Bereavement Flashcards

1
Q

Bereavement definition

A
  • State of loss resulting from death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Definition of Grief

A
  • Emotional response to loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Definition of Mourning

A
  • Process of adaptation to loss
  • cultural, social rituals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Definition of anticipatory grief

A
  • Emotion that precedes death
  • Expectation of loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Definition of pathological grief

A
  • Abnormal outcome
  • psychological, social or physical morbidity
  • includes complicated grief
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Definition of disenfranchised grief

A
  • Hidden sorrow for marginalized
  • less social permission to express grief
  • AIDS, very elderly
  • stigma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Attachment theory and grief

A
  • close effectionate bonds with others gives secruity and survival potential
  • parents, spouse, child
  • bonds of close relationship broked in death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Psychodynamic theory

A
  • childhood experiences guide emotional experience in relationships
  • mourning lifelong mehcanism to cope with trauma in life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Interpersonal theory and grief

A
  • relational influences grief
  • schemas of who the self is
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Psychosocial transition theory

A
  • loss results in changed world view
    *
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Sociological model of bereavement

A
  • breaking of bonds in a relationship
  • continuing bonds theory results in ongoing relationship with deceased
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Family Systems

A
  • family is unit of support
  • family function or dysfunction determines outcome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Characteristics of normal grief

A
  • somatic distress
  • preoccupation with sad memories
  • guilt
  • anger
  • loss of regular conduct
  • identifcation with symptoms of deceased
  • emotional distress in waves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Anticipatory Grief presentation

A
  • periods of grief interspersed with contentment and happiness
  • marker of risk for complicated grief

Clinician

  • encourage open sharing of feelings
  • saying goodnbye is a process
  • create opportunities for remininsence, celebration, gratitude, life completion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acute Grief and time course of bereavement

A
  • intial numbness and unreality
  • waves of distress
  • phase of disorganization and loneliness
  • phase of re organization and recovery
    • nostalgia replaces sadness
    • altered world view
  • Time course proportional to the attachment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Complicated grief

A
  • Persistent Complex Bereavement Disorder (DSM-5)
    • > 12 months symptoms
    • intense yearning
    • intense sorrow and preoccupation more days than not
    • out of proportion to culture norms
    • significant impairment in life
    • no other mental disorder
  • Can also have:
    • non acceptance
    • intense anger
    • life is empty
    • indecisiveness about future

Inventory of Complicated Grief (questionnaire)

17
Q

What are risk factors for developing complicated grief?

A
  • history of childhood neglect or abuse
  • traumatic death
  • unexpected death
  • intimate relationship with deceased
  • limited support after death
18
Q

Chronic grief

A
  • overly dependent relationships
  • sense of abandonment
  • fantasy of reunion via suicide
  • memorialization of deceased
  • social withdrawal, depression
19
Q

Comorbid complications of grief

A
  • Depression
  • anxiety
  • ETOH
  • PTSD
  • recurrence of psychotic disorders
20
Q

Risk factors for pathologic / complicated grief

A
  1. Nature of the death
  • untimely (child)
  • sudden
  • traumatic
  • stigmatized (suicide, aids)
  1. Strengths and vulnerabilities of bereaved
  • history of psych d/o
  • personality and coping style
  • cumulative losses
  1. Nature of relationship with deceased
  • dependent
  • ambivalent (angry, insecure, infedility, etc)
  1. Family and support
  • dysfunctional
  • isolation
  • alienation

-

21
Q

How can palliative care team address bereavement?

A
  • identify at risk people ahead of death
  • continue relationship post death
  • expression of condolences (cards, call, funeral attendance)
  • Bereavemenet coordinator, counsellor
  • Formal therapy
22
Q

List types of bereavement therapies

A
  • General support
  • Supportive expressive therapy
  • Psychotherapy
  • CBT
  • Family Focused Grief Therapy
23
Q

Grief and the “death bed”

A
  • respect for patient
  • guidance about dying process
  • religious rituals
  • discussion of autopsy
  • normalize process
  • experience has large impact on future for family members