Death and Dying

Palliative Care: During your career as a nurse’s aide, there will be times when you will take care of patients that have incurable diseases and that are dying. While every patient handles death and dying in their own unique way, it’s up to you to follow the care plan that is designed to help get them through this natural, but often traumatic experience.

Palliative care refers to a comprehensive approach during patient care. This multifaceted technique includes management of physical, social, psychological, spiritual and existential needs of the patient.

The ultimate goal of palliative care is for the patient to achieve the best possible quality of life through relief of suffering, control of symptoms and restoration of functional capacity. Additionally, you will need to be sensitive to the patient’s cultural and religious values during this time of need.

Palliative care is often complementary to other forms of treatment, but just as essential.  This method of care helps guide patients and families as they make their transition during the changing goals of care during the dying process. It also assists the dying patient in addressing end of life issues.

The goal of this care is also to ease stress for terminally ill patients and their families. As a nurse’s aide, you will develop these necessary skills through experience and on-the-job observation as well by taking an active role in continuing education opportunities related to dying patients.

Relieving Pain

According to the Joint Commission on Accreditation of Health Care Organizations, pain is a common part of the patient’s experience during the dying process. Mental stress often accompanies the physical pain during fatal illness. It is important for you to know how to help relieve both physical and mental trauma during this time.

Patients will perceive pain differently and many factors come into play such as fear, anxiety, fatigue, insomnia and depression. In your role as a nurse’s aide, you can help to eliminate some of the underlying psychological factors. Having a positive attitude and simply taking the time to listen to the patient’s complaints can play a major role in helping to relieve their pain.

Many healthcare facilities rely on a numeric pain scale of 0 to 10 to measures a patient’s pain level. These levels are self-reported by the patient, based on the intensity of pain at that time. Knowing the patient’s level of pain is necessary to help keep the nursing staff informed.

Always trust what patients say about their pain and don’t make any assumptions regarding their pain or suffering. Your role is to be courteous during this time of high anxiety. Do your best to comfort patients and let them know that you are there to help.

Sometimes even a hot towel or a warm water bottle can help relieve some of the patient’s pain. Use your training, common sense and care giving techniques to help ease the dying patient’s physical and mental pain.

Keeping the Patient Comfortable

As the patient progresses through the dying process, the goals shift from treating illness to a concentrated effort on keeping the patient comfortable. As a nurse’s aide, you will have a hands-on role during this crucial time. At times, it may be emotionally draining, but never forget this is the time when patients need you the most.

Keep the patient comfortable by talking to them as well as assessing their needs. You will still have to be responsible for your primary duties such as taking vital signs and reporting any issues to the nursing staff.

During this time, it is also still important to remember the basic fundamentals of caring for the patient. Keep the patient clean by giving them frequent baths and monitor any hygiene issues. If the patient is unable to get out of bed, change their position every two hours or more frequently as needed. Help the patient get into whatever position is comfortable for them.


Q.  What is palliative care in terms of patients who are not likely to recover from their illnesses (terminally ill)?

A.  Palliative care is a term used for care that is provided for patients who are not likely to recover from their current medical conditions.  This type of care is to be a total and comprehensive care.  The care is to address a variety of needs of the individual including their physical, psychological, spiritual and social needs.

Explanation:  This care is intended to help keep patients comfortable when they are terminally ill.  It is intended to help patients and families when an individual is terminally ill.  A CNA will be a part of this care in many settings. The CNA should provide compassionate and kind care and extend their care to the family and friends of the individual who is not likely to recover from their medical conditions.

Q.  How can a nursing assistant help a patient to have improved “spirits” even if they are not likely to recover from their illness?

A.  Nursing assistants can help patients to have a more positive attitude even if they are not likely to recover.  You can do this by providing empathetic and compassionate care.  Take the time to listen to patients if they express feelings of frustration, fear, etc.  Provide encouraging words.  Try to encourage patients to continue with their daily activities and to eat.

Explanation:  Patients who are not likely to see a full recovery will have many emotions.  Provide al listening ear for patients whenever you can so they can work though some of those emotions.  Provide encouragement when a patient sees some improvement.  Remind patients the importance of eating and completing other activities to keep up their strength.  You can help a patient to feel better emotionally even if they are not going to improve physically.

Q.  Why is it important for a CNA to take good care of themselves so they can take good care of terminally ill patients?

A.  You need to take good care of yourself so that you can care well for your patients.  Get a good night’s sleep before your shifts.  Do not skip meals.  Find someone you can take to when you are sad about a patient who is in declining health and not expected to recover.

Explanation:  When you take good care of yourself, you will have better health and more energy to care for your patients.  You will also have an improved mood which will make it more possible for you to help you own patients keep a positive attitude.  It is sad to work with patients who have terminal illnesses.  You should always have someone you can talk to about your own feelings when a patient is not doing well or when a patient has passed away.

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