Caring for terminally ill clients

As a nursing assistant, you will be caring for clients that have a terminal illness. It’s important to learn about these diseases and how you can provide the best care for these clients. A terminal illness is a disease for which there’s no cure.

Common examples include various types of cancers; heart diseases; respiratory problems; kidney disorders; and liver diseases; as well as chronic infections, such as acquired immunodeficiency syndrome, or AIDS, which is caused by the HIV virus.

Although there’s no definitive treatment for terminal diseases, it’s important to ensure that these clients will receive palliative care, which focuses on alleviating the client’s symptoms in order to make them feel as comfortable as possible.

The goal of palliative care is to improve the client’s quality of life and it can be provided in healthcare centers, such as hospitals and long-term care facilities, but also at home.

The most common examples of palliative care are medications to relieve pain and oxygen therapy for clients with difficulty breathing.

Surgical procedures, chemotherapy, and radiation therapy that will not cure the disease but will reduce the client’s symptoms are also forms of palliative care.

Clients with a terminal illness that have approximately six months left to live can also receive hospice care. Hospice care focuses on the client’s physical, emotional, and spiritual needs.

Similarly to palliative care, the goal of hospice care is to improve the quality of life and ensure that the client will live and die with dignity.

Hospice care is provided by a team of doctors, nurses, nursing assistants, and social workers. It is available in hospitals and long-term care facilities, as well as at home.

The team also provides support for the family, even after the client’s death. When caring for a terminally ill client, it’s important to be familiar with some terms.

First, a will is a legal document that states the person’s wishes regarding the management of their affairs when they’re no longer around. At the time the will is made, the person must be mentally competent.

If your client expresses interest in preparing a will, let the nurse know. The nurse can notify the client’s lawyer or arrange a meeting with someone who can assist with the will.

Next, an advance directive is a legal document that allows a client to write out their decisions about end-of-life care ahead of time and allows for a client to identify a person responsible for communicating the client's wishes regarding their health care when the client can no longer speak for themselves.

A durable power of attorney is a type of advance directive, where the client names a family member, a friend, or someone else that they trust to be responsible to make decisions on their behalf. This person becomes their healthcare agent.

A living will is another type of advance directive, where the client specifically states what methods of treatment they wish to receive or not receive in case they lose their decision-making capacity in the future.

Next, there’s Physician Orders for Life-sustaining Treatment, or POLST, which contains specific treatments that the client can and can’t receive if they are unable to make decisions.

Unlike the living will, which is a guideline based on preferences of the client, the POLST is a physician’s order, so it must be carried out. This means it requires the physician’s signature and, in some states, the client’s, too.