[CANRN]

Originally Posted by GrumpyRN63

ditto

Your right, because this is a Hospice forum, we all assumed that anyone posting on this board would understand the Hospice philosophy of care.

Hospice is a philosophy of care which provides end of life care to patients and their families who no longer wish to have curative treatments for their illness. The illness or disease process, would ultimately cause the patient's death if untreated, within a 6 month time frame, should the disease follow it's natural course. That does not mean the patient is kicked off hospice if they do not die within six months!

Most of theses patients have chosen to die in their homes, or hospice inpatient units and most of them, have Do Not Resucitate orders.

When the patient passes, they are not considered a case for the coroner's case. As a hospice nurse, we are called to the home to provide emotional support to the families, provide post-mortem care to the patient, such as cleaning them, changing their briefs, gowns, or whatever. Many patients have excessive body fluids in the form of sweat, urine, and feces. The nurse will also notifiy the attending MD to let him know when vital signs ceased, and the MD will call the death. This however, depends on each state's regulations.

This is a nutshell version, there is much more to hospice, but I was trying to give a very brief over-view for someone who might post here that is not a hospice nurse or who is trying to learn more about hospice.

Hope this helps some.
Cindy

[mc3]

Originally Posted by Chaoticdreams33

With all due respect, perhaps someone should explain what Hospice is to this person...

[Bullakey13]

Thak you for the Information..I apologise for calling it a death wash...My lecturer used that term ad at the time of joining the forum I used the term she used in the lecturer cos I did not know what else to call it...I didnot mean it disrepctively..I just didnot know anyother term for it..Than you reading all the replys have helped me understand that it is part of our duty...I just had never know about any of the thinks that happen when we die..Call it me being naive but i was so involved with getin my head around treatin patients when they are alive I just never thought of dead..Silly hmm..Put it down to naivety...I am so sorry for offending anyone and again thank you I am not so scared now

[CANRN]

Originally Posted by Bullakey13

Thak you for the Information..I apologise for calling it a death wash...My lecturer used that term ad at the time of joining the forum I used the term she used in the lecturer cos I did not know what else to call it...I didnot mean it disrepctively..I just didnot know anyother term for it..Than you reading all the replys have helped me understand that it is part of our duty...I just had never know about any of the thinks that happen when we die..Call it me being naive but i was so involved with getin my head around treatin patients when they are alive I just never thought of dead..Silly hmm..Put it down to naivety...I am so sorry for offending anyone and again thank you I am not so scared now

Awww No problem. I guess we all get so caught up in what WE know, we tend to think it is common knowledge. So sorry if we came down too hard. HOspice nurses really are nice people!

[redding-er-rn]

Thank you, Family appreciates it also as many don't think of "sending them out clean".

[NurseyPoo7]

Originally Posted by CANRN

I alwyas, pull the catheter, clean the body, change the gown, comb their hair and spray the room with air freshner (a small bottle I carry with me, has a nice fresh scent). I can not imagine someone thinking it is not okay or simply not doing it. One of our nurses actually got written up for not doing it when a funeral home complained. (I guess the man threw up on himself, etc and the new RN, a male nurse, never cleaned the body and just sent him on his way). I thought this was taught in nursing 101.

I learned nothing about post mortem care during nursing school.

I learned about it here and through research (I have a little obsession with medical examiners and death/dying.. not to sound morbid. I just find it very interesting)

[jeannepaul]

I usually ask the family what they would like me to do. Some families do not want me to do a complete bath. but I still wash the head, face, check the brief. With some families, I so everything including painting nails and fixing hair.I never take out the foley. The funeral homes actually prefer us not to take it out because during transport, urine usually leaks and it is cleaner for them to leave it in. I just empty the bag.

[redding-er-rn]

Since this is a Hospice thread in most cases the coroner may be notified but as the person is on hospice the death is "expected", therefore not a coroners case for investigation. As far as washing the body it is all about family preference. I ask the family if they would like to help in all cases, some prefer to do it all themselves. I always check the bottom and change briefs/depends and was hands and face at a minimum. Enbalming is not required in all states. Thanks you for the information on skin and embalming, I was not aware of the potential "problems" if skin is damaged.
As far as Nurses or CNA doing post mortem care, it was covered and expected to be done if a pt died in my first semester of nursing school.

[redding-er-rn]

[quote=DDRN4me;2825228]

Originally Posted by Ronvalder

I have never heard of a RN or CNA, or anyone doing postmotem care....except a Mortician. A dead human body has to be treated in a certain way. This is what Morticians learn in Mortuary College. Changing a person's clothes after death, washing the body, closing the eyes and mouth are a Mortician's job....not a Nurse!

If you pull too hard on an eyelid and break the skin it will leak for hours after the body is embalmed. A scratch to an arm after death will also leak after embalming. All sorts of dammage that can be done by a well meaning Nurse. Any dammage to the skin after death will be a problem after embalming. Running a brush through someone's hair will leave marks on the scalp....many problems will occur during and after embalming if the body was not cared for by someone who is trained to take care of the dead. Washing, drying, moving arms and legs, closing eyes and mouth are all things that will dammage the tissues.


sorry, in more than 30 years as a cna then a nurse i have never heard any of this... and in the "old days" we ALWAYS did complete post mortem care. I havent worked in Hospice so I cant speak to that; but as a nurse I know I would feel neglectful if I didnt do pm care.

The correct thing to do is to cover the body with a sheet and call the Funeral Home or the Coroner. You should never fuss with a Coroners Case because you'll destroy evidence.

????? evidence??/ like expelled feces and urine etc???

Since this is a Hospice thread in most cases the coroner may be notified but as the person is on hospice the death is "expected", therefore not a coroners case for investigation. As far as washing the body it is all about family preference. I ask the family if they would like to help in all cases, some prefer to do it all themselves. I always check the bottom and change briefs/depends and was hands and face at a minimum. Enbalming is not required in all states. Thanks you for the information on skin and embalming, I was not aware of the potential "problems" if skin is damaged.
As far as Nurses or CNA doing post mortem care, it was covered and expected to be done if a pt died in my first semester of nursing school.

[heron]

re: coroner's cases ... it depends on state regulations.

Hospice pts. die of all sorts of things, including crimes ... it should be noted in the pts chart whether the death is to be reviewed by the medical examiner. In my state, any death following a fall or other accident within 6 weeks has to be called into the medical examiner ... usually they just want to review the chart, if anything ... but we still have to call.

When I worked in Massachusetts, any death of an inmate in custody was a medical examiner case.

It should have been covered in your hospice orientation ... if it wasn't, check with your state authorities.

BTW, we always clean the body unless the medical examiner takes jurisdiction, including changing any soiled linens. It's simple respect for the dignity of the pt. and feelings of the family - especially if they're saying goodbye at the bedside.

A rolled towel to keep the mouth closed works well. A little discreetly applied surgilube can help keep the eyes closed if there's been a lot of peri-orbital wasting.

I have yet to successfully place dentures after death ... any tips?