how do you tell people their loved one is near death?

if you're a nursing assistant, it is not your responsibility to tell the family anything....you should refer any questions to the nurse.

Purple, you did well to involve the family in the care. As Earle states, refer questions about their meds or prognosis etc to the nurse. Its nicest if you can say something like "I'll tell the nurse you have some questions for her" and then go fill her in. That way she will have a few minutes to prepare by checking to see what meds the patient had when and maybe reviewing the chart a bit if necessary. If the family is having trouble coming to acceptance of the disease process, she may need a few minutes to think about how best to help them with this.

Families want to know that their loved one has been comfortable and well taken care of so its helpful to tell them of things you did or observed that demonstate that...such as "I changed and repositioned him about 1/2 an hour ago and he's been resting quietly since then", or "he was a bit restless earlier but after I gave him his bath he was much more calm."

It is natural that you should feel grief when the people you have assisted die. There is a bond there, even if you only cared for them once. Take solace that you made their last days or hours a bit better though with your best efforts to make them comfortable.

I agree with above posts. A couple of things come to mind in reading your post. Something that you can do is to ask the family about what his life has been like. They usually recall the good times they've had with him. Nothing wrong with a comment such as, "he's lived a productive life." Or "He's really lived a special life, hasn't he?" It just brings back good memories and helps the family to remember how special their time with him has been.

Another comment you made:

"and then they're gone." I really look at it as if they went home. If a person has any spirituality, the feeling is that the life here on earth is temporary. We will meet again.

There is a book called, "Healing Conversations: What to say when you don't know what to say." Author: Nance Guilmartin. Very good. I saw the author speak and really enjoyed her.

You sound like a very caring person. Thanks for all you do. You can take care of me any time! (I'm headed for the Alzheimers Unit any day now!

I agree with Earle it is up to the MD or the licensed to discuss the residents condition and prognosis with the family. With Hippa you can only discuss information to people who are legally entitled to have it, and only in the area that concerns you. Once you have confirmed with your charge nurse who those people are you could tell them if you gave the patient a bath, how much the patient ate, the things a nurses aid does for a patient. Giving medical advice and telling them that their loved one is going to die is legally out of your scope.

I agree with the above posts. It is beyond the CNA's scope for a CNA to inform a pt or family member about any diagnosis or prognosis, or to express a medical opnion on such. You could get in a lot of trouble for doing that. In fact, I worked with a wonderful CNA who did get in a lot of trouble. We worked in a hospice, so the CNA assumed the pt knew he was dying. The pt did not know this, and the family member who had Power of Attorney did not want the pt to know. The POA really raised a big stink about what the CNA said to the pt. She almost got fired, which would have been tragic. she was the best CNA I've ever worked with. She just made a mistake.

Do you know for a fact that the pt is dying? Is the pt on hospice, or have you been told by a nurse or doctor that the pt is terminal?
In any case, a physican must inform a pt of family that in his professional judgement, a pt is terminal. Even a nurse can't give a prognosis.

As a CNA You cannot tell the patients family anything regarding the pt status...all questions should be referred to the RN. Aides are an important role in patient care and in the hospice setting it is your responsibilty to make the patient as comfortable as possible,giving a hug here and there. Be thankful that you can refer questions to the RN..there are times I wish I could do the same