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Planning for the Actual Death 

Planning for the Actual Death
Chapter:
Planning for the Actual Death
Author(s):

Patricia Berry

, and Julie Griffie

DOI:
10.1093/med/9780190862374.003.0033
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date: 18 October 2019

This chapter examines and addresses the critical role that nursing has in facilitating a “good death”—however the patient and family define it—including care before and after the death. As death nears, there is only one chance to “get it right.” In addition to summarizing the symptoms that are common and intensify as death nears, the chapter presents a nursing framework for working with patients and families during this stressful yet meaningful time. The chapter also revisits and discusses, in the context of approaching death, issues related to advance care planning, a family goals of care conference, vital signs, medically administered fluids, cardiopulmonary resuscitation, and discontinuing dialysis. Signs and symptoms of impending death and postmortem changes are summarized to enable the nurse to interpret and normalize these changes to those present before and after the death. The chapter concludes with a discussion of how the nurse can facilitate the early grieving process.

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