CARES: How to Care for the Dying

Within the first four months of working as a new bedside nurse, I’ve encountered two patients who were actively dying. I wasn’t sure what to do. After coming across this article from Medscape though (btw you need a free login to read this article), I finally understand what the palliative care nurse practitioners were doing.

The City of Hope came up with a tool called CARES to help the nurse take care of those who are dying.

C stands for comfort. You aim to alleviate pain and suffering for the patient. Additional testing and blood draws should be questioned, as the aim is to comfort, not treat.

How to care for the dying

C: Comfort

A stands for airway. We used a scopolamine patch placed behind the ear. It’s used to help stop secretions from building up. While oxygen and oral secretion will not necessarily help, it may be comforting for the patient to have those things.

How to care for the dying

A: Airway

R stands for restlessness or delirium. It occurs in 25-85% of actively dying patients. It could be due to uncontrolled pain, a distended bladder, or it could be that the patient feels that there are unresolved issues with the family. Playing familiar music and providing a non-stimulating environment will help.

How to care for the dying

R: Restlessness or Delirium

E stands of emotional and spiritual support. Don’t underestimate a listening ear and providing clear and open communication. Whatever can be done to promote a comfortable and peaceful death should be considered.

How to Care for the Dying

E: Emotional and Spiritual Support

S stands for self-care. The nurse is often stressed and may need to debrief too.

CARES: How to Care for the Dying

S: Self Care

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  • stephanie

    Hey Jess i have quick question, well a couple , through out college, I have been doing well on all my general classes. I would usually study 2 to 3 hours before the exams and do well. I know in nursing school you should be studying at least 30 hours a week or 5 to 6 hours a day. Do you have any study tips for me , and how can i mentally prepare my self for this program. How many hours a day should i be studying? and how should i be studying because I am so use to memorizing , but i know in nursing school it is not about memorizing but applying concepts . How did you study nursing school alone, or in a group. How were the exams? Were majority based off of class notes or the text book or a combination of the two? Did you have at least one day a week to just sleep? Was it as hard as you expected?

    • Studying is about quality, not quantity. One of the most important things to do is to prepare for the lecture prior to attending class. The best is to scan the textbook chapter. The minimum is to review the powerpoint slides (and trust me, there’s a lot!). Memorizing information will definitely be helpful, especially when you first study alone.

      For me personally, I learn well when I’m “teaching” the material to others and others are questioning what I know. This helps you get a better working knowledge base.

      Nursing was just as hard as I expected. Exams are based off of notes primarily but having a clear understanding is more important. Just remember that what you learn is the foundation. It’s not something you ought to forget as soon as finals are over because it will come back again. And again.

      I hoped that helped!