End-Of-Life Care for Mr. Stephens
Mr. Stephens is an elderly patient at Morningstar Hospital who has a terminal illness. There is no cure for his type of cancer, and the treatments for it are no longer working for him.
Mr. Stephens spoke with his doctor about his end-of-life wishes, and his doctor discussed end-of-life procedures with him. They talked about whether Mr. Stephens would like life-sustaining procedures near his death in order to keep him alive. Mr. Stephens thought about it, and he talked it over with his daughter. He decided that he did not want to be kept alive by machines to help him breathe or by other devices. Mr. Stephens signed a do-not-resuscitate order (DNR) so that the medical staff at the hospital knows his wishes. The staff will continue to provide care for him, but when he is very close to death, they will only provide comfort care, also called palliative care. Mr. Stephens will continue to receive this regular care, such as personal care and medications, but machines will not prolong his life.
Recently, Mr. Stephens’ health has declined. His nursing assistant Paul knows that Mr. Stephens will die soon. Paul has grown close to Mr. Stephens. He encourages Mr. Stephens to share how he feels, including his fear and sadness about his illness. Mr. Stephens gradually comes to accept that he will die soon. When his family visits, they share good memories from the past. They know that he is in pain, and they do not want that pain to continue.
Paul checks on Mr. Stephens frequently. He notices when Mr. Stephens shows the signs of dying, including difficulty breathing. Paul repositions Mr. Stephens’s body when necessary and wipes his face with a damp washcloth. He also contacts Mr. Stephens’s daughter so she can visit her father before he dies. Paul knows that both physical comfort and emotional support are important when providing end-of-life care to his patients and to their families.