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The registered nurse will assess the patient if he / she is symptomatically dehydrated, and consider artificial hydration if it is in the patient's best ...
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NESCN Caring for the Dying Patient (CDP) document 2015
Please complete with the patient and relative / carer if appropriate. If the patient is unable to contribute to their care assessment, complete on their behalf. Circle any identified problems and cross out those not present.
Assessment completed by: Name (print) …………………….…. Designation ………….……... Signature ..……………….. Completed and discussed with: (please circle) patient / relative / carer : Name ………………….
Date completed: …………………………………….…..…. Time: ………………………………..
Physical Problems Social / environmental concerns Do you have any problems with your comfort? Pain / discomfort Breathlessness Mouth – sore / dry / painful Chest secretions Sputum Cough Swallowing difficulties Feeling sick / being sick Constipation / diarrhoea Urinary problems Catheter care Sweats / hot / cold Skin – sores / wound / dry / itch / weeping Oedema (Swelling) Personal care – washing / hair care Sleep Mobility
Other? ………………………………….
Do you feel the needs of yourself and your family / carers are being met? Eating / drinking facilities Quiet environment Comfortable surroundings Worries / fears Written information Update on plan of care Support for relative / carer / friend Support for children Financial concerns Parking facilities
Other? ………………………………….
Emotional wellbeing Spiritual / religious needs Do any of these words describe how you feel? Distressed Lack of dignity / respect Upset / sad Lack of privacy Lack of peace / calm Agitated / restless Not listened to Frightened / worried Angry / frustrated Other? ………………………………….
Are the things important to you being considered? Faith Support from faith leader Prayers / rights / rituals Culture Music Values Things that help you cope
Other? ………………………………….
NESCN Caring for the Dying Patient (CDP) document 2015
Please record your assessment of the patient’s identified problems below. Ensure that there is a care plan for each identified problem, including review date and time.
Date & Time
Problem Identified / Care plan
Summary of Assessment
Signature & Designation
NESCN Caring for the Dying Patient (CDP) document 2015
Please document discussions with the patient and / or relative / carer regarding:
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Completed by:
Name (print) ………….………….…. Designation ……….…….....…. Signature ………………..............
Discussed with: (circle) patient / relative / carer Name …………….…...… Date: ………..... Time: ……...
Written information
What written information / leaflets have been given to the patient and / or relative / carer?
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