Ten key elements of care for the dying patient

Recognition that the patient is dying



Communication with the patient (where possible) and always with family and loved ones



Spiritual care



Anticipatory prescribing for symptoms of pain, respiratory tract secretions, agitation, nausea and vomiting, dyspnoea



Review of clinical interventions should be in the patient’s best interests



Hydration review, including the need for commencement or cessation



Nutritional review, including commencement or cessation



Full discussion of the care plan with the patient and relative or carer



Regular reassessment of the patient



Dignified and respectful care after death

DESERVING A RAISE

Conchita, the Mexican maid wanted a raise and approached the lady of the manor about it.

Grace, the lady of the manor, was clearly not amused and decided to have a word with her about it.

She said, “Now Conchita, why do you believe you deserve a raise?”

Conchita: “Well, Señora, dere are tree reasons why I tink I deserve raise...  De first is dat I iron better dan you…”

Grace: “Who said you iron better than me?”

Conchita: “Jor huzban, he say so…”

Grace: “Oh, really..?”

Conchita: “De second reason eez dat I am better cook dan you…”

Grace: “Nonsense, who said you are a better cook than me?”

Conchita: “Jor hozban, he say so...”

Grace increasingly agitated: “Oh, he díd, did he?!”

Conchita: “De tird reason is dat I am better in bed dan you...”

Grace, now really outraged and through gritted teeth hissed, “And did my husband say that as well..?!”

Conchita: “No Señora… Manuel, the gardener he say so...”

Grace: “So Conchita, how much did you have in mind..?”