End-Of-Life Care for Practical Nurses

End-of-life care is not a single event or a set of tasks performed only during the last hours. Palliative care can begin when a serious illness is diagnosed and can occur alongside disease-directed treatment. Its purpose is to relieve pain, dyspnoea, nausea, delirium, anxiety, and other sources of suffering while supporting the person’s goals, relationships, dignity, and sense of control. As death approaches, treatment priorities commonly shift from surveillance and life prolongation toward comfort and meaningful interaction. The practical nurse’s contribution is grounded in close observation. The nurse notices a change in attention, breathing effort, facial expression, swallowing, urine output, bowel function, or family distress; connects that change with possible causes; performs permitted interventions; and reports what requires a prescriber or registered nurse’s assessment. Care remains individualized. A patient may want conversation, music, oral fluids, or family presence, while another may prefer quiet and fewer interactions. The dying process can produce expected changes such as increasing sleep, reduced appetite, less urine, cool extremities, irregular breathing, and reduced responsiveness. “Expected” does not mean “ignore.” The nurse still assesses whether the change...