1 - Death - Holroyd

Question 1

Changes in Death Causes

Answer 1

More deaths in hospital

More death due to chronic illness

Higher expectation for “miracle of modern medicine”

Question 2

Talking About Death to Patients/Families

Answer 2

Objective/Don’t assign emotional labels

Short

Allow questions

Question 3

What might be required if you suspect capacity to make medical decisions is compromised?

Answer 3

2nd opinion

Cognitive screen

Question 4

Advance Health Directives - Living Wills

Answer 4

Legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity.

May simply appoint a decision maker.

Optimal if family aware of the Directive prior to patient becoming incapacitates

Question 5

Power of Attorney

Answer 5

Makes decision who will make medical, legal, and financial decisions

Begins when patient found no longer to have capacity, or when they legally direct the perosn to begin acting as their power of attorney

Question 6

Guardianship

Answer 6

Patient does not pick their medical decision maker, it is appointed through court order

Question 7

Order of Who makes Medical Decision if not named in POA

Answer 7

Spouse

Adult Child

Parent

Adult Sibling

Question 8

Hospice and Palliative Care

Answer 8

Palliative Care focuses on symptom relief, pain management, not just for terminal patients

Hospice Care focuses on improving quality of life for terminal patient (expected to die within 6 months)

Question 9

Kubler-Ross Stages

Answer 9

Denial

Anger

Bargaining

Depression

Acceptance

• Can occur in any order, not required, not define normal grief

Question 10

Konigsburg Concept of Grief

Answer 10

Experience of grief depends on the individual temperament, life experiences, individuals circumstances

Humans “wired” to grieve

No right or wrong way to eperience grief

Question 11

Grief

Answer 11

Can occur to to any loss, not just death

“Pangs of Grief” arise intermittently and become less frequent over time

Early grief marked by sleep/appetite loss, lack of enjoyment

Normal

Question 12

Grief vs Depression

Answer 12

Both have sadness, sleep/appetite disturbances

Normal grief does not have:

Suicidal Ideation

Change in Self Attitude

Hallucinations/delisions

Inability to Function

Question 13

When do you treat depression following loss?

Answer 13

If symptoms persist following 2-3 months

Question 14

Antidepressant for a Grieving Patient

Answer 14

Don’t project your feelings

Help mind to deal with loss better