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- Assist with Hygiene
- routine personal care
- bathing
- shaving
- oral care
- personal odor control
- colostomy
- perineal
- wounds
- skin care
- Assist with Grooming
- hair care
- nail care
- cleaning
- filing
- foot care
- soaking
- cleaning
- hearing aids and eyeglasses
- dressing and undressing (clothing and accessories)
- Assist with Ambulation/Mobility
- foster/maintain independence
- use of durable medical equipment (DME)
- walker
- mechanical lift
- positioning
- exercise and range of motion
- transfers
- prevention of falls
- Assist with Toileting
- bowel and bladder training
- scheduled toileting
- catheter care
- ostomy care
- adaptive equipment
- raised toilet seat
- bedside commode
- Nutrition/Hydration
- support patient decision not to eat/drink
- feed patient safely
- offer fluids/foods according to patients choice and comfort
- observe and report issues related to tube feeding and IV hydration
- Observe and Report on Patient Condition
- patient status in relation to the documented diagnosis
- level of pain (e.g.- on a 0-10 scale)
- changes in level- type- and location in pain
- nonverbal cues
- effectiveness and side effects of medications
- Facilitate Non-Drug Treatment for Symptoms
- therapeutic support
- meditation
- music
- massage
- deep breathing
- diversional/recreational activities
- hot/cold compresses
- repositioning
- Maintain Infection Control
- universal/standard precautions
- biohazardous waste disposal
- sharps
- fluids
- isolation techniques
- Provide and Maintain Best Possible Environment to Support Patient
- personal environment
- familiar objects
- pictures
- homelike
- death in patients place of choice
- care according to the patients preferred schedule
- safety
- fall precautions
- prevention of hazards
- storage and use of oxygen
- privacy storage and use)
- Identify Changes in Physical Status
- activity level
- vital signs and weight changes
- skin impairment
- breakdown
- rash
- itching
- injury
- elimination habits
- swallowing ability
- nausea/vomiting
- edema and ascites
- signs of impending death
- seizure activity
- Identify Changes in Mental Status
- confusion
- responsiveness
- emotional change
- anxiety
- fear
- depression
- agitation
- terminal restlessness
- Identify Changes in Functional Status
- mobility
- weakness
- sleepiness
- fatigue
- appetite
- Identify Changes in Respiratory Status
- effectiveness of interventions
- nebulizers
- inhalers
- oxygen therapy
- air circulation
- change in breathing patterns
- cough
- apnea
- increased secretions
- Psychosocial/Spiritual Care of the Patient and Family/ Caregivers
- Spiritual Care
- identify spiritual issues
- guilt
- estrangement
- meaning of life
- honor and support individual spiritual beliefs
- enable spiritual practices
- sacraments
- prayer
- arrange transport services
- provide patient and family/caregivers support with letting go
- Respect Differences and Maintain Neutral Attitude
- race- ethnicity- and cultural background
- religious/spiritual preference
- sexual preference
- age
- social and economic circumstances
- treatment choices
- advance directives
- holistic approach
- veterans
- gender identity
- criminal background
- Identify and Assist Patient and Family/Caregiver Needs
- Education
- signs and symptoms of end-of-life
- agency/community services
- grief and loss
- infection control practices
- nutrition/hydration (including unique needs as the patient declines)
- personal care techniques and comfort measures
- Patient and Family/Caregiver Support
- respite (including volunteer support)
- companionship and compassion
- advocacy for patient and family/caregivers
- reframing hope (patients expectations)
- end of life concerns
- Assure Dignity and Honor Patient and Family/Caregiver
- allow closure time for loved ones
- bereavement resources
- support groups
- literature
- post-mortem care
- care of body
- care of room
- allow for cultural or spiritual practices at time of death
- Assist with Communication Between Patient- Family/Caregivers- and Care Providers
- barriers to communication
- active listening
- adaptive communication devices (e.g.- word boards)
- use of interpreters
- Provide Support for Changes in Body Image
- physical appearance
- weight change
- hair loss
- amputation
- elimination changes
- ostomies
- incontinence
- catheters
- loss of independence
- Provide Support for Changes in Mental Status
- memory
- medication-related altered mental status
- depression
- anxiety
- post-traumatic stress disorder
- Observe and Report Threats to Patient and Family/Caregiver Safety
- physical abuse
- neglect
- substance abuse
- caregivers inability to provide care
- suicidal ideation
- encourage patient and family/caregiver involvement in the plan of care
- provide input to team members in carrying out the plan of care
- provide support and communication during changes in levels of care and across care settings
- assisted living
- hospitalization
- respite
- recognize and report change in family/caregiver dynamics
- review death with the team
- Ethics- Roles- and Responsibilities
- identify and respond to ethical issues
- confidentiality
- honest communication
- maintain boundaries
- within job description
- with patient/family/caregivers
- assist in resolving work-related conflicts
- maintain accurate and timely documentation according to the patients plan of care
- identify risks to personal safety (e.g.- firearms in the home)
- serve as a mentor/trainer for new staff
- participate on committees- professional organizations-
- performance-improvement projects
- maintain continuing education confidentiality- honest communication
- promote hospice and palliative care in the community
- practice self-care (e.g.- stress management)