1. ASSISTING WITH COMFORT
CHAPTER 24

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

3. 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

4. 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

5. CARING FOR PEOPLE WHO ARE DYING
CHAPTER 25

6. 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

7. 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

8. 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

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

10. 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

11. 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