opioids dosage may need to be reviewed in order to deal with the discomfort it causes. The adjustments can be made on the type of opioids given or on the dosage amounts of the opioids administered. This should also be considered in case the pain medications are not helping the patient. If the case is a renal failure, the patient should be given fentanyl. This also helps deals with seizure like tremors (often small) that the patient may be experiencing. The dosage of opioids needs to be reduced. This is because; the medication may stay longer in the system of a dying patient for they are dealing with renal failure. If the pain remains uncontrolled, the dosage of opioids needs to be

During the dying process it is common for patients to lose their ability to swallow and control their airway secretions (Patient Info, 2014). This can be addressed using various agents such as, scopolamine patch, glycopyrrolate (Robinul) or atropine 1% ophthalmic which is a solution that needs to be given bucally. The dosage will vary according to the patient and also the institution that one is working at. It is important to avoid oral suctioning as it does not help the patient since the secretions often accumulate within no time.

• Educating the family. Management of the airway also involves educating the family. This is an important process for the nurse to do as the family may not understand and think that the patient is in