What Do I Do? Managing Physical and Emotional Symptoms of Dying

Course Learning Outcomes

As a result of participating in this learning activity the learner will be able to:

  • Demonstrate knowledge of the physical and emotional signs of the terminally ill patient, including the expected sequence of changes and teaching aids for communication with the patient and family as symptoms occur as evidenced by passing the final exam with a score of 80% or higher at the end of the on-line learning activity.

Dying is much more than a medical "event". It is a time of emotions that may include fear, grief, joy, anger, reconciliation, forgiveness, and transformation for all involved. Fear of the unknown for the patient and family is only natural.

One of the fears the professional might face is the observation of the emotional and bodily changes of the patient as death approaches. The professional may not be prepared to provide the appropriate assessments and education that is expected by the patient and family. In the journey between living and dying, this is an emotional time during which the professional is needed for support, encouragement, and direction.

This course is designed for professionals with a desire to learn more about the physical and emotional signs of the terminally ill patient, including the expected sequence of changes. Included are teaching aids for communication with the patient and family as symptoms occur.

This is a self-paced course with optional knowledge check quizzes after each lesson. These non-graded quizzes allow you to check your understanding of the lesson objectives before proceeding to the next lesson. After the final lesson you will be required to take the final exam. You must score 80% or higher to pass the course and obtain a certificate of completion.

  • Identify Personal fears associated with care of the dying patient
  • Identify the needs of the dying patient and his or her family
  • Describe supportive measures for the patient and family
  • Describe ways to be present with the patient and/or family
  • Outline ways of communicating openly and honestly while not extinguishing hope
  • Recite examples of leading questions that enhance communication
  • Identify the possible emotional symptoms and concerns of the dying patient
  • Describe the importance for individual assessment of the emotional and psychological needs of anxiety, depression, fear and anger for each hospice patient
  • Describe the possibilities for fear and opportunities for communication regarding those fears
  • Describe anger as well as the strategy for discussions with the patient and/or family regarding anger
  • Identify the challenges of pain management encountered during the dying process
  • Compare and contrast the assessment of acute and chronic pain
  • Identify the challenges of the fatigue and adjustment to daily activities
  • Describe the responsibilities of the professionals in pain assessment
  • Compare and contrast the difference between anorexia, starvation and dehydration
  • Identify the burdens and benefits of dehydration in the terminally ill
  • Describe the cardiovascular changes that are expected in the terminally ill patient
  • Describe the first places you might observe mottling in the terminally ill patient
  • Describe the respiratory changes that are commonly observed in the dying patient
  • List intervention strategies
  • Recall communications that are useful with family members
  • Identify the changes expected in the gastrointestinal and genitourinary systems
  • Describe assessment of and interventions for nausea and vomiting to provide comfort and relief
  • Identify the steps in abdominal assessment
  • Describe the causes of peripheral edema and the associated treatment options
  • Identify preventive measures to minimize skin breakdown
  • Describe Terminal Restlessness
  • Outline appropriate interventions to treat symptoms of Terminal Restlessness
  • Define expected observations during the transitional phase of dying
  • Describe the predictable sequence of physical and emotional changes throughout the dying phase
  • Recite the priorities and responsibilities of the registered nurse and hospice professionals immediately following death
Contact Time

3.75 Contact Hour: based on 60 minute contact hour

Estimated Time

The estimated time for completion for this activity is 3.75 hour(s).

Intended Audience

Health care professionals and volunteers to: include Registered Nurses, Licensed Practical Nurses, Social Workers, Physicians, Chaplains/Counselors, Home Healthaides, Certified Nursing Assistants, Homemakers, Volunteers, Therapists, and others interested in hospice services and information.

Course Planning Team

Kathy Richie, BSN, RN, Lores Vlaminck, RN, BSN, MA, Technical Nurse Consultant, Lores Consulting

Course Expiration Date

As required by ANCC, this continuing nursing education activity must carry an expiration date. You must complete the content, Final Quiz and Course Survey on or before that day. The last day to successfully complete this course and receive a Certificate of Completion will be December 31, 2023.

NCPD - Nursing Continuing Professional Development
Rochester Community & Technical College is approved with distinction as a provider of nursing continuing professional development by the Wisconsin Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
Provider Approval Number: WICEAP-0149-007
Disclosure Statements:

Commercial Support: This course was developed in accordance with ANCC Commercial Support Guidelines. No commercial support was accepted for the development of this course.

Non-endorsement of Products and Off Label Use: This course provides a balanced view of therapeutic options. Use of generic names is always considered before using trade names. Consequently, if trade names are necessary, when available, we will use trade names from several companies. RCTC and the course planning team do not endorsed any products or drugs that may be mentioned in this course.

Author Originating

Lores Vlaminck - RN BSN MA Technical Nurse Consultant Lores Consulting

Lores received both her Bachelors of Science Degree in Nursing and her Master's in Nursing Education from Bethel University, St. Paul, MN. Lores has a varied background of healthcare experience to include acute and critical care, clinical nurse specialist, and most recently, 19 years of experience as the founder and director of a rural home care and hospice agency.

Lores' passion is education for health care professionals, para-professionals, volunteers, and the community at large in the specialty of end-of-life care. Lores offers seminars, training, orientation, coaching, presentations, compliance monitoring, and mentoring for home care, hospice agencies, and health care organizations.


Materials used in connection with this course may be subject to copyright protection. Retention of the materials for longer than the class term, unauthorized further dissemination of the materials, or use of copyrighted materials in any way other than intended for this class is prohibited by Copyright and Teach Act laws.


This course was developed with Rochester Community and Technical College's Continuing Education and Workforce Development Division located in Rochester Minnesota. Development was funded from the Minnesota State Colleges and Universities System.

Course Code
Course Category