ch 36 potter loss and grief

Question 1

(a law requiring that patients be made aware of their medical decision rights), nurses and other health care providers are starting these conversations earlier, but there is more work left to do.

Answer 1

Self-Care Determination Act of 1990

Question 2

compassion, attentiveness, and patient-centered care

Answer 2

nurse learn to provide what patients and families need most at the time of a serious loss

Question 3

is belief in a higher power.

Answer 3

Faith

Question 4

provides assistance with pain management when a patient is not eligible for hospice care.

Answer 4

Palliative care

Question 5

less than 6 months to live

Answer 5

Patients accepted into a hospice program usually have

Question 6

(belief in a higher power or in the meaning of life)

Answer 6

spiritual

promotion

Question 7

(curing a disease)

Answer 7

Curative therapy

Question 8

acknowledge the loss and talk about the common renewal of grief feeling

Answer 8

facilitates mourning

Question 9

uncomplicated loss

Answer 9

grief.

Question 10

Children develop independence from the adults who raise them, and as they begin and leave school, change friends, begin careers, and form new relationships, loss is a part of their maturation

Answer 10

maturation loss

Question 11

Sudden, unpredictable external events bring about

-ex: getting in car accident= loss job, income, body part

Answer 11

situational loss.

Question 12

occurs when a person can no longer feel, hear, see, or know a person or object

Answer 12

actual loss

Question 13

is uniquely defined by the person experiencing the loss and is less obvious to other people.
-experienced so internally and individually

Answer 13

perceived loss

Question 14

is the ultimate loss.

Answer 14

Death

Question 15

is a “normal but bewildering cluster of ordinary human emotions arising in response to a significant loss, intensified and complicated by the relationship to the person or the object lost”
-its not state but a process

Answer 15

Grief

Question 16

Most individuals recover adequately within a year after a loss; however, some individuals experience an extension of the standard grieving process, described as

Answer 16

complicated grief or prolonged grief disorder

Question 17

Coping with grief involves a

Answer 17

period of mourning

Question 18

is a time period when normal life activities come to a stop.

Answer 18

Jewish mourning ritual of Shivah

Question 19

encompasses both grief and mourning and includes the emotional responses and outward behaviors of a person experiencing loss.

Answer 19

bereavement

Question 20

is a common and universal reaction characterized by complex emotional, cognitive, social, physical, behavioral, and spiritual responses to loss and death.
- grief include disbelief, yearning, anger, and depression

Answer 20

Normal (uncomplicated) grief

Question 21

before the actual loss or death occurs

-, shock, denial, and tearfulness

Answer 21

anticipatory grief

Question 22

when their relationship to the deceased person is not socially sanctioned, cannot be shared openly, or seems of lesser significance.

Answer 22

disenfranchised grief

Question 23

can occur when the person who is lost is physically present but not psychologically available, as in cases of severe dementia or brain injury.
-ex: refugees and immigrants , kidnapped child

Answer 23

Ambiguous loss (type of disenfranchised grief)

Question 24

a person has a prolonged or significantly difficult time moving forward after a loss.
-more than 1 yr

Answer 24

complicated grief

Question 25

chronic, exaggerated, delayed, and masked grief.

Answer 25

Specific types of complicated grief include

Question 26

a normal grief response, except that it extends for a longer period of time. This can include years to decades of intense grieving.

Answer 26

chronic grief experiences (types of complicated grief)

Question 27

response often exhibits self-destructive or maladaptive behavior, obsessions, or psychiatric disorders.
- Suicide is a risk for these individuals.

Answer 27

exaggerated grief (types of complicated grief)

Question 28

is unusually delayed or postponed because the loss is so overwhelming that the person must avoid the full realization of the loss.
- delayed grief response is frequently triggered by a second loss

Answer 28

delayed grief (types of complicated grief)

Question 29

Sometimes a grieving person behaves in ways that interfere with normal functioning but is unaware that the disruptive behavior is a result of the loss and ineffective grief resolution.
-Physical symptoms exhibited by the masked grief could be headaches, heartburn, rashes, or tachycardia.

Answer 29

Masked Grief

Question 30

Denial:
The person cannot accept the fact of the loss. It is a form of psychological protection from a loss that the person cannot yet bear.
Anger:
The person expresses resistance or intense anger at God, other people, or the situation.
Bargaining:
The person cushions and postpones awareness of the loss by trying to prevent it from happening.
Depression:
The person realizes the full impact of the loss.
Acceptance:
The person incorporates the loss into life.

Answer 30

Stages of Dying

Kübler-Ross (1969)

Question 31

-Numbing
Protects the person from the full impact of the loss
-Yearning and Searching
Emotional outbursts of tearful sobbing and acute distress; common physical symptoms in this stage: tightness in chest and throat, shortness of breath, a feeling of lethargy, insomnia, and loss of appetite
-Disorganization and Despair
Endless examination of how and why the loss occurred or expressions of anger at anyone who seems responsible for the loss
-Reorganization
Accepts the change, assumes unfamiliar roles, acquires new skills, builds new relationships, and begins to separate himself or herself from the lost relationship without feeling that he or she is lessening its importance

Answer 31

Attachment Theory

Bowlby (1980)

Question 32

Accepts the reality of the loss
Experiences the pain of grief
Adjusts to a world in which the deceased is missing
Emotionally relocates the deceased and moves on with life

Answer 32

Grief Tasks Model

Worden (2008)

Question 33

Recognize the loss
React to the pain of separation
Recollect and re-experience the relationship with the deceased
Relinquish old attachments
Readjust to life after loss
Reinvest by putting emotional energy into new people

Answer 33

Rando’s “R” Process Model

Rando (1993, 2014)

Question 34

Loss-Oriented activities: grief work, dwelling on the loss, breaking connections with the deceased person, and resisting activities to move past the grief
Restoration-Oriented activities: attending to life changes, finding new roles or relationships, coping with finances, and participating in distractions, which provide balance to the loss-oriented state

Answer 34

Dual Process Model

Stroebe and Schut (1999)

Question 35

provides nurses with basic and advanced curricula to care for patients and families experiencing loss, grief, death, and bereavement

Answer 35

End-of-Life Nursing Education Consortium (ELNEC)

Question 36

developed the Scope and Standards of Hospice and Palliative Nursing Practice in conjunction with the Hospice and Palliative Care Nurses Association

Answer 36

American Nurses Association (ANA)

Question 37

• cannot understand loss or death but often feel anxiety over the loss of objects and separation from parents. -Common expressions of grief include changes in eating and sleeping patterns, bowel and bladder disturbances, and increased fussiness

Answer 37

toddlers

Question 38

• understand the concepts of permanence and irreversibility but do not always understand the causes of a loss.
• Some have intense periods of emotional expression and experience changes in eating, sleeping, and level of social engagement

Answer 38

School-age children

Question 39

• experience many necessary developmental losses related to their evolving future
• Illness or death disrupts the young adult’s future dreams and establishment of an autonomous sense of self

Answer 39

Young adults

Question 40

also experience major life transitions such as caring for aging parents, dealing with changes in marital status, and adapting to new family roles

Answer 40

Midlife adults

Question 41

the aging process leads to necessary and developmental losses. Some older adults experience age discrimination, especially when they become dependent or are near death, but they show resilience after a loss as a result of their prior experiences and developed coping skills

Answer 41

older adults

Question 42

gives a person the ability to see life as enduring or having meaning or purpose

Answer 42

Hope

Question 43

often arises from a patient’s inability to feel hopeful or to foresee any favorable outcomes.

Answer 43

spiritual distress

Question 44

has been shown to reduce the symptoms of pain, anxiety, nausea, shortness of breath, and stress and to increase relaxation and peacefulness.

Answer 44

Massage

Question 45

• available in home, hospital, extended-care, and nursing home settings.
• Patients accepted into a hospice program usually have less than 6 months to live

Answer 45

Hospice