Home Health & Hospice

Insider’s scoop | Managing seizures

Homecare Insider, March 14, 2016

Editor’s note: This week’s Insider’s scoop is from Hospice Aide On-the-Go In-Service Series, Volume 3. Help your hospice aides fulfill the CMS requirement to complete 12 hours of in-service training with this exceptional resource, which contains 12 comprehensive lessons on the timeliest topics in hospice care. Click here for more information.

Seizures—sometimes called convulsions—involve rhythmic jerking of the body or an involuntary change in body movement, sensation, awareness, or behavior. They can last anywhere from a few seconds to a few minutes and are generally broken into two major groups: primary generalized seizures and partial seizures, which are differentiated by how and where the seizure originates.

Medications for controlling seizures (called anticonvulsants) must be taken regularly as directed. Missed doses may cause a single seizure, several seizures, or even death. In addition, people with severe seizures who don’t take their medications have a shorter life expectancy and an increased risk of cognitive impairment.

If a hospice patient is having a seizure, alert your supervisor, and then follow the directions given by your clinical team, which may include:
• Roll the patient onto his or her side to prevent choking on any fluids or vomit.
• Loosen any tight clothing around the patient’s neck so it doesn’t inhibit breathing.
• Do not restrict the patient from moving unless he or she is in danger.
• Do not put anything—including medicine and liquid—in the patient’s mouth, as doing so can cause choking or damage to the person’s jaw, tongue, or teeth. Contrary to popular belief, people cannot swallow their tongues during a seizure or at any other time.
• Remove any sharp or solid objects that the patient might hit during the seizure.
• Note how long the seizure lasts and what symptoms have occurred, so you can give an accurate report to your supervisor and/or other emergency personnel.
• Stay with the patient until the seizure ends. After a seizure, the individual may feel tired, have a headache, be confused and embarrassed, or require your help cleaning up, so be patient and understanding.