Manage Dying - Residential Aged Care
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Manage Dying

This section reviews resources to assist you in recognising that someone is imminently dying and to provide support for dying residents and their families.

Manage Dying - ELDAC Care Model
Recognising Dying

While individuals may differ in their signs and symptoms of dying there are some common indicators that a person may be in the final days of life. These include:

  • Signs and symptoms associated with the terminal phase
  • Experiencing rapid day-to-day deterioration that is not reversible
  • Requiring more frequent interventions
  • Becoming semi-conscious with lapses into unconsciousness
  • Increasing loss of ability to swallow
  • Refusing or unable to take food, fluids or oral medications
  • Irreversible weight loss
  • An acute event has occurred requiring revision of treatment goals
  • Profound weakness
  • Changes in breathing patterns

Some organisations have a specific care plan for residents in the final days or weeks of life. The use of an end of life care pathway or terminal care plan may help to focus the care required for residents in the last days or weeks of life. palliAGED has a downloadable Practice Tip for End-of-Life Care Pathways for Nurses (pdf 330kb) and Careworkers (pdf 451kb)

The Residential Aged Care End-of-Life Care Pathway (RAC EoLCP) is available for download from Metro South Health in Queensland and the document is licensed under a Creative Commons licence. There is no cost associated with downloading or using the RAC EoLCP document. However, you must agree to the terms of the licence. The website also offers further information and guidance on using the RAC EoLCP.

Talking About Dying

Talking about death and dying can be difficult.

CareSearch provides an End-of-Life Essentials factsheet on discussing the process of death and dying (127kb pdf). Even though the End-of-Life Essentials resources were designed for use in hospital settings, the factsheet provides useful phrases for discussing the process of death and dying.

palliAGED has a downloadable Practice Tip on Talking About Dying for Nurses (pdf 315kb) and Careworkers (pdf 454kb)

End of Life Medications

Assessment and management of symptoms is critical for dying residents. Information about medication is available on the CareSearch GP Hub - End of Life Symptoms webpage including:

1. An overview of key points guiding quality pharmacological management of end of life (terminal) symptoms.

2. Prescribing information for managing common end of life symptoms: Pain; anxiety and emotional distress; delirium that is causing distress; excessive secretions; nausea and vomiting; and shortness of breath.

Syringe Drivers

A syringe driver are commonly used for symptom management and are used to provide continuous medications subcutaneously when a person is no longer able to swallow.  More information and resources about syringe drivers can be found at this CareSearch webpage.

palliAGED also has information on Subcutaneous Medication Administration.

After the Resident Has Died

There are legal regulations and laws concerning death certification and coronial procedures. Death is to be verified and depending on which state or territory you are in this may be done by a nurse or doctor. Certification of death must occur which is usually by the General Practitioner. In some instances deaths must be reported to the coroner.

palliAGED has a downloadable Practice Tip on After-Death Choices for Nurses (pdf 220kb) and Careworkers (pdf 442kb)

ELDAC Toolkit Educational Video

Watch the ELDAC Manage Dying educational video will help you to recognise deteriorating health; implement the Residential EOL Care Pathway and identify the changes that show death is near.

  • Assessment Tools
  • Family Resources

The Residential Aged Care End-of-Life Care Pathway (RAC EoLCP)

Available for download from Metro South Health in Queensland, the RAC EoLCP document is licensed under a Creative Commons licence. There is no cost associated with downloading or using the RAC EoLCP document. However, you must agree to the terms of the licence.

Palliative Care Australia

Palliative Care Australia has a webpage and accompanying handout on explaining the Dying Process including changes that family might notice, how to know that death has occurred and what they can do to help.

CareSearch

CareSearch offers a suite of resources for families with information on what to expect during the final weeks. Supportive materials include: Saying Goodbye; Family issues at the End; and Changes at the Time of Death.

PalliAGED

PalliAGED has information to support families who are dealing with a loved one dying. There are family resources on the end of life to help explain palliative care and what to expect.

Page updated 29 June 2020