1. Nursing Assistant Monthly Copyright © 2008 Delmar, Cengage Learning. All rights reserved. Hospice and Palliative Care April 2008

2. Copyright © 2008 Delmar, Cengage Learning. All rights reserved. April 2008 / Hospice and palliative care 2 What is hospice and palliative care? The goals of hospice and palliative care are to provide:  physical comfort  emotional support  spiritual support to the patient/resident and his or her family.

3. Copyright © 2008 Delmar, Cengage Learning. All rights reserved. April 2008 / Hospice and palliative care 3 The role of a CNA The CNA’s role is to:  Provide high quality physical care  Be the “eyes and ears” of the nurse  “Be with” the resident and family and offer support The CNA often develops a very special relationship with the resident and family.

4. Copyright © 2008 Delmar, Cengage Learning. All rights reserved. April 2008 / Hospice and palliative care 4 Physical care Physical care is:  Watching for signs of –Pain –Facial expressions (grimacing, crying, withdraw) –Rapid/shallow breathing –Difficulty breathing –Gasping, clutching, or picking at clothing or bedding  Providing –Good mouth and skin care –Repositioning as needed and tolerated

5. Copyright © 2008 Delmar, Cengage Learning. All rights reserved. April 2008 / Hospice and palliative care 5 Emotional and spiritual care  Emotional and spiritual care is: –Being a listening “ear” to resident and family –Being careful not to give “advice” –Withholding your opinion and judgment –Reducing the isolation of dying  A main goal is to help residents and family be at peace with the end-of-life choices  CNAs often become “like part of the family”

6. Copyright © 2008 Delmar, Cengage Learning. All rights reserved. April 2008 / Hospice and palliative care 6 Preserving the dying residents’ dignity Treat resident with great respect  Keep the resident’s body covered –Avoid unnecessary exposure during care  Offer choices as much as possible during caregiving activities  If resident is non-verbal, speak to him or her, as hearing/understanding may be preserved

7. Copyright © 2008 Delmar, Cengage Learning. All rights reserved. April 2008 / Hospice and palliative care 7 Losing a resident, a friend The death of a resident can be very difficult  Honor your feelings by taking time to pay attention to them  Consider attending the funeral services, or send a note to the family  Reach out to each other, to hospice staff, or to spiritual advisor  Remember all you did to comfort the resident and family