THE CARES TOOL (by Kathrynn Thompson)
THE CARES TOOL: A Blog Series Addressing the Role of the Bedside Nurse in End of Life (EOL) Care
The CARES TOOL was designed by Bonnie Freeman and is discussed in the book Compassionate Person-Centered Care for the Dying (2015). It is an evidence based tool that is designed to address and guide EOL care for the bedside nurse. CARES is an acronym that stands for:
- C= Comfort
- A= Airway
- R= Restlessness and delirium
- E= Emotional and spiritual support
- S= Self-care
The CARES TOOL is based on the most common needs of the dying and their families. Comfort includes both pain management and other comfort measures. Airway covers airway management, including respiratory distress, and secretion control. Restlessness and terminal delirium are discussed. Emotional issues, which include spirituality to provide holistic care, are covered. And very importantly, self-care is discussed to address the impact of caring for the dying on the nurse.
The CARES TOOL was developed to deal with the knowledge deficits related to EOL nursing care and to help the bedside nurse understand the unique needs of the dying patient. Emphasis is placed on treating the dying patient and their family as a unit. This tool also focuses on the nursing role of patient advocate for dying patients and their families. One of the things I really like about this tool is the focus placed on the nurse. Self-care is addressed, as well as, the need for nurses to embrace their own humanity, compassion and empathy. This is operationalized in care of the dying by the nurse’s ability to actively listen and be a therapeutic presence.
My hope is that by using this tool each bedside nurse can reach a balance between what the nurse has to give to the patient and what dying patients and their families can teach the nurse.
Next month the topic of my blog will be: C= Comfort.
Freeman, B. (2015). Compassionate Person-Centered Care for the Dying: An Evidence-Based Palliative Care Guide for Nurses. New York, New York: Springer Publishing Company, LLC