End of Life Care: The Elderly Patient

• End-of-life care needs to ensure that comfort and pain are managed.   
• Spiritual and emotional needs must not be overlooked and serve as a critical component to end-of-life nursing care. 
• After death care must be completed as an act of service and courtesy to the family/caregivers. 

What Families and Caregivers Expect During End of Life Care

Family members often look to the nurse to help them understand what to expect when a loved one is dying.  It is important as a nurse to show one’s desire to be helpful during this time. 

As a nurse, this can be demonstrated by being available to answer questions and manage any requests the family/caregivers may have.  If the nurse is unsure of the answer to a question or a request that has been made, it is imperitave to connect them to the appropriate resources. 

Family members and caregivers typically appreciate the extra efforts being made during such a difficult time.  It is equally important to be knowledgeable and aware of the primary family contact if death occurs.  

My Personal Nursing Experience With End Of Life Care

Prior to pursuing a nursing degree and also during my experience as a nurse in long term care I have provided end-of-life care to several elderly patients. I was granted the opportunity to work as a personal care assistant at an assisted living facility, and it was during this time of providing end-of-life care to a resident that my desire to become a nurse, specifically a long-term care nurse, was solidified.   

To this day, I still remember doing frequent rounds on that particular resident, holding their hand, and simply being a source of total comfort and support during their last moments – a true representation of end-of-life care.

Managing Pain and Ensuring Comfort During End of Life Care

Discomfort during the dying process can come from a variety of sources. Pain, breathing problems, skin irritation or itching, digestive issues, temperature sensitivity, and fatigue are all possible causes of discomfort.   

As a nurse, it is important to investigate the source of discomfort and provide appropriate nursing interventions in a prompt manner to ensure that comfort is being established as much as possible.  A collective coordination that includes the family/caregivers, primary care provider, and the hospice team is vital for quick intervention and positive outcomes.

Spiritual and Emotional Needs During End of Life Care

Ensuring the patient’s spiritual needs during end-of-life care is important as it assists in providing support and ensuring that the patient’s desires are followed.   

Many elderly patients may wish to have their pastor and close church members nearby during their end-of-life experience.  Emotional support is also necessary as the elderly patient may become fearful, uncertain, and anxious about the events leading up to one’s end-of-life journey.   

It is important to remember that all dying elderly patients may not have family close by to assist in providing these needs and the patient may look to the nurse for this support.  Depending on what stage the patient is in during the dying process he/she may or may not be able to verbalize his/her needs.   

For this reason, it is vital to acknowledge body language and non-verbal cues that indicate additional emotional support is needed.  An example of this can be the patient reaching out his/her hand to hold the nurse’s hand and desiring emotional support to promote a sense of calm and peace for the patient.  

After Death Care

After the elderly patient passes, it is important to tidy up the room and ensure the patient looks as peaceful and comfortable as possible.  It is a crucial step to clean the patient, if necessary, to ensure that any foul-smelling odors are eradicated.   

Any nursing equipment that is no longer needed in the room as well as other unnecessary items should be removed in order to allow space for family members/friends/loved ones to gather and spend time in a peaceful and uncluttered atmosphere.    

The Bottom Line

As one can see, providing end-of-life care can be emotionally and physically exhausting but the patient’s family/caregivers are dependent on the nurse to provide high quality and compassionate care to their loved one.   

Nurses also need to be aware of various self-coping mechanisms during the dying process and the importance of practicing self-care.  Nurses can easily become attached to elderly patients they have taken care of and talking to other staff members may be beneficial in overcoming one’s grief.   

While end-of-life care has its own set of obstacles for the nurse, it is important to remember the important role and impactful meaning the nurse plays in the final moments for each patient and the sincere respect that is offered to family/caregivers.    

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