Guidelines for In-Patient Hospice Post Mortem care

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[color=#7f007f]does anyone have written guidelines for an in-patient hospice for pm care.?

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[color=#7f007f]a written guideline will hopefully prevent misunderstandings and false accusations when staff are observed doing different things.

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[color=#7f007f] i work in a multi-cultural hospice where change can be seen as a threat. i am in the firing line next week at our staff meeting .:eek:

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[color=#7f007f]i have a ton of hospice experience as an rn internationally starting in london with dame cicely and including 20 years in the usa i also trained as an lmt and offer alternate/complimentary therapies to those that request them.

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[color=#7f007f]please read some of the extras i have been including in my pm care and give feed back as to whether you have done these things yourself and if you think they are a good idea or not.

[color=#7f007f]if i know the patient well and we have talked about how they want to die then it is easy to respect wishes. obviously the family are includued in this process.

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  • giving a full bed bath and making every effort to present the body to look as immaculate as possible for the family .yes, and that includes the patient who had a bed bath one an hour ago.
  • asking the family if they wish to participate in the last bath to allow closure. when family is not available having 2 staff members/ perhaps a volunteer work together. i was taught that since most patients develop a terminal fever it's nice to bath them .it seems from reading other threads on this topic that this is a matter of personal opinion and there are no set guidelines. obviously if they have a religious /spiritual preference for handling the body then we respect that .personally my belief is that we are midwifes and just as a midwife baths a new born baby, so the hospice nurse baths her patient for the next journey. also it's not good to send a stinky body to the morgue!
  • placing a flower on the bed /pillow if a lady. making the room clean by removing all medical equipment and supplies. making it appears like "home". making sure a box of tissues are nearby and chairs and available for the family. i also try not to dress the body a ghastly hospital gown and try to use colored sheets so it feels more like home.
  • handling the body with the same gentleness and respect (as if they were still alive) right up to the point of leaving in the pick up vehicle. i always follow the deceased as they wheel them out and watch that they are gently placed in the vehicle. i support family members as the body leaves the building as this is can be incredibly painful goodbye
  • making the room smell good with a hint of aromatherapy if permitted.sometime playing relaxation music.
  • offering to light a candle if permitted and obviously no o2 around

[color=#7f007f]would anyone be interested if a wrote an article / book on this subject as .this is very close to my heart and a part of hospice care which i feel should not be skipped. :redbeathe

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hi solacetherapy

sorry to hear you are having problems.....to be honest...I work in Australia in a cardiac ward have always tried to treat deceased pts with dignity and respect by doing all the things you mentioned...I think thats the very least we can do..... are you saying that where you work this is not the norm.....all pt should be washed and treated with care....I even try and find a flower to put an their gown, male or female....I think it helps to reach closure for nurses knowing that they have done the best for the next journey ahead to "Rose Cottage"

hope this helps

umina :nurse:

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Hello Down Under..wow I did not expect to hear from a cardiac nurse .Its very nice to know that you do the same for your patients ..love the bit about Rose Cottage

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

I also am pretty fastidious about post mortem care...I do not have flowers, though. I do not work in the inpatient residence...this is the care I provide in the field.

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Specializes in LTC, Home Health, Hospice.

Post Mortem Care is kind of a touchy area especially when you are dealing with different cultural backgrounds. Each have their own "ritualistic way of cleaning the newly deceased"

1. Clean Body

2. Freshly shaved if man tried to keep their face shaved

3. New bed linens, not wet in any fashion.

4. Clean neat clothes.

5. Clean Hair

6. Combed hair

7. Oral Care!

8. Please make sure you put a disposable diaper on! and dont leave a "bunch in front"

9. Put Dentures in mouth

10. Hands neatly folded or overlapped on abdomen (use rolled wash rags to hold arms in place if possible)

11. top linens neat, quarter fold at top

12. Body Straight if possible

13. Clean over bed table and side table

14. Tissues at each table

15. Fresh Water and ample cups

16. Coffee if you can!

17. If in the home, you can set the mood, allow for grieving, but enforce the "Happy times/thoughts"

18. If in the Facility, time is not on the families side, usually 2-3 hours. Be very considerate as to the family..go out of your way to make them comfortable, show tons of compassion for their newly departed loved one.

19. Dont be afraid to HUG the Family, express your condolences to them. They need you.

20. Job well done.

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Thanks so much for taking the time to reply I really appreciate the feedback:)

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