Self Directed Learning Package - University of Queensland

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38 • The Palliative Approach ToolkitWriteDocument your actionsDocument enough information to allow others in themultidisciplinary team a clear picture of the clinical situation.Avoid general statementsPOOR COMMUNICATION‘Evaluation of artificial hydration’.GOOD COMMUNICATION‘Resident denies thirst or discomfort,mouth moist and intact, urinary outputstill moderate’.ReviewEvaluate and reassess as necessaryJust because artificial nutrition or hydration has been starteddoes not mean that it should be continued until the residentdies.• Artificial nutrition or hydration needs to be reviewed regularlyto ensure it is still the most appropriate intervention for theresident.• If artificial hydration is commenced, clear criteria andtimelines for evaluation need to be documented.• At the end of life assessment should occur daily. What mayhave been appropriate a week ago may not be if they are nowlikely to die in the next 48-72hrs.
39 • Self Directed Learning Package - Introductory Registered & Enrolled NurseOral careThe ageing process, even when uncomplicated by illness,creates changes in the body which may combine to decreaseoral health. As a resident approaches the end of their life,especially when they stop eating or drinking, oral carebecomes even more important.SeeRecognise and assessNurses need to complete and document a comprehensivebaseline assessment of the resident’s oral cavity using the OralHealth Assessment Form (see Module 3).Key PointCareworkers should be directed to check aresident’s oral cavity at least daily for problems andreport them to a nurse. e.g. whenever assisting withfeeding, providing fluids, or conducting mouth care.Potential problems may include:• bad breath• sore mouth and gums• lip blisters/sores/cracks• difficulty eating• broken teeth• bleeding gums• reports of pain inmouth/lips• tongue coated orabnormal colour• excessive food leftin mouth• mouth ulcer• refusing oral care• swelling of face/mouth• dentures broken/lost. 11Dry mouth (xerostomia) is the most common oral problem atthe end of life. 11
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Self Directed Learning Package - University of Queensland

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