Signs and Symptoms of Approaching Patient Death in Hospice Care

1. The Hospice Interdisciplinary Team

Hospice care is a unique specialty of care provision where dying comfortably and with dignity is the primary goal of care for the patient and the family/caregiver. An interdisciplinary team approach is utilized to implement patient/family-focused goals of care that are aimed at an optimal death experience. This chapter defines the hospice interdisciplinary team and reviews its structure, function, standard practice, and collaboration. In addition, this chapter identifies the elements of hospice care provision by the interdisciplinary team to the patient and the family/caregiver as death approaches.

2. The Signs and Symptoms of Approaching Patient Death

There are general physical and behavioral signs and symptoms that are indicators of approaching patient death in the weeks and days before actual death. This chapter defines the general signs and symptoms of imminent death and how the interdisciplinary team manages those signs and symptoms to help the patient achieve a peaceful and dignified death.

3. Hospice Nurse Management of the Patient’s Plan of Care

The hospice nurse is a part of a larger interdisciplinary team that cares for the patient and the family. The nurse is designated as the manager of the patient/family plan of care and serves as a coordinator of care for the entire hospice team. This chapter will examine and explain how the hospice nurse manages the individualized patient/family plan of care for the interdisciplinary team.

4. Management of Patient Death by the Hospice Team

Patients receiving hospice care die in various settings with the support of the interdisciplinary team. Patient and family/caregiver needs are individualized at the time of death. The interdisciplinary team works to identify and meet those needs throughout the death process and at the time of the patient’s death. This chapter will describe the process of a visit by the hospice nurse and other hospice team members prior to or at patient death and the care of the patient and the patient's family/caregiver. This chapter will also examine a case study related to management of a patient’s imminent death by the hospice interdisciplinary team.