Don’t follow the mobilization protocols and those for the treatment of pressure sores as “standard” protocols in the dying patient.

Don’t follow the mobilization protocols and those for the treatment of pressure sores as “standard” protocols in the dying patient.

Type of practice

Other health practices

Age

Adult, Geriatric

Topic Area

Nursing

Given the limited temporal horizon, the mobilization and the wound care performed routinely do not bring any benefit to the dying patient. Instead, these procedures can engender discomfort and cause unnecessary pain.
At the end of life you need to redefine the goals of care and target them to the comfort and control of the disturbing symptoms. In particular, it is essential to assess the risk of pressure sores and use anti-decubitus devices without mobilizing the patient routinely but only according to his/her real needs and requirements, ensuring maximum comfort.
In presence of bedsores, taking into consideration that the continuous control of bacteria and/or the debridement of necrotic tissue are meaningless, it becomes a priority to use atraumatic dressings, which can remain in place for several days and can control the stink.

Sources

1. Prevention and Treatment of Pressure Ulcers/Injuries: Clinicall Practice Guideline - The international Guideline 2019 (EPUAP) [Internet]. https://www.biosanas.com.br/uploads/outros/artigos_cientificos/127/956e02196892d7140b9bb3cdf116d13b.pdf (accessed January 2024].
2. Pressure Injury/Ulcer Risk Management in Palliative Care and Hospice, 2018 October. WoundSource Editors [Internet]. https://www.woundsource.com/blog/kennedy-terminal-ulcerpalliative-care-and-hospice-care [accessed January 2024].
3. Langemo D, Haesler E, Naylor W, Tippett A, Young T. Evidence-based guidelines for pressure ulcer management at the end of life. Int J Palliat Nurs. 2015 May;21:225-32.
4. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Emily Haesler (Ed.). Cambridge Media: Osborne Park, Australia; 2014 [Internet].: https://www.nzwcs.org.nz/images/International_PUG/Quick_Reference_Guide_DIGITAL-PPPIA-Jan2016.pdf [accessed January 2024].

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.