Hospice gives home health care to terminally ill patients.

887 Questions
Death and Dying

What are the signs of approaching death?

The dying process occurs in two stages: the pre-active stage of dying and the active stage. The pre active stage may last about two weeks, while the active stage of dying lasts about three days. Symptoms of the pre-active stage include restlessness, agitation, social withdrawal, increased sleep, decreased appetite and drinking, pausing in the breathing, speaking about dead relatives or friends, swelling of the hands or legs, or requests to settle financial or family affairs. Symptoms of the active stage of dying may include coma, hallucinations, longer pauses in the breathing, very rapid breathing, lung congestion, inability to drink, urinary or bowel incontinence, dark color of the urine, a dramatic drop in blood pressure, very cold hands and feet, numbness in the legs or feet, a bluish or purple coloring to the person's arms, hands, legs, and feet. Because this is such a sensitive question and one we all think of from time to time (some fearing it, others able to cope with it) when we know it can happen at any age and not just to the elderly a more informative explanation is needed. I have been through this process many times, recently my own mother and the following information is excellent. The following is from a Hospice and the copyright allows the original copy to copies with the stipulation that no alterations are made and that the name of the Hospice is shown: Preparing for Approaching Death When a person enters the final stage of the dying process, two different dynamics are at work which are closely interrelated and interdependent. On the physical plane, the body begins the final process of shutting down, which will end when all the physical systems cease to function. Usually this is an orderly and undramatic progressive series of physical changes which are not medical emergencies requiring invasive interventions. These physical changes are a normal, natural way in which the body prepares itself to stop, and the most appropriate kinds of responses are comfort enhancing measures. The other dynamic of the dying process at work is on the emotional-spiritual-mental plane, and is a different kind of process. The spirit of the dying person begins the final process of release from the body, its immediate environment, and all attachments. This release also tends to follow its own priorities, which may include the resolution of whatever is unfinished of a practical nature and reception of permission to "let go" from family members. These events are the normal, natural way in which the spirit prepares to move from this existence into the next dimension of life. The most appropriate kinds of responses to the emotional-spiritual-mental changes are those which support and encourage this release and transition. When a person's body is ready and wanting to stop, but the person is still unresolved or unreconciled over some important issue or with some significant relationship, he or she may tend to linger in order to finish whatever needs finishing even though he or she may be uncomfortable or debilitated. On the other hand, when a person is emotionally-spiritually-mentally resolved and ready for this release, but his or her body has not completed its final physical shut down, the person will continue to live until that shut down process ceases. The experience we call death occurs when the body completes its natural process of shutting down, and when the spirit completes its natural process of reconciling and finishing. These two processes need to happen in a way appropriate and unique to the values, beliefs, and lifestyle of the dying person. Therefore, as you seek to prepare yourself as this event approaches, the members of your Hospice care team want you to know what to expect and how to respond in ways that will help your loved one accomplish this transition with support, understanding, and ease. This is the great gift of love you have to offer your loved one as this moment approaches. The emotional-spiritual-mental and physical signs and symptoms of impending death which follow are offered to help you understand the natural kinds of things which may happen and how you can respond appropriately. Not all these signs and symptoms will occur with every person, nor will they occur in this particular sequence. Each person is unique and needs to do things in his or her own way. This is not the time to try to change your loved one, but the time to give full acceptance, support, and comfort. The following signs and symptoms described are indicative of how the body prepares itself for the final stage of life. Coolness

The person´s hands and arms, feet and then legs may be increasingly cool to the touch, and at the same time the color of the skin may change. This a normal indication that the circulation of blood is decreasing to the body's extremities and being reserved for the most vital organs. Keep the person warm with a blanket, but do not use one that is electric. Sleeping

The person may spend an increasing amount of time sleeping, and appear to be uncommunicative or unresponsive and at times be difficult to arouse. This normal change is due in part to changes in the metabolism of the body. Sit with your loved one, hold his or her hand, but do not shake it or speak loudly. Speak softly and naturally. Plan to spend time with your loved one during those times when he or she seems most alert or awake. Do not talk about the person in the person's presence. Speak to him or her directly as you normally would, even though there may be no response. Never assume the person cannot hear; hearing is the last of the senses to be lost. Disorientation

The person may seem to be confused about the time, place, and identity of people surrounding him or her including close and familiar people. This is also due in part to the metabolism changes. Identify yourself by name before you speak rather than to ask the person to guess who you are. Speak softly, clearly, and truthfully when you need to communicate something important for the patient's comfort, such as, It is time to take your medication, and explain the reason for the communication, such as, so you won't begin to hurt. Do not use this method to try to manipulate the patient to meet your needs. Incontinence

The person may lose control of urine and/or bowel matter as the muscles in that area begin to relax. Discuss with your Hospice nurse what can be done to protect the bed and keep your loved one clean and comfortable. Congestion

The person may have gurgling sounds coming from his or her chest as though marbles were rolling around inside these sounds may become very loud. This normal change is due to the decrease of fluid intake and an inability to cough up normal secretions. Suctioning usually only increases the secretions and causes sharp discomfort. Gently turn the person s head to the side and allow gravity to drain the secretions. You may also gently wipe the mouth with a moist cloth. The sound of the congestion does not indicate the onset of severe or new pain. Restlessness

The person may make restless and repetitive motions such as pulling at bed linen or clothing. This often happens and is due in part to the decrease in oxygen circulation to the brain and to metabolism changes. Do not interfere with or try to restrain such motions. To have a calming effect, speak in a quiet, natural way, lightly massage the forehead, read to the person, or play some soothing music. Urine Decrease

The person´s urine output normally decreases and may become tea colored referred to as concentrated urine. This is due to the decreased fluid intake as well as decrease in circulation through the kidneys. Consult with your Hospice nurse to determine whether there may be a need to insert or irrigate a catheter. Fluid and Food Decrease

The person may have a decrease in appetite and thirst, wanting little or no food or fluid. The body will naturally begin to conserve energy which is expended on these tasks. Do not try to force food or drink into the person, or try to use guilt to manipulate them into eating or drinking something. To do this only makes the person much more uncomfortable. Small chips of ice, frozen Gatorade or juice may be refreshing in the mouth. If the person is able to swallow, fluids may be given in small amounts by syringe (ask the Hospice nurse for guidance). Glycerin swabs may help keep the mouth and lips moist and comfortable. A cool, moist washcloth on the forehead may also increase physical comfort. Breathing Pattern Change

The person s regular breathing pattern may change with the onset of a different breathing pace. A particular pattern consists of breathing irregularly, i.e., shallow breaths with periods of no breathing of five to thirty seconds and up to a full minute. This is called Cheyne-Stokes breathing. The person may also experience periods of rapid shallow pant-like breathing. These patterns are very common and indicate decrease in circulation in the internal organs. Elevating the head, and/or turning the person onto his or her side may bring comfort. Hold your loved one's hand. Speak gently. Normal Emotional, Spiritual, and Mental Signs and Symptoms with Appropriate Responses Withdrawal

The person may seem unresponsive, withdrawn, or in a comatose-like state. This indicates preparation for release, a detaching from surroundings and relationships, and a beginning of letting go. Since hearing remains all the way to the end, speak to your loved one in your normal tone of voice, identifying yourself by name when you speak, hold his or her hand, and say whatever you need to say that will help the person let go. Vision-like Experiences

The person may speak or claim to have spoken to persons who have already died, or to see or have seen places not presently accessible or visible to you. This does not indicate an hallucination or a drug reaction. The person is beginning to detach from this life and is being prepared for the transition so it will not be frightening. Do not contradict, explain away, belittle or argue about what the person claims to have seen or heard. Just because you cannot see or hear it does not mean it is not real to your loved one. Affirm his or her experience. They are normal and common. If they frighten your loved one, explain that they are normal occurrences. Restlessness

The person may perform repetitive and restless tasks. This may in part indicate that something still unresolved or unfinished is disturbing him or her, and prevents him or her from letting go. Your Hospice team members will assist you in identifying what may be happening, and help you find ways to help the person find release from the tension or fear. Other things which may be helpful in calming the person are to recall a favorite place the person enjoyed, a favorite experience, read something comforting, play music, and give assurance that it is OK to let go. Fluid and Food Decrease

When the person may want little or no fluid or food, this may indicate readiness for the final shut down. Do not try to force food or fluid. You may help your loved one by giving permission to let go whenever he or she is ready. At the same time affirm the person s ongoing value to you and the good you will carry forward into your life that you received from him or her. Decreased Socialization

The person may only want to be with a very few or even just one person. This is a sign of preparation for release and affirms from whom the support is most needed in order to make the appropriate transition. If you are not part of this inner circle at the end, it does not mean you are not loved or are unimportant. It means you have already fulfilled your task with your loved one, and it is the time for you to say Good-bye. If you are part of the final inner circle of support, the person needs your affirmation, support, and permission. Unusual Communication

The person may make a seemingly out of character or non sequitur statement, gesture, or request. This indicates that he or she is ready to say Good-bye and is testing you to see if you are ready to let him or her go. Accept the moment as a beautiful gift when it is offered. Kiss, hug, hold, cry, and say whatever you most need to say. Giving Permission

Giving permission to your loved one to let go, without making him or her guilty for leaving or trying to keep him or her with you to meet your own needs, can be difficult. A dying person will normally try to hold on, even though it brings prolonged discomfort, in order to be sure those who are going to be left behind will be all right. Therefore, your ability to release the dying person from this concern and give him or her assurance that it is all right to let go whenever he or she is ready is one of the greatest gifts you have to give your loved one at this time. Saying Good-bye

When the person is ready to die and you are able to let go, then is the time to say good-bye. Saying good-bye is your final gift of love to your loved one, for it achieves closure and makes the final release possible. It may be helpful to lay in bed and hold the person, or to take his or her hand and then say everything you need to say. It may be as simple as saying, I love you. It may include recounting favorite memories, places, and activities you shared. It may include saying, I 'm sorry for whatever I contributed to any tension or difficulties in our relationship. It may also include saying, Thank you for... Tears are a normal and natural part of saying good-bye. Tears do not need to be hidden from your loved one or apologized for. Tears express your love and help you to let go. How Will You Know When Death Has Occurred?

Although you may be prepared for the death process, you may not be prepared for the actual death moment. It may be helpful for you and your family to think about and discuss what you would do if you were the one present at the death moment. The death of a hospice patient is not an emergency. Nothing must be done immediately. The signs of death include such things as no breathing, no heartbeat, release of bowel and bladder, no response, eyelids slightly open, pupils enlarged, eyes fixed on a certain spot, no blinking, jaw relaxed and mouth slightly open. A hospice nurse will come to assist you if needed or desired. If not, phone support is available. The body does not have to be moved until you are ready. If the family wants to assist in preparing the body by bathing or dressing, that may be done. Call the funeral home when you are ready to have the body moved, and identify the person as a Hospice patient. The police do not need to be called. The Hospice nurse will notify the physician. Thank you

We of Hospice thank you for the privilege of assisting you with the care of your loved one. We salute you for all you have done to surround your loved one with understanding care, to provide your loved one with comfort and calm, and to enable your loved one to leave this world with a special sense of peace and love. You have given your loved one one of the most wonderful, beautiful, and sensitive gifts we humans have to offer, and in giving that gift have given yourself a wonderful gift as well. Related Articles:

Saying Good-bye

Keeping Watch Copyright © North Central Florida Hospice, Inc. 1996 Please note: These articles are being made publicly available in the hope that they benefit others in the hospice community. Feel free to use them provided you credit Hospice of North Central Florida with sole authorship and do not alter the content. Please include this note in any copies you choose to make. Thank you.

Death and Dying
Medical Fields

Who is authorised to certify death?

The doctor must give a death certificate.

Only a doctor can verify, confirm and certify that a person is dead or not.


Is Hospice only for people who are terminally ill who have no hope left?

Not necessarily. Hospice and Palliative care are somewhat entwined. Someone with a possibly terminal illness, can benefit from Palliative care, in the sense that the symptoms and care options can be addressed to a specific patient. Rather than a general prognosis/treatment of the disease.

No, in the hospice I worked at we also took people who needed a lot of care after treatment.


If a doctor says surgery has successfully removed all cancerous growths why then would a patient receive Hospice care?

Hospice care is also associated with Palliative care. Which is a term used to describe the alleviation of severity of symptoms, the exploration of all treatment options, etc. Whereas, hospice care is thought of as helping someone to die with as little pain and mental anguish as possible.


Can hospices help babies and young children?

Yes Young mothers and Children hospices


What happens if a hospice patient dies and the family can't afford to bury the patient?

Check with your local county (or city) Medical Examiner or Coroners Office. There is probably some mechanism in place for burying deceased paupers.

Sports Memorabilia
Lakes and Rivers

Willen Heaumeaux neuqen?

Heaumeaux willen meestal geyle neuqseks, behalve heaumeaux die net een jaar nicht zijn, die doen elkaar fap-fappen.


How might hospice be an alternative to euthanasia?

Hospice allows you to continue to live, comfortably, for the last days or months, sometimes years, of your life. They give you pain medication, so that you are comfortable. Your family can still see you and be with you. You can still live and spend time with your loved ones. In some cases, euthanasia still happens. In the state of Oregon (USA), assisted suicide is completely legal.

United Arab Emirates

Nursing registration exam model question papers for ministry of health uae?



Does a cna earn more money working for hospice?

I currently am working in Bowling Green Kentucky as a CNA and have been a Nursing Assistant for almost two years. I currently make $9.58 an hour but I work night shift. If I were to work day shift I would make $8.34.CNA

I work as a CNA in rural Tennessee and I make about $8.60 per hour.

i work as a cna in California and i make 14.37 an hour but you can make as much as 18 to 28 an hour working in a hospital...It all depends on where you work, because all states are different.

I currently work for a HOME Health and i am a SRNA i make 14.50 hr i live in Lexington,Ky and i have 4 years exp.

I currently work in Taylor, Pa and I'm making $15 an hour working perdiem. But if I were to go full time day shift I'd earn around $12.55 an hour and $14.05 an hour for 3-11. That's with 6 years experience. That's the best I've found yet.

I know CNAs who work privately w/ clients and make 25+ an hour. Work Privately!

An LNA or CNA is low man on the totum pole in the nursing field. Starting out here in vermont we make $10 an hour and that's if you work days. For every shift change or differential you earn a $1- $2 more. So second shift is 11 to 12 dollars and 3rd is 12 to 14 dollars. Each state and facility is different. If I were to work in Mass I could make up to 8 dollars more an hour. And home health services pay much more for their aids.... some places will pay you up to $28 an hour. If you're getting min wage for being an aid then I would look else were for a job or look for a new career. Most states, in the northeast anyway, usually start aids off at around $10 an hour. Hospitals or home health will pay more.

Salary and Pay Rates

How much does a registered nurse earn in Missouri?

Given the current state of the economy, many businesses are looking for ways to reduce costs without adversely affecting their service capabilities or their operational effectiveness. When faced with such a task, companies often look to the inherent benefits afforded to them from video conferencing. Whether it’s the multinational corporation with offices around the world and with employees in different time zones, or the company that wants to reduce travel costs but still remain within reach of their customers, there are a number of inherent benefits from video conferencing that allow businesses to do both and more. Video conferencing not only saves on travel costs, but also helps companies become more efficient by being able to work on time critical projects and effect immediate changes. Business success today is measured by speed. Being able to reduce a company’s day to day operating costs while improving efficiency and eliminating redundant work process, is possible. With video conferencing it’s quickly becoming a reality. It amounts to speeding up the time it takes to make decisions. In order to better explain its benefits, here are some additional points to consider.

Video Conferencing Improves Customer ROI (Return on Investment)

Every company wants to reduce travel expenses but still benefit from face time with customers. Well, it’s a possibility with video conferencing. In fact, video conferencing not only reduces travel costs, but drastically reduces the incidence of customer being unable to meet because of emergencies. Being out of the office is a direct cost to the company. The hope is that these visits will provide solid returns in additional sales. However, when sales executives travel to visit customers and are unable to meet because of issues beyond the customer’s control, it’s quickly classified as a complete loss. It’s a loss measured by the cost of the plane ticket, the hotel and the time away from the office.

Video Conferencing Allows for Remote Desktop Management

The benefit of video conferencing is that it allows everyone to become active participants in corporate presentations and meetings. Being able to view the changes as they occur is a direct savings in time and in operational effectiveness. Whether it’s conversing with customers, or going over corporate budgets and strategic planning initiatives, video conferencing allows everyone to become actively involved.

Video conferencing is lending itself well to today’s constantly changing business environment. Shortening the time it takes to meet with customers and close deals is one benefit. Other benefits include shortening the time needed to make decisions and improving on a company’s ability to work internally.

Aging and Life Extension

How many hospices are in Massachusetts?

47 according to

Salary and Pay Rates

What is the annual salary of a nurse?

It is approximately 45,000.00 for an RN, and approximately $32,000.00 for an LPN.

Job Applications

Is there another or better way to word Hospice Care for Both Parents as Reason for Leaving?

I would state it as "Urgent Family Illness", or "Prolonged Family Illness". Your way of wording it is fine, but just a little confusing.


What is hospice movement?

A hospice is a place where people who have a terminal (fatal) illness can find respite care during their illness and then return home. If they can't go home, they have to go to a nursing home. They may well be under the care of the Hospice for a long time but most of that care will be in their own home via MacMillan Nurses (who are usually employed by the hospice) or in day-care. Some are places where people will go for the final stages of the illness. The hospice movement specialises in pain control and the aim of the hospice movement is to give people with painful and terminal diseases the best possible quality of life.

United States of America
United States

How many hospice programs are in the US?


Salary and Pay Rates

What is a nurse annual salary?

Salaries for nurses anywhere in the USA are payed by the hour not on a per year basis. Starting salaries for RN's are between $19 to $24 dollars per hour depending on where you work (hospital, nursing home, doctors office, home care, ect.) and what you specialty is. Depending on the policy of your employer overtime may be counted as time and a half for anything over 40hours/week. Hospitals and critical care pays the most. Each year a nurse has been working a pay increase of about one dollar per hour is standard. You may ask for a raise after six months of being on the job.

Salary and Pay Rates

How much do registered nurses earn?

A Registered Nurse Gets Paid Roughly About $32,968 A Year Working In A Hospital, Emergency Room Or Doctors Office. However If You Work Elsewhere Such As A Rest Home, Nursing Home, Or Other Hospitals (Mental Evaluation, Clinics Ect.) You Will Get Paid Less. it all depends on where you are working and how much your hospital pays, to find out what your pay would be at the hospital you want to work at you woul have to go ask someone at that hospital The median expected salary for a typical Staff Nurse - RN in Cherry Hills Village, CO 80111, is $60,278. This basic market pricing report was prepared using our Certified Compensation Professionals' analysis of survey data collected from thousands of HR departments at employers of all sizes, industries and geographies. You can expect 54,000 to 65,000 range depending on location and area of expertise. My friend makes $56 / hour as an RN for 3 years. Depends on where you live. In the DFW area in Texas, an RN can earn anywhere from $23-$37 per hour depending on the hospital, experience and whether or not you are full-time or PRN. Pay rate in Michigan is comparable to the range given in the previous answer for Texas.
My wife makes $53.00 dollars an hour in San Francisco MY wife is is an rn. working for the state of IL. and makes $58,000 per year

Conditions and Diseases

How long can a human live without a liver?

24 hours


What skillsknowladgecan you identify that would support your role as a carerforsomeone who is palliative care?

Be empathetic, patient, carint, talk to them calmly, depending if they are bed ridden or not there are a variety of skills and actions that need to be addressed - I would be happy to answer any questions if I can.


One of the key differences between hospital services and hospice services for elderly patients is?

Patients are given palliative care in hospice, rather than the curative treatment likely in a hospital.


What is starting salary for hospice administrator in California?

The starting salary for a hospice clinical supervisor is $83,000.


What is palliative hospice?

Palliative Hospice care is a somewhat redundant way to describe Hospice care. Let's break it down.

Palliative care: Care focused primarily on pain and symptom management. It's often prescribed for those with chronic pain or with conditions that cause chronic symptoms that are difficult to manage. It can be performed concurrently with other treatments such as chemotherapy and series of surgeries.

Hospice care: Care focused primarily on pain and symptom management. Here is where the difference lies: Hospice is prescribed for those with terminal diagnosis and those who are no longer eligible for or interested in invasive and curative treatments.

Therefore, Hospice care is ALWAYS Palliative care, but Palliative care is NOT ALWAYS Hospice care.

I hope this answers your question! For more info, see my site!

Medication and Drugs

Does hospice use morphine to help end life more quickly?

No. Morphine is used to control pain or shortness of breath. People at end of life may require very little morphine or major doses depending on their disease process.

People will state but I gave my loved one morphine and she died right afterward.

When someone is in pain or discomfort the body releases adrenaline that keeps the patient going. With the decrease in pain / discomfort there is no adrenaline and the body is able to relax and the dying process continues.


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