CONCEPT OF DEATH AND DYING/ GRIEF OR GRIEVING

Question 1

is an actual or potential situation in which something that is valued is changed, no longer available, or gone. Loss
occurs when a valued person or object, or situation is changed or made inaccessible so that its value is diminished or
removed. People can experience the loss of body image, a significant other, a sense of well-being, a job, personal
possessions, or beliefs. Illness and hospitalization often produce losses

Answer 1

Loss

Question 2

experienced by one person but cannot be verified by or is intangible to others. Psychologic
losses are often perceived losses, in that they are not directly verifiable

Answer 2

PERCEIVED LOSS

Question 3

Can be identified by others and can arise either in response to or in
anticipation of a situation. For example, a woman whose husband is dying may experience actual loss in anticipation of
his death

Answer 3

ACTUAL LOSS

Question 4

TWO TYPES OF LOSS

Answer 4

1. ACTUAL LOSS
2. PERCEIVED LOSS

Question 5

is experienced as a result of natural developmental processes. It is a loss resulting from normal life transitions

Answer 5

MATURATIONAL LOSS

Question 6

occurring suddenly in
response to specific external event. It is experienced as a result of an unpredictable event, including traumatic injury, disease, death, or national disaster.

Answer 6

SITUATIONAL LOSS

Question 7

In which a person displays loss and grief behaviors for a loss that has yet to take
place. Anticipatory loss is often seen in the families of patients with serious and life-threatening illnesses and serves to lessen the impact of the actual loss of family member

Answer 7

ANTICIPATORY LOSS

Question 8

may include a body part,physiological function, or psychological function

Answer 8

LOSS OF AN ASPECT OF SELF

Question 9

involves any possession that is worn out, misplaced, stolen or ruined by disaster

Answer 9

LOSS OF EXTERNAL OBJECTS

Question 10

Includes leaving a familiar settin

Answer 10

LOSS OF A KNOWN ENVIRONMENT

Question 11

• this includes parents, spouses, children, siblings, teachers, clergy, friends, neighbors, work associates and entertainment figures

Answer 11

LOSS OF A SIGNIFICANT OTHER

Question 12

person who face death live, feel, think and respond to events and people around them until the moment of
death

Answer 12

LOSS OF LIFE

Question 13

refers to the subjective emotions and affect that are a normal response to the experience of loss. Grieving, also
known as bereavement refers to the process by which a person experiences the grief. It involves not only the content (what a person thinks, says and feels) but also the process (how a person thinks, says and feels).

Answer 13

GRIEF

Question 14

is when people facing an imminent loss begin to grapple with the very real possibility of the loss
or death in the near future. Mourning is the outward expression of grief. Rituals of mourning include having a wake, holding religious ceremonies and arranging funerals

Answer 14

ANTICIPATORY GRIEVING

Question 15

The therapeutic relationship and therapeutic communication skills such as active listening are paramount when assisting
grieving clients. Recognizing the verbal and nonverbal communication content of the various stages of grieving can help nurses to select interventions that meet the client’s psychological and physical needs.

Answer 15

THE GRIEVING PROCESS

Question 16

5 STAGES OF GRIEF

Answer 16

1.Denial
2.Anger
3.Bargaining
4.Depression
5.Acceptance

Question 17

The initial stage: “It can’t be happening.”

Answer 17

DENIAL

Question 18

: “Why ME? It’s not fair?!” (either referring to God, oneself, or anybody perceived, rightly or wrongly,
as “responsible”)

Answer 18

ANGER

Question 19

“Just let me live to see my son graduate.

Answer 19

BARGAINING

Question 20

I’m so sad, why bother with anything?”

Answer 20

DEPRESSION

Question 21

: “It’s going to be OK

Answer 21

ACCEPTANCE

Question 22

• Refuses to believe that a loss is happening
• Isolates self from reality and represses what is discussed
• Ignore the signs of the loss.
• May be artificially cheerful in order to prolong the denial.
• May begin to use

Answer 22

DENIAL

Question 23

• Become angry with God, with oneself or with others
  • Client or family express rage and hostility, sometimes at nurse and staff members, about things that
  normally would upset them.
• “Why me? I didn’t do anything to deserve this.”
• May pick out “scapegoats” on which to vent anger e.g. doctors, friends, rehabilitation specialists, etc.
  May begin to use:
  • Self blaming
  • Switching blame
  Blaming the victim
  Aggressive anger: believing to have the right to vent blame and rage aggressively to the closest target

Answer 23

ANGER

Question 24

• Bargain or strike a deal with God to make the loss go away
Promise to do anything to make the loss go away
• Seeks to bargain to avoid loss
• May begin putting affairs in order, for example making wills and giving away personal items
• Guilt for real or imagined past sins may be expressed
• May begin to:
• Shop around: believing to look for the “right” agent with the “cure” for the loss.
4
• Gamble: believing that taking chances on “cures” for the loss
• Take risks: believing to put oneself in jeopardy financially, emotionally, and physically to get to an
answer or “cure” for the loss
• Sacrifice: believing that ignoring the real needs in pursuit of the “cure” can change the los

Answer 24

BARGAINING

Question 25

• Grieves over what has happened and what cannot be
May cry and talk freely about the loss or may withdraw
May begin to experience:
Guilt: believing oneself is responsible for the loss
• Remorse: believing that should feel sorry for the real or perceived “bad past”, deeds for which the
loss is some form of retribution or punishment
Loss of hope: believing that no hope of being able to return to the calm and order of life prior to loss
Loss of faith and trust: believing that because of the loss, can no longer trust in the goodness and
mercy of God and mankind

Answer 25

DEPRESSION

Question 26

• Comes to terms with loss
• May have decreased interest in surroundings and significant others
• May wish to begin making plans
• Can now:
• Describe the terms and conditions involved in the loss
• Cope with the loss
• Test the concepts and alternatives available in dealing with the los

Answer 26

ACCEPTANCE

Question 27

refute irrational beliefs or fantasy thinking to address loss

Answer 27

RATIONAL THINKING

Question 28

can incorporate changes necessary after the loss

Answer 28

Adaptive behavior

Question 29

expresses emotional responses freely and are better able to verbalize pain, hurt and suffering that has been experience

Answer 29

Appropriate emotion

Question 30

recognize that it takes time to adjust to the loss and gives
oneself time to “deal” with it. Sets realistic time frame

Answer 30

Patience and self-understanding

Question 31

gains confidence needed for personal growt

Answer 31

SELF-CONFIDENCE

Question 32

CHARACTERISTICS OF NORMAl GRIEF REACTION

Answer 32

CHARACTERISTICS OF NORMAL GRIEF REACTION

Question 33

• Feelings of tightness in the throat
• Choking
• Empty feeling in abdomen
• Lack of muscular strength
• Subjective distress such as mental pain or distress
• Sleep disturbance

Answer 33

PHYSICAL SYMPTOMS

Question 34

• Hears, sees or imagines the deceased person
• Feeling of emotional distance from others
• Feeling of loss of emotional control

Answer 34

PREOCCUPATION WITH IMAGE OF THE DECEASED OR LOSS

Question 35

• Searches for ways that loss could have been prevented
• Accuses others of negligence or fault

Answer 35

FEELINGS OF GUILT

Question 36

• Restlessness, inability to sit still, aimless movement
• Impaired concentration
• Lack of capacity to initiate usual interests or activities
• Inability to experience pleasure
• Changes in eating habit

Answer 36

LOSS OF USUAL BEHAVIOR

Question 37

an event, a state. It does not have the same meaning for everyone

Answer 37

DEATH

Question 38

Many patients realize without being told that they are suffering from a terminal illness; they often pick up this knowledge
from nonverbal communication by their families and by healthcare professionals. Patients must be allowed to go through
the stages of grieving process and to make decisions about their care. Competent patients have the right to consent and
refuse any and all indicated medical treatment-even life-sustaining treatment-and should be made aware of this right

Answer 38

IMPACT ON PATIENT

Question 39

The family and significant others of terminally ill patients should be encouraged to participate in planning the patient’s
care. Healthcare personnel should be available to discuss the patient’s condition with family members and should offer
support and care as the family begins the grieving process. The family may want to make arrangements with the patient
for funeral or memorial services, depending on which stage of grief both the patient and the family members are in

Answer 39

IMPACT ON FAMILY

Question 40

Palliative care means taking care of the whole person-body, mind, and spirit, heart and soul. It looks at dying as something natural and personal. The goal of palliative care is to gibe patients with life-threatening illnesses the best
quality of life they can have by the aggressive management of symptoms. Palliative acre is sometimes called hospice care.

Caring for the dying and the bereaved is one of the nurse’s most complex and challenging responsibilities, bringing into
play all the skills needed for holistic physiologic and psychosocial care. To be effective, nurses must come to grips with
their own attitudes toward loss, death, and dying, because these attitudes will directly affect their ability to provide car

Answer 40

PALLATIBE CARE

Question 41

Fears experienced by the Dying Persom

Answer 41

Fear of the unknown.
Fear of abandonment and loneliness.
Fear of loss of relationships and experiences in the future.
Fear of dependency and loss of independence.
Fear of pain

Question 42

The major nursing responsibility for clients who are dying is to assist the client to a peaceful death. More specific responsibilities are the following:

Answer 42

1. To provide relief from loneliness, fear and depression.
2. To maintain the client’s sense of security, self-confidence, dignity, and self-worth.
3. To maintain hope.
4. To help the client accept losses.
5. To provide physical comfort