Care at the Time of Death Flashcards

After a hospice patient dies at home, the nurse's first priority action is to:

Answer: Confirm absence of respirations, pulse, and responsiveness, then provide support to the family

The nurse must first confirm that death has occurred through clinical assessment, then immediately focus on providing compassionate support to the bereaved family before initiating other notifications.

In most US states, when a hospice patient dies at home, who is legally authorized to pronounce death?

Answer: A licensed hospice nurse can pronounce death under a physician's standing order or state-specific hospice statutes

Many US states have enacted hospice-specific legislation allowing RNs to pronounce death in the home setting under standing physician orders, eliminating the need for a physician to be present.

Which of the following is the most important nursing documentation required immediately following a hospice patient's death?

Answer: Time of death, assessment findings confirming death, notifications made, and family's condition

Documentation must include the exact time of death, clinical findings confirming death, all notifications made (physician, funeral home, supervisor), and the emotional status of those present.

When performing post-mortem care in the home setting, the hospice nurse should:

Answer: Remove all IV lines and catheters, clean and position the body with dignity before the funeral home arrives

Removing medical devices, cleaning, and positioning the body with dignity respects the patient and family and prepares the body appropriately; however, family preferences and cultural practices should guide the process.

After a hospice patient dies, unused controlled substances in the home must be disposed of by:

Answer: Flushing them down the toilet or destroying them per DEA and state regulations with a witness present

DEA regulations and hospice policy require that controlled substances be destroyed (flushed, mixed with waste, or using a DEA-authorized take-back program) with a witness, and the process must be documented.

A family member is crying intensely and saying 'I can't believe she's gone' immediately after the patient's death. The hospice nurse's best response is:

Answer: 'Sit with the family member, offer a compassionate presence, and allow them to express their grief without interruption.'

Acute grief immediately after death requires compassionate, non-judgmental presence; the nurse should sit with the family, allow emotional expression, and provide supportive silence or validation.

The hospice interdisciplinary team's bereavement follow-up obligation under Medicare guidelines requires contact with bereaved family members for at least:

Answer: 12 months after the patient's death

Medicare Conditions of Participation for hospice require that bereavement services be offered to the family for at least 12 months following the patient's death as part of the hospice benefit.