Comfort Care

RE air hunger/sob....

When Oxygen/morphine doesn't help, found good old table based plastic fan oscilating back and forth often will move air across patients checks and decrease sense breathlessness/ no air.

Really helped my COPDer's.

I've fanned people with magazines and such. Feeling the air does help some people a lot.

oh yes, a fan works wonders!!
it's right up there with the morphine, and even more valuable than o2...
esp when they're wearing nasal cannulas but are mouth breathers.

leslie

Comfort care does mean not checking vitals but

If you think someone is running a fever (very common at EOL), you can check the temp (auxiliary if it's intrusive to do oral) before administering acetaminophen (which should be part of your comfort orders set).

You might want to check O2 sats if you think you need to add/adjust oxygen

If someone is diabetic with erratic bloodsugars (esp if they're on steroids) you might want to check BG and administer insulin if they're over 300 (can be very uncomfortable)

Just as I said in another thread, comfort means doing what is necessary to keep the person comfortable -- for example, while you might not keep to a strict Q2H turning schedule, you may want to reposition at least 1x/shift to keep muscles from getting tight.

I really, really really try to stay away from any suctioning beyond use of a yanker as it really is more disturbing that helpful. Atropine drops can help with upper airway secretions w/o being invasive.

Also, remember that sometimes you are treating the family as well as the patient. Going in and checking on your patient, making changes as needed, meticulous oral care, lotion/massage, talking to them (and any family present) -- it's all part of good care and the family will not feel like thier loved one is abandoned.

(Along the same line, while it's common to put someone in a single room so that they and family can have privacy, it's also important to not ignore them "because there's nothing more we're doing for them.") Do not isolate a dying person.

If your floor has access to a boombox & music that can be a nice touch.

Fan's are great for SOB