ASSISTING WITH COMFORT CHAPTER 24

GENERAL COMFORT MEASURES Support, comforting touch Positioning, Massage Take care of basic needs Environment Rituals

MANAGING PAIN ACUTE PAIN -Short duration CHRONIC PAIN -Improves with healing CHRONIC PAIN Occurs over time Often left untreated Impacts quality of life CNA ROLE Report & Observe Use comfort measures GET DETAILS Where, How long? What does it feel like? Rate intensity 0-10 MANAGING PAIN

HOT APPLICATIONS COLD APPLICATIONS Dilates blood vessels Reduces pain Promotes circulation Relieves muscle spasms Provides warmth Constricts blood vessels Reduces pain Prevents swelling Numbs sensation Controls bleeding Reduces fever

CARING FOR PEOPLE WHO ARE DYING CHAPTER 25

STAGES OF GRIEF Denial Anger Bargaining Depression Acceptance The person and family may pass through stages of grief but not always in order Provide support Be open to listen

HOSPICE CARE PALLIATIVE CARE Prognosis of 6 months Paid for by separate benefit from Medicare, Medicaid, Insurance Hospice team (MD, RN, CNA, SW, Chaplain) Goal is quality of life Manage symptoms Provide support for person and family PALLIATIVE CARE Approach to chronic illness (can’t be cured but can be treated) May not qualify or want hospice Includes active treatment Focus on managing symptoms Uses normal payment system

ADVANCED DIRECTIVES POWER OF ATTORNEY FOR HEALTH CARE LIVING WILL WILL A document written by the person describing the kind of care they want at end of life Not as good as a Durable Power of Attorney WILL Instructions for what happens to your belongings after you die POWER OF ATTORNEY FOR HEALTH CARE Assigns someone to make decisions for you if you are unable to make the decision Has more power than a Living Will Make sure person knows what you want Need a strong person willing to speak in your behalf

PHYSICAL CHANGES CHANGE IN VITAL SIGNS BREATHING CHANGES DECREASED INTAKE INCONTINENCE INCREASED WEAKNESS DEMINISHED SENSES

WHAT CAN YOU DO? Oral care Frequent Position Change Observe Provide for needs Report Observe Oral care Frequent Position Change Yes and No Questions Listen: Hearing is last to go

POSTMORTEM CARE Rigor Mortis - Stiffening of the body Wash the body Sets in in 2-4 hours Wash the body Use Standard Precautions Place in good alignment Tubes are removed by nurse Dentures, glasses, etc sent with body Family may view body Prepare the person & room POSTMORTEM CARE