ch 35 - loss, death and palliative care Flashcards
grief model:
-can be used to improve understanding of grieving and
to assist nurses in caring and comforting those who have
experienced, or are experiencing, a loss
• grievers are viewed as part of a system that is striving to maintain equilibrium or stability
loss response model
response to a real or perceived loss before it
occurs
anticipatory grief
somatic, functional, and emotional symptoms of
distress, occur in waves of varying lengths of time
acute grief
occurs in waves of varying lengths of time during
the period of impact, inhibits some function
shadow grief
Debilitating, posttraumatic stress, prolonged
disorder
complicated grief
Loss cannot be openly acknowledged or publicly
mourned experiences
disenfranchised grief
examples of good coping skills
- avoids avoidance
- confronts realities and takes appropriate actions
- focuses on solutions
- redefines problems
- considers alternatives
- has good communication with others
- seeks and uses constructive help
- accepts support when offered
- can keep up morale
what is goal of grief assessment
to differentiate those who are likely to cope effectively from those who are less likely so that appropriate interventions can be planned
6 interventions for helping grievers move through impact of loss
- functional disruption (assistance)
- searching for meaning (access to info, listening)
- engaging emotions (express, support, listening)
- informing others (physical presence, listening)
- adaptation (how loss has affected life)
- reframing memories (reminiscence)
goal of palliative care
prevent or minimize suffering
hospice - for people with <6 months to live
Advanced directive that is specifically related to a
situation in which a person is facing terminal
illness and unable to speak for him or herself
living will
physical S+S approaching death
- coolness
- increased sleeping
- disorientation
- fecal and/or urinary incontinence
- noisy respirations
- restlessness
- decreased intake food/fluids
- decreased urine output
- altered breathing pattern
emotional S+S approaching death
- withdrawal
- vision experiences of family or religious vision
- restlessness
- unusual communication
nursing intervention for coolness
- socks
- blankets
- NO ELECTRIC BLANKET
nursing intervention for increased sleeping
- respect want
- ask about desired companionship
