Question about hospice patients

[neuron]

Hi,

I have a question about hospice care. I have a CNA and am working in home hospice (and sometimes in a facility -when needed). I am concerned with their unresponsive state (days/even hours before death). What do nurses/experienced CNA's think about repositioning? The ethical issues is to give care until they pass, but I do not want to harm them in their last stage state. Are there any views on this? I had a hospice patient last week and I repositioned every 2 hours (7pm - 7am shift), although very heavy :) - she was not 'end stage'. Question is, two hospice patients that I had were in their front position for a few days (before 1 passed) and I am concerned whether to 'reposition' when they appear comfortable. Sometimes the family does not want the person giving care to move the client.

Any suggestions?

Thank you

[NursieDP]

A lot depends on the family, but I try not to move them if they are comfortable unless I have to ( cleaning, assessing).

[Caffeine_IV]

If they have family I will ask. Beyond that I use my judgement. If they had pain or distress that was difficult to control and we had them settled, I would ask that they not be moved. I work inpatient hospice. Actively dying patients being repositioned is not a priority unless it aids In their comfort.

[tewdles, RN]

Use your judgment and that of the family.

I am old(er), if I lay in one position too long it gets uncomfortable...I keep that in mind when I assess my patients.

Thank you for considering how to keep your patients most comfortable.

[loriangel14, RN]

I will take the wishes of the family into consideration and not move them if that's what they want. Other wise I will turn them side to side but it's a very slight turn with a pillow under the hip to relieve the pressure on the coccyx.

[prettymica, ASN, BSN, MSN, LPN, RN, APRN, NP]

Positioning is not priority when actively dying,unless its causing severe discomfort. I only move the patients for necessary ADLs.