End of Life Care Worksheet

The final stage of grief (in response to near death) when person has worked through feelings and understands that death is imminent
A living will written while resident is mentally competent or by resident's legal representative which outlines choices about withdrawing or withholding life-sustaining procedures, if terminally ill
The second stage of grief (in response to near death) when person expresses rage and resentment; often upset by smallest things; lashes out at anyone
Respiration stops
The third stage of grief (in response to near death) when person tries to arrange for more time to live to take care of unfinished business; bargains with the doctors or God
When resident takes several shallow breaths followed by periods of no breathing for 5, 30, or even 60 seconds; does not cause the resident discomfort
The end of life and cessation of bodily functions
The first stage of grief (in response to near death) when a person is told of impending death; person may refuse to accept diagnosis or discuss situation
An order written by a doctor at the request of a resident, which tells the health care team that the resident does not wish any extraordinary measures to be used when resident suffers cardiac or respiratory arrest
The fourth stage of grief (in response to near death) when person begins the process of mourning; cries, withdraws from others
The near end of life and near cessation of bodily functions
Support and care provided during the time surrounding death
Interventions used to restore heart beat or respiratory effort
Cardiopulmonary Resuscitation
Stages of grief in responses to near death, based on personal, cultural, and religious beliefs and experiences, according to Elizabeth Kubler-Ross
Health care agency or program for people who are dying (usually less than 6 months to live) that provides comfort measures and pain managment, preserves diginity, respect and choice, and offers empathy and support for the resident and the family
Changes in skin color (pale or bluish) of the hands, arms, feet, and legs when death is near
A descripition (typically placedin a local newspaper) of a resident's life, including listing of relatives, birth information, accomplishments/activities, and death, written upon the death of the resident
Care of the body after death