Death and Dying Flashcards
seeks to bargain to avoid loss
Stage 3: Bargaining
TYPES OF GRIEF RESPONSES
contributing factors: prior traumatic loss, family or cultural barriers to the emotional expression of grief, sudden death, strained relationships , lack of adequate support
COMPLICATED
CHARACTERISTICS OF NORMAL GRIEF REACTION
- PHYSICAL SYMPTOMS
- PREOCCUPATION WITH IMAGE OF THE DECEASED OR LOSS
- FEELINGS OF GUILT
- LOSS OF USUAL BEHAVIOR
TYPES OF GRIEF RESPONSES
occurs when a person is unable to acknowledge the loss to other persons
DISENFRANCHISED GRIEF
total response to the emotional experience related to the loss
Grief
taking care of the whole person-body, mind, and spirit,
heart and soul
Palliative Care
become angry with God, with oneself or with others
Stage 2: Anger
(Types of Loss)
occurs in the process of normal development
DEVELOPMENTAL LOSS
refuses to believe that a loss is happening
Stage 1: Denial
Grieves over what has happened and what cannot be
Stage 4: Depression
TYPES OF GRIEF RESPONSES
exists when the strategies to cope with the loss are maladaptive
COMPLICATED
What should you do in Meeting Physiologic Needs of the Dying Client
- providing personal hygiene measures
- controlling pain
- relieving respiratory difficulties
- assisting with movement, nutrition, hydration, and elimination
- providing measures related to sensory changes
FACTORS INFLUENCING LOSS AND GRIEF RESPONSES
- age
- significance of the loss
- culture
- spiritual beliefs
- gender
- socioeconomic status
- support system
- cause of the loss or death
ignores the signs of the loss
Stage 1: Denial
(Types of Loss)
can be recognized by others and can arise either in response to or in anticipation of a situation
Actual Loss
Type of Loss
loss resulting from normal life transitions
DEVELOPMENTAL LOSS
behavioral process through which grief is eventually resolved or altered
MOURNING
The physician is usually responsible for deciding what, when, and how the patient should be told.
Care of Terminally Ill Patients and Their Families
May cry and talk freely about the loss or may withdraw
Stage 4: Depression
strike a deal with God to make the loss go away
Stage 3: Bargaining
manifested in thoughts, feelings, and behaviors associated with overwhelming distress or sorrow
Grief
may express feelings of guilt or fear of punishment for past sins, real or imagined
Stage 3: Bargaining
FEARS EXPERIENCED BY THE DYING PERSON
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
Death is an ______, a ________
an event, a state
often influenced by culture, spiritual beliefs, and custom
MOURNING
making arrangements with the patient for funeral or memorial services
Impact on Family
TYPES OF GRIEF RESPONSES
often relate to a socially unacceptable loss that cannot be spoken about
DISENFRANCHISED GRIEF
Goals of Hospice Care
- To control and relieve pain and symptoms of the illness
- To provide physical comfort for the terminally ill
- To provide social, emotional, and spiritual comfort for the client, family, and friends throughout the final stage of illness, at the time of death, and during the bereavement period of survivors
hospice care
Palliative Care
May begin to experience:
- guilt
- remorse
- loss of hope
- loss of faith and trust
Stage 4: Depression
participation in planning the patient’s care
Impact on Family
isolates self from reality and represses what is discussed
Stage 1: Denial
subjective response experienced by the surviving loved ones after the death of a person with whom they have shared a significant relationship
BEREAVEMENT
may begin putting affairs in order
Stage 3: Bargaining
NURSING RESPONSIBILITIES FOR DYING CLIENTS (Specific)
- To provide relief from loneliness, fear and depression
- To maintain the client’s sense of security, self-
confidence, dignity, and self-worth - To maintain hope
- To help the client accept losses
- To provide physical comfort
Type of Loss
experienced as a result of an unpredictable event
SITUATIONAL LOSS
occurs when a valued person or object, or situation is changed or made inaccessible so that its value is diminished or removed
Loss
(Types of Loss)
experienced by one person but cannot be verified by or is intangible to others
PERCEIVED LOSS
Focus of Nursing
HEALTH MAINTENANCE and HEALTH RESTORATION, with an emphasis on maintaining maximum potential
in wellness
May begin to use:
* rational thinking
* adaptive behavior
* appropriate emotion
* patience and self-understanding
* self- confidence
Stage 5: Acceptance
to promote “_____ _______” through compassionate palliative care and to facilitate coping with disability and death
good dying
Patients must be allowed to go through the stages of
grieving process and to make decisions about their care
Impact on Patient
Initial stage: “It can’t be happening.”
Stage 1: Denial
focus on support and care of the dying person and family
Hospice Home Care
Comes to terms with loss
Stage 5: Acceptance
Goal: facilitating a PEACEFUL and DIGNIFIED DEATH
Hospice Home Care
Sources of Loss
inanimate objects that have importance to the person
Loss of External Objects
May have decreased interest in surroundings and signifacnt others
Stage 5: Acceptance
an actual or potential situation in which something that is valued is changed, no longer available, or gone
Loss
TYPES OF GRIEF RESPONSES
brief but genuinely felt
ABBREVIATED GRIEF
4 Sources of Loss
1.Loss of an Aspect of Self
2. Loss of External Objects
3. Loss of a Familiar Environment
4. Loss of a Loved One or Valued Person
Types of Griefs in Complicated Grief Response
a. unresolved /chronic grief
b. inhibited grief
c. delayed grief
d. exagerrated grief
May begin to:
* shop around
* gamble
* take risks
* sacrifice
Stage 3: Bargaining
Who made 5 stages of Grief?
Kubler-Ross
Goal of Palliative Care: to give patients with life-threatening illnesses the
______ ______ of life they can have by the aggressive
management of symptoms
best quality of life
Ability to function as a significant and integrated person
Helping clients die with dignity
Sources of Loss
body part, physiological function, psychological function
Loss of an Aspect of Self
Sources of Loss
a fundamental loss both for the dying person and those who survive
Loss of a loved one
(Types of Loss)
experienced before the loss actually occurs
- ANTICIPATORY LOSS
NURSING RESPONSIBILITIES FOR DYING CLIENTS (Major)
to assist the client to a peaceful death
TYPES OF GRIEF RESPONSES
experienced in advance of the event
ABBREVIATED GRIEF
Type of Loss
occurs suddenly in response to specific external event
SITUATIONAL LOSS
It is a subjective and private experience a dynamic process, a stage of life
Dying
________ is often the key person in providing support and care when loss or death occurs. To be effective, the nurse must have accepted her/his own feelings about death and understand the stages of grieving and dying.
Nurse
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 loss
Stage 5: Acceptance
may be artificially cheerful in order to prolong the denial
Stage 1: Denial
may begin to use:
* self blaming
* switching blame
Stage 2: Anger
Sources of Loss
can stimulate people to grow in their understanding of themselves and others
Loss of a loved one
