Can anyone help me find research in palliative care and should patients be turned at the end of life?

should you turn palliative patients in the last hours of life

That is the standard of care. There are not exceptions to the standard of care. It is up to the family (if POA) and the patient to make exceptions at the end of life.

If the patient is uncomfortable, then of course they should be turned. Why should the last few hours of life be unnecessarily painful or uncomfortable.

There are many good books at the library on palliative care or a hospice will also make recomendations. The last sense to leave a person is hearing. yes turning a person to make them comfortable is essential unless physician has directly ordered not to.

If they need turning - turn. But not unneccesarily so. The patient's comfort and dignity count for more than following some pre-conceived idea that patients need turning because 'its time they were'. At the end of life the nurse should be totally in tune with the patient's needs and responsive in a quiet, unhurried manner. Never move a patient without assessing their pain level first - if the pateint is able try to get them to signal 'yes' or 'no' without having to talk. Often this is just too much effort. My experience has been that at the end if you absolutely have to move a patient for personal hygiene reasons, they often die during the procedure. This is distressing for all concerned, so I minimise any activity that causes stress to the patient. If you are working in a hospital, the Palliative Care Team will be only too willing to talk to you about any issues involving the care of a terminally ill patient, and usually run workshops and study days. You can also ask for secondment for a day or two to work with them. If you are in the community Macmillan Nurses www.macmillan.org.uk or Marie curie nurses www.mariecurie.org.uk will advise you. Nursing Homes should also have comprehensive policies covering the care of terminally ill patients. All organisations should have care pathways which include references to help you. I hope this has been of some help for this very important time in a person's life and I wish you all the best. x
PS - a good pressure relieving mattress may avoid the need for turning at all.

HI, I work on a palliative care ward as a staff nurse and we use the liverpool care pathway (see link for info) this care pathway ensures that all the important things are seen to during a patients last days and unessesary interventions are discontinued.
It is not nessessary to turn a patient regularly in the last days of life, only for comfort of the patient. I do not agree with turning them every 2-4 hours, although some of my colleagues find this new practice hard to deal with. The 40 degree tilt can be utilised for minimum disturbance to the patient and bedsores should not be an issue, only the comfort of the patient. If you want any more info feel free to e mail me on Ktloop123@hotmail.co.uk

http://www.mariecurie.org.uk/forhealthca...

My mother died of Lung Cancer in January of this year and was cared for at home by myself and my older sister.
During her last hours with us, she became very irritated and uncomfortable, as she had lost a dramatic amount of weight she found it very painful to be laying in the same position as she had no flesh on her body and suffered with bed sores,
we asked mum's wonderful Mcmillian/Marie Curie nurses if we should turn her and they said it was up to us, if we felt mum should be turned, we turned her.
To be honest i would have moved heaven and earth to make her comfy and give her some sort of comfort during her last hours!