Chapter 6- Lecture

Question 1

What are the five aspects influenced by grief?

Answer 1

Cognitive
Physical 
Spiritual
Social
Behavioral

Question 2

What spiritual aspects occur when people are faced with grief?

Answer 2

Reconciliation with others
Forgiveness from God
Disconnected from God (higher Power)

Question 3

How do you support the patient through difficult news?

Answer 3

Content
Context
Emotional support

Question 4

What should be remembered when delivering difficult news?

Answer 4

Everyone involved in patient care plays an active role in creating memory

Question 5

What is considered under content?

Answer 5

Cognitive vs. feelings
Safe space
Repetition

Question 6

What is considered under context?

Answer 6

Privacy: Safe environment

Respond to emotions

Question 7

What is considered under emotional support?

Answer 7

Their own resources

Medical center resources

Question 8

What are Kubler-Ross’ five stages of grief?

Answer 8

Denial and isolation
Anger
Bargaining
Depression
Acceptance

Question 9

What are Worden’s tasks of mourning?

Answer 9

Accepting the reality of the loss
Feeling the pain and experiencing grief
Adjusting to an environment from which the decreased is missing
Withdrawing emotional energy from the deceased and reinvesting it in another relationship.

Question 10

Which Kubler-ross stages match up with Worden’s tasks?

Answer 10

Denial with accepting the reality of the loss
Anger, bargaining, depression with feeling the pain and experiencing grief
Acceptance with the last two

Question 11

What are Bowlby and Parkes 4 phases of grief?

Answer 11

Shock and numbness
Searching and Yearning
Disorganization and despair
Reorganization

Question 12

What is shock and numbness?

Answer 12

Shock acts as a protective mechanism against the full effects of loss. New information is difficult to process and denial is a shield for pain

Question 13

What is searching and yearning?

Answer 13

Many people feel that they are “going crazy” because of things they are seeing, feeling, thinking…

Question 14

What is disorganization and despair?

Answer 14

Withdrawal from others.
Substance abuse
Depression
Unwillingness to get help

Question 15

What is reorganization?

Answer 15

Resolution.

Sometimes it is coupled with feelings of guilt because the pain is over

Question 16

What are the six determinants of grief?

Answer 16

Relation to the survivor
Nature of the attachment
The mode of death
Prior grief experiences/Mental health
Religious beliefs
Gender

Question 17

What is part of the nature of attachment?

Answer 17

Whether the deceased provided strength, security, or ambivalence in the relationship
Some people are relieved

Question 18

What is part of the mode of death?

Answer 18

Natural death is easier to cope with than accidental death, suicide, or murder

Question 19

What questions might be asked when dealing with religious beliefs and death?

Answer 19

Why me?
Why now?
Why this?
Miracles?
Afterlife?

Question 20

Where do the differences in gender grieving come from?

Answer 20

Socialization of gender-related expressions of grief and their roles.

Question 21

Generally, how can men show grief?

Answer 21

Need to know they are respected

Question 22

Generally, how can women show grief?

Answer 22

Need to know they will be related to.

Question 23

What are normal grief feelings?

Answer 23

Sadness, anger, guilt, self-reproach
Anxiety, death phobia
Loneliness, fatigue, helplessness
Shock
Yearning
Emancipation
Relief
Numbness

Question 24

What are normal physical sensations of grief?

Answer 24

Hallowness in the stomach
Tightness in the chest and throat
Sense of depersonalization
Breathlessness
Weakness in muscles

Question 25

What are normal cognitive thoughts of grief?

Answer 25

Disbelief
Confusion
Preoccupation
Sense of presence
Hallucinations

Question 26

What are normal behaviors of grief?

Answer 26

Sleep disturbances, 
Appetite disturbances
Absent-minded behaviors
Social withdrawal
Dreams of the deceased
Restless over activity
Sighing or crying
Fear of losing memories
Treasuring objects

Question 27

What is the definition of abnormal grief?

Answer 27

Too little grieving immediately after a death or too much grieving long afterward.

Question 28

What increases the risks of abnormal grief?

Answer 28

Not seeing the body
Sudden loss
Ambiguous loss

Question 29

What can decrease the risk of abnormal grief?

Answer 29

Helping patients and families effectively grieve during the INITIAL phases of grief

Question 30

What are ways to say goodbye?

Answer 30

I remember when...
Forgive me...
I forgive you...
I will miss...
I love you...
Goodbye

Question 31

What should the medical professional be aware of when dealing with grief?

Answer 31

Be aware of your own history with loss
Plan support for crisis situations
Acknowledge your won personal needs

Question 32

How can you be aware of your own history of loss?

Answer 32

Think about past and present

Be aware of your coping mechanisms

Question 33

How can you plan support for crisis situations?

Answer 33

Use the interdisciplinary team to debrief

Question 34

How can you acknowledge your own personal needs?

Answer 34

Forgive and reconcile
Sleep
Personal limitations
You cannot save everyone
Watch for burnout, depression, and job dissatisfaction