Cu4133 Support Individulas Last Days Of Life

Support individuals during the last days of life.

Lisa Ward

Understand the impact of the last days of life on the individual and others.

1.1 Describe psychological aspects of the dying phase for the individual and others.

Stage 1- Denial and isolation: this is when the individual may not want to come to terms with the fact they are going to die or an individual they know is going to pass away or has passed away they are in shock and most of all disbelief. Stage 2- Anger: This is when the individual comes to terms with the situation and the denial turns into anger and usually take their frustration out on people closest to them. Stage 3- Bargaining: This is when the individual may decide to change their life goals and expectations to try and negotiate with a fate or god they believe in. Stage 4- Depression: Individuals go through a stage of depression when they realise the loss is real or that it is actually going to happen and they feel they are going to leave people behind, they may lose interest in personal appearance and socialising as well as possibly not finding a reason to carry on. Stage 5- Acceptance: This is when an individual has finally come to terms with what has happened or is going to happen the no longer feel angry or depressed.

1.2 Analyse the impact of the last few days of life on the relationships between individuals and others.

The impact that the last few days of life has on a relationship can either be stressful or bring people together. I have witnessed individuals become calmer and have a sense of greafulness that the individual who is at end of life is now coming to the end and will be out of pain and suffering, but i have also witnessed individuals be distant form the person because they don't know how to handle the situation, or don't know what to say this can maybe cause relationship issues due to they will isolate themselves from the situation and other family members may not understand there reasons causing family feud.

Understand how to respond to common symptoms in the last days of life.

2.1 Describe the common signs of approaching death.

Nobody can really tell when somebody is going to die but there are signs that i have noticed when it does become end of life care, these to me are lack of food and fluid intake, more sleepy and fatigue then usual, more confused then usual and irregular breathing patterns.

2.2 Explain how to minimise the distress of symptoms related to the last days of life.

Ways in which i would help minimise distress is to make sure i listen to the individual taking all their needs and preferences into account not doing something i know thy wouldn't want me to, make them comfortable, provide adequate amount of pain relief to relief any discomfort and pain they are in.
Everybody experiences pain and discomfort in different ways and this is the reason its important to use a holistic and person centred approach, people feel pain in different ways and doesn't necessarily need to be physically, it can be mentally, spiritually, as well as social pain and using a holistic approach will enable you to help and understand the individuals needs a lot better.

2.3Describe appropriate comfort measures in the final hours of life.

Making sure they are comfortable, making sure they are out of pain, be there to listen to them or to talk to them and hold their hand, be able to arrange individuals to be there who they wished to have, meeting all their wishes and preferences.

2.4 explain the circumstances when life prolonging treatment can be stopped or withheld.

Circumstances when life-prolonging treatment can be stopped or withheld: are if its in the individuals Advance Care Plan that they refuse the treatment or refusal of patient to give consent or the treatment would prolong the dying process or cause the patient unnecessary distress.

2.5 Identify the signs death has occurred.

Signs that death has occurred can include things such as the individuals breathing has stopped, there is no heartbeat, being unresponsive, the body is relaxed and possible loss of control of bladder and bowels.

3. Be able to support individuals and others during the last days of life.

3.1 Demonstrate a range of ways to enhance an individuals well-being during last days of life.

There are ways that you can enhance an individuals well being during end of life, you could arrange for them to have a possible head massage different thearpy sessions, such as reflexology, playing their favourite music, allowing them to watch their favourite films, talk to them about all their memories, take them to their favourite places, there is lots you can do to enhance their well being.

3.2 work in partnership with others to support the individuals well being.

There are lots of people who will be involved in an individuals end of life care this will be their G.P they will have the overall responsibility of the service users care.
Oncologist- will help with treatment of cancer
Cardiologist- will help with heart problems
Geriatrician- has responsibility to care for the older generation
Specialist nurses will also play a part in end of life care.

3.3 Describe how to use a range of tools for end of life care according to agreed ways of working.

The most common form of being able to monitor an individuals pain and discomfort is to use a numerical pain assessment scale this is important to be able to recognise if we have the individuals pain relief under control or if it needs adapting, this should then be recorded and documented in the care plan and changes should be made if necessary. Nobody should experience pain when they are at end of life as there is adequate amount of pain relief available. tools you can also use are a diary, or a pain faces scale.

3.4 Support others to understand the process following death according to agreed ways of working.

Ways to support others of a close relative or friend on their death is to acknowledge the situation, expressing concern, listening with compassion, allowing person to express their feelings, not being afraid to express own feelings, being patient and offering practical assistance.

Be able to respond to changing needs of an individual during the last days of life.

4.1 Explain the importance of following the individuals advance care plan in the last days of life.

It’s important to follow the individuals care plan in the last days of life to make sure that all the individuals needs and wishes and preferences are being met, so that the individuals is aware of what the individual does and doesn't want, they may want people to read a prayer out, they may want to be alone, they may want music playing all individuals wishes and preferences are different all of this is a good way to help them have a good death.

4.2 Record the changing needs of an individual during the last days of life according to agreed ways of working.

You would record all changes in the individuals care plan making sure all who need to know are aware of the changes that have occurred and need to be in put into place, whilst doing this you also need to take into consideration the data protection act swell as the individuals rights.

4.3 Support the individual when their condition changes according to agreed ways of working.

I will support the individual by helping them as much as possible such as speaking to other multi disciplinary team members about pain relief making sure this is readily available for the individual, i will also support the individual with their needs, wishes and preferences as long as i am able to do so within my works policies.

Be able to work according to national guidelines, local policies and procedures, taking into account preferences and wishes after the death of the individual.

5.1 Implement actions immediately after a death that respect the individuals preferences and wishes according to agreed ways of working.

With this i would look on the individuals advance care plan and see what their wishes was, if they wanted a male or female carer to prepare the body or family member, who they wanted to be contacted first thing if they was for burial or cremation, if they had a specific funeral director, if they had anything they wish to be wearing, i would look at all this and implement all the individuals wishes

5.2 Provide care for the individual after death according to national guidelines, local policies and procedures.

when an individual has passed away you should firstly carry out all their wishes and prefrences, notify the service users G.P record the time of death and who was present, inform their next of kin, undertake ‘last offices’ washing and preparing the body, ensure that privacy and dignity is maintained at all times and return all personal belongings to the service users family.

5.3 Explain the importance of following the advance care plan to implement the individuals preferences and wishes for they after death care.

It’s important to follow the advance care plan to understand if they wanted a male or female carer undertaking last offices or a family member to see if there was a particular outfit they wish to wear, if they was an organ donor and if they had a preference on funeral directors, there are lot’s of different things that can be involved in this and should always be adhered to.

5.4 Follow agreed ways of working relating to prevention and control of infection when caring for and transferring a deceased person.

A risk assessment should be done to eliminate infection individuals should always wear personal protective equipment whilst with the individual and remove when leaving the room and dispose of correctly, maintaining a clean and appropriate environment will help eliminate infection when transferring the individual and using a body bag if felt necessary.

5.5 explain ways to support others immediately following the death of the individual.

I can support others by being there, acknowledging them, showing empathy, talking to them, maybe offer them information about support groups, answer any outstanding questions they may have, and contacting them after to ensure they are well.

Be able to manage own feelings in relation to an individual’s dying or death.

6.1 identify ways to manage own feelings in relation to an individuals death.

Previously when an individual had passed away i had spoken to another member of staff about how i was feeling and i attended the funeral to pay my respects and say goodbye, this helped me to overcome the sadness.

6.2 Use support systems to manage own feelings in relation to an individuals death.

Support system i use is within my work place and that is the people i work with, i will have regular supervision meetings with my manager at these times to make sure that i am ok and managing with my emotions.