Chapter 6: Physical Care
Overview:
- Necessary and unnecessary medications are explained
- Pain Management is discussed in depth
- Essential physical care topics such as hygiene, continence, mouth and skin care are explained
- Case studies are provided to highlight each point raised
- Importance of nutrition and hydration in terms of the person’s best interests are discussed
- Causes and aids to issues such as fatigue, dysphagia, dyspnoea, nausea and vomiting are explained
Description:
This chapter discusses the common physical signs and symptoms of older persons who are dying. It looks at various types of patients from those who find the dying process to be gentle deterioration with no distressing symptoms to others who find it accompanied by varying degrees of discomfort and how they should be cared for. Also discussed are the aged care staff’s responsibilities of undertaking continuous assessment, reporting and documentation of signs and symptoms by careful observation.
Topics:
- Introduction
- Medications
- Family meetings
- Necessary and unnecessary medications
- Regular and frequent reviews
- Pain management
- A collaborative approach
- Assessment
- Consent
- Route of administration
- Use of opioids
- Incident pain
- Education
- Non‐physical causes of pain
- Hygiene and grooming
- Continence care
- Constipation
- Mobility, skin care, and positioning
- Mouth care
- Nutrition and hydration
- Social significance of food and drink
- End‐of‐life choices
- Tube‐feeding
- Weight loss
- Acting in the person’s best interests
- Fatigue
- Nausea and vomiting
- Dysphagia
- Dyspnoea
- Documentation
- Support
- Conclusion
Speaker / Author:
Rosalie Hudson
Rosalie is a registered nurse and consultant/educator in aged care and palliative care with 12 years experience as the director of nursing of a 50 bed nursing home. She provides in-service training to residential aged-care and palliative care services, as well as being a contracted educator with Alzheimer’s Australia (Victoria). Rosalie has also worked in hospice/palliative care, including management roles in both community and inpatient settings. In addition to being a registered nurse, Rosalie holds a bachelor’s degree in applied science, bachelor’s and master’s degrees in theology, a graduate diploma in gerontological nursing and a PhD. Her work has been published widely in nursing and theological journals on end-of-life issues, palliative care, pastoral care and the ethics of aged care. She has also been the author or co-author of five books and 12 book chapters.
Rosalie is an associate professor and honorary senior fellow at the school of nursing in the University of Melbourne, where she teaches undergraduate and postgraduate nurses in aged care and palliative care. From 2002 until 2004 Rosalie was the project manager (Victoria and Tasmania) for developing the government-sponsored Guidelines for a Palliative Approach in Residential Aged Care. In 2007 Rosalie was involved in the preparation and teaching of a new unit entitled ‘Spirituality and Health’ for undergraduate nurses at the Australian Catholic University. She is a frequent speaker at conferences both nationally and internationally.
Margaret O’Connor
Margaret holds the Vivian Bullwinkel Chair in Palliative Care Nursing, School of Nursing and Midwifery, Monash University. In this role, she liaises closely with clinical partners in Peninsula Health, the Peninsula Hospice Service and the Royal District Nursing Service. Margaret is also responsible for the palliative care research team in the School of Nursing and Midwifery and manages several clinical research projects in the areas of service systems, cultural issues and care of veterans at the end of life.
In addition to being a registered nurse, Margaret holds a master’s degree and a doctorate in nursing, and a bachelor’s degree in theology. She is a fellow of the Royal College of Nursing, Australia. Margaret sits on many state and national committees related to palliative care and has had many articles published in her areas of research. In 2005, she was made a member of the Order of Australia for services to the development of palliative care in the state of Victoria. Margaret has been president of Palliative Care Australia since 2006.
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