Death and dying

Question 1

Communication with the dying: liberation

Answer 1

• having the opportunity to prepare for death can be a freeing and liberating experiences
• you might ask for what you want and express yourself freely. conversations may reflect deeply held thoughts and values without fear of egocentrism

Question 2

communicating with the dying: denial

Answer 2

• easy to work with people who have accepted death as inevitable, then work with families who have not accepted and are using everyday to deny or attempt control
• this denial may develop from a belief that to do otherwise will cause a loss of the will to live or to lose hope

Question 3

communicating with the dying: pattern consistency for the dying person

Answer 3

• progression is not linear
• family and pt might be at different stages
• if you dont communicate about your knowledge if stages, as it can diminish their importance

Question 4

what are the stages of loss

Answer 4

1) denial
2) anger
3) bargaining
4) depressing
5) acceptance

Question 5

stages of the caregiver

Answer 5

1) intellectualization
2) survival
3) depression
4) emotional arrival
5) deep compassion

Question 6

philosophy of hospice

Answer 6

(not a location) that promises the pt will die with pain pain controlled to the greatest possible extent and the the qualify of life will become the focus of treatment

Question 7

palliative care

Answer 7

used for patients who are not expected to die in the next 6 months but still wants care the controls discomfort and pain ongoing with chronic illness can also have curative care while in palliative care

Question 8

hospice care

Answer 8

pts who are expected to die within the next 6 months. care includes care for the family, comfort care focuses on symptom control, pain relief and quality of life . Cannot be seeking for curative treatment

Question 9

signs of a dying pt

Answer 9

• no water for 7-10 days
• 30 days without food
• lingering response to hearing and touch (particularly of a loved ones voice and touch)
• say comforting and soothing things that you think they would want to hear; reminisce
• Morphine does not make death come giver; they have resolve breathless discomfort from pulmonary problems

Question 10

living will

Answer 10

• written statement that includes a persons desires regarding their medical treatment and circumstances in which they are no longer able to express informed consent
• usually a family member, spouse will be in charge of medical decisions once the pt is unable to carry out their own wishes

Question 11

Advances directives

Answer 11

• a form in which an individual appoints a health care power of attorney or provides guidance or instructions for health care decisions removing end of life
  ex: DNR and POLSTS

Question 12

POLSTS (physician orders of life sustaining treatment)

Answer 12

form consists of a set of medical orders that applies to the limited population with specific diagnosis

Question 13

focus for working with dying pts

Answer 13

• remain in control
• keep their “lived world” as large as possible
• pain control
• provide support for the family
• active listening and touch
• avoid desires to “fix” things