LAST HOURS OF LIVING
Preparing for the Last Hours
Saying Goodbye
Signs of Dying
Neurological Failure • Altered level of consciousness • Abnormal breathing patterns • Apnea • Cheyne-Stokes • Shallow tachypnea • Agonal breathing • Loss of swallow / gag • Oral / tracheal secretions • Delirium (irreversible) • Hyperactive • Hypoactive • Loss of sphincter control Cardiac Failure • Tachycardia / hypotension • Venous pooling / mottling • Cyanosis • Peripheral cooling Renal Failure • Oliguria / anuria
Advance Care Planning • Healthcare power of attorney • Advance directives Financial Planning • Bank accounts, ‘or’ not ‘and’ • Credit cards • Loans, mortgages • Business power of attorney • Insurance • Retirement benefits Legal Planning • Estate distribution • Will / last testament • Trusts • Guardianship • Dependents • Pets Spiritual • Prayers • Rites • Rituals
Digital Footprint / Social Media • List of accounts • Passwords Donations
Empowering the Survivor • I will love you always • I hope you will never forget me • Please find a new partner • Have a very successful life! Saying Goodbye • I love you • I hope you love me • I forgive you • I hope you forgive me • Goodbye
• Organ / body donation • Gifts to family / friends Dying
• Where will be acceptable • Enrollment in hospice / palliative care • Skills for the caregivers • Anticipated changes After Death • What to do when death occurs • Death certification • Burial, cremation • Funerals, memorial services
37 NB: These Reference Cards do not replace careful clinical judgment specific to each patient / family situation. PCIC: Palliative Care Interdisciplinary Curriculum is a collaborative effort of OhioHealth, The Ohio State University Wexner Medical Center, and Nationwide Children’s Hospital in Columbus, Ohio, USA, and other contributors. Permission to reproduce any or all of these PCIC Reference Cards is granted for non-commercial educational purposes only, provided that the attribution statement and copyright are displayed. To reproduce for all other purposes, contact Frank D. Ferris at info@pallmed.us. Copyright © Frank D Ferris 2013-2024. All rights reserved. V14.1, 2024
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