Pathophysiology of Death - Death is defined as the cessation of integrated tissue and organ function, manifested by lack of heartbeat, absence of spontaneous respirations, or irreversible brain dysfunction. 2. Symptoms of approaching death - coolness of extremities, increased sleeping, decreased fluid and food, incontinence, gurgling, breathing pattern change (Cheyne-Stokes), fear, anxiety, difficulty coping, apnea, skin changes (waxy) 3. Management of End-of-Life symptoms - Interventions to relieve symptoms of distress include positioning, administration of medications, and a variety of complementary and integrative therapies. When medications are used, they are often scheduled around the clock to maintain COMFORT and prevent recurrence of the symptom. 4. Postmortem care - care of the body after death... Pronouncing death...RN can pronounce but not identify cause of death Allow family time with client Follow protocols of facility 5. Hospice Care - 6 months or less to live. End of Life Care 6. Palliative Care - Management of terminal illness or chronic illness. Not necessary 7. Psychosocial Needs - HOPE mnemonic - H=Sources of Hope O=Organized religion P=Personal Spirituality E=Effects of religion and spirituality