Bereavement Flashcards
1
Q
Bereavement definition
A
- State of loss resulting from death
2
Q
Definition of Grief
A
- Emotional response to loss
3
Q
Definition of Mourning
A
- Process of adaptation to loss
- cultural, social rituals
4
Q
Definition of anticipatory grief
A
- Emotion that precedes death
- Expectation of loss
5
Q
Definition of pathological grief
A
- Abnormal outcome
- psychological, social or physical morbidity
- includes complicated grief
6
Q
Definition of disenfranchised grief
A
- Hidden sorrow for marginalized
- less social permission to express grief
- AIDS, very elderly
- stigma
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
8
Q
Psychodynamic theory
A
- childhood experiences guide emotional experience in relationships
- mourning lifelong mehcanism to cope with trauma in life
9
Q
Interpersonal theory and grief
A
- relational influences grief
- schemas of who the self is
10
Q
Psychosocial transition theory
A
- loss results in changed world view
*
11
Q
Sociological model of bereavement
A
- breaking of bonds in a relationship
- continuing bonds theory results in ongoing relationship with deceased
12
Q
Family Systems
A
- family is unit of support
- family function or dysfunction determines outcome
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
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
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
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
- Nature of the death
- untimely (child)
- sudden
- traumatic
- stigmatized (suicide, aids)
- Strengths and vulnerabilities of bereaved
- history of psych d/o
- personality and coping style
- cumulative losses
- Nature of relationship with deceased
- dependent
- ambivalent (angry, insecure, infedility, etc)
- 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
