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1) Communication by HPN to support patients approaching a natural death

HPN sharing meaningful time with the patient

・creates a place where patients can talk about what they want to

・intentionally makes time to be to get her with patients

・gauges the pace and timing at which a patient wants to talk

・haves a sense of proper distance from the patient, not too close or far

・sits and listens to patients carefully with eye contact

・listens to patients patiently without interrupting, even if it takes time

・listens to patients with an open mind, without being skeptical

・shares time with patients in silence

HPN’s continual attempts to know the world in which the patient lives

・tries to know the patient’s suffering and pain

・builds up relationships with patients

2) Care by HPN to support patients approaching a natural death

HPN providing comfortable care so that patients can value their last moments

・matches care to the condition and wishes of the patient

・tries to fulfill a patient’s modest wishes

・provides the best possible care

・judges the need for medical treatment from the suffering of the patient

・tries to have the patient spend quality time with the family

・cooperates with staff to provide better care

HPN’s efforts to attend to patients so they can die as they hope to

・accepts the patients dying as they hope to

・wants to give care that enables the patient to meet the end they hope for

3) Predicting worsening of symptoms in a patient approaching natural death

HPN observation in a range that does not interfere with the patient’s comfort

・checks the patient’s temperature, pulse, respiration and reflexes by directly touching the patient’s body

・chooses measuring methods with the least burden according to the patient’s condition

・is sensitive to day-to-day changes

HPN’s sense that something is different from before

・senses something is different overall from the patient than before

・The family notices a lack of vitality

・senses that the time of death is near