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End-of-life terms

LTC Nursing Assistant Trainer, June 16, 2005

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Thanks to advances in medical technology and changing societal norms, more and more people choose to die in skilled nursing facilities than in the home. This means you will often be responsible for caring for a person at the end of his or her life.

As you work with dying patients, you will encounter certain terms in conversations with doctors, other caregivers, and family members. It's important for you to know what each term means in order to provide the best care.

The following is a list of words and phrases people often use when talking about end-of-life care:

• Palliative care. According the Institute of Medicine, palliative care "seeks to prevent, relieve, reduce, or soothe the symptoms of a disease or disorder while not accomplishing a cure." There is no time limit on how long this type of care can be provided in the nursing home.

• Hospice. Hospice provides emotional support to the patient and family throughout the dying process, as well as to the family after the patient's death. In addition, hospice staff provide relief to the patient from the discomfort of symptoms. Hospice provides care in many settings. In the past, hospice provided services only to people who had six months or fewer to live. However, it can be difficult to determine how long someone will survive the effects of certain chronic illnesses. Therefore, some hospices are flexible with when they take on new patients.

• Passive euthanasia. The act of withdrawing support or treatment necessary to keep a patient alive, such as unplugging a ventilator or removing a feeding tube.

• Advance directives/living wills. Written methods for patients to communicate their requests for procedures/treatments and when to discontinue them, in the event they are unable to speak for themselves.

• Durable power of attorney for healthcare/healthcare proxy. Documents providing a designated individual the power to make decisions on behalf of the patient regarding healthcare choices only.

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