Care of the Dying: Loss, Grief, and Growth Flashcards
Dying is a unique experience for patients and family that we all have in common. True/False
True
What are the four realms of dying that must be attended?
- Physical 2. Psychological 3. Social 4. Spiritual
Dying is not confined to cancer or AIDS. True/False
True; it includes all life-threatening illnesses and cases of sudden death
How many of the terminally ill patients will lose all of their savings?
1/3
Who consists of the patient’s “unit of care”?
The family
Family includes people and animals. True/False
True
Is EOL/hospice care covered under medicare?
Yes
How many states have medicaid coverage of hospice?
43 states and D.C.
How many businesses offer hospice benefits?
82%
What percentage of family members quit work to provide care to someone dying in their family?
20%
Is there a law that mandates accessibility to good EOL care?
No; even for those who have insurance coverage
What factors must be involved when trying to understand the dying patient?
Role in the family Employment Social factors Cultural Factors Spiritual factors
What needs must be meet for the dying patient?
- Receive adequate pain and symptom management 2. Avoid inappropriate prolongation of dying 3. Achieve a sense of control 4. Relieve burden 5. Strengthen relationships with loved ones.
A patient may elect to be less comfortable in order to be alert. True/False
True
Families frequently overestimate the suffering of their loved one. True/False
True; sometimes they want an end to the suffering
People over 80 want more treatment to extend their life. True/False
True; there are fewer days ahead than behind
Why is the sense of control so important in the needs of a dying patient?
You need to give people time to get their affairs in order.
Name some tools that are useful when caring for the dying patient.
Advance medical directives Code status General POA Office notes Personal letters Organ donation
Tennessee honors documents from all 50 states. True/False
True
How many states honor the “5 wishes” from FL?
40 states
Who is the most common decision maker for an incapacitated person recognized in most states?
the spouse
What are some contributors of sudden death?
MI and accident(10-15%_
What are some contributors in a progressive disease with a terminal phase?
Pancreatic cancer(10-15%)
What are some contributors to chronic, fatal diseases and sudden death?
CHF,COPD, DM, AIDS, Neuro(70-80%)
Which pattern do most people follow when dying? A. Sudden death B. Progressive disease with a terminal phase C. Chronic, fatal disease
C. Chronic fatal disease As time goes forward, the patient’s condition gets worse
There is an expanded notion of pain and suffering. True/False
True Physical, Psychological/emotional Social Spiritual
Palliative care is a huge portion of managing symptoms. True/False
True
When will a patient be referred to hospice care?
When there is 6 months or less to live
What are the issues involved in caring for the dying?
- Tension between two extremes(killing vs. letting die) 2. Care even when cure is impossible 3. Effective management of pain in all of its forms
When deciding to withdraw or withhold treatment, which question should always be addressed?
Does this help the patient
Define assisted suicide.
Pt asks doctor for a prescription that aids in dying( this is the assisted part)
Where is assisted suicide legal in the U.S?
WA, OR, NM, VT, MT
Define euthanasia.
the practice of intentionally ending the life b/c it is the only way to relieve the suffering of the patient
What are the stages of grief according to Kubler-Ross?
Denial
Anger
Bargaining
Depression
Acceptance
What are the stages of grief according to Temes?
Numbness
Disorganization
Reorganization
How much time is needed for the person and the family to accept death?
About 6 months
About how much time does it take to cope with the death of a loved one?
takes up to 24 months
Name some emotions associated with grief.
Anger
Confusion
Dazed feeling
Denial
Depression
Despair
Fear
Guilt
Isolation
Sadness
When should a person who is coping with death get help?
Apparent absence of grief
Hyperactivity and prolonged restlessness
Assuming the symptoms of the one who died
Psychosomatic illnesses
Emotional numbness
Abrupt or severe changes in lifestyle
Self-destructive behavior
Long-lasting or very deep depression
Hostility
Rage
Continued inappropriate emotional outbursts
Thoughts or talk of suicide
What are some things that can be said to the loved ones of a dead patient?
I’m so sorry for your loss.
How are you feeling?
Are you able to talk about what happened?
Can you tell me?
S/he loved you so much.
S/he was a wonderful friend.
You were a wonderful husband/wife/daughter/
son.
What are some things that should NOT be said to the loved one of a dying/dead patient?
I know just how you feel. (We know how we feel but we really don’t know how they feel)
It’s better this way.
You’ll feel better in a little while.
I’m glad it’s over for you.
Now you can heal and get some closure.
