Final answer:
Management of 'death rattle' in hospice involves providing comfort through palliative measures, such as repositioning, suctioning, and medication. It's important to respect end-of-life wishes and facilitate a death with dignity.
Step-by-step explanation:
The management of “death rattle”, a common phenomenon in the active phases of dying, primarily in a hospice setting where a patient has decided against “cure-oriented treatments,” involves palliative care measures to provide comfort for both the patient and the family. It's essential to understand that hospice care focuses on the quality of life and symptomatic relief, as cure is no longer the objective. Interventions for the “death rattle” may include repositioning the patient, gentle suctioning if appropriate, and the use of anticholinergic drugs to reduce secretions. The goal is to ensure the patient's death with dignity and to alleviate any distress the sounds may cause to loved ones. Aspects such as the five stages of grief described by Elizabeth Kübler-Ross (denial, anger, bargaining, depression, and acceptance) play a role in how patients and their families cope with the end-of-life process. It is also crucial to consider the patient's wishes, potentially outlined in living wills or Do Not Resuscitate (DNR) orders, when managing their care.