Death and dying Flashcards
What are the key guiding principles for physicians regarding death and dying?
- Recognize and tell the patient when they are dying to get their things in order
- Support family ( how are YOU doing?)
- Keep patient comfortable
What is patient autonomy, and how does it relate to death and dying?
Autonomy is the ability to makes choices for oneself.
Patients have the right to receive considerate and respectful care, and choose their care surrounding death (not family or physician)
What defines a “good” death?
A death that is:
- free from needless pain/suffering
- In accord with patient’s wishes
- C/w professional/social norms
What defines a “bad” death?
A death characterized by:
- Needless suffering
- Dishonoring of the patient’s wishes
- Norms of decency offended
What defines a “hard” death?
A hard death is one that
-is well managed
-family is given good support-
BUT family and pt still suffer severely
What are the four components of suffering?
- Physical pain
- Emotional distress
- Mental distress
- Spiritual distress
What are the stages of dying?
- Shock and denial
- Anger
- Bargaining
- Depression
- Acceptance
What is the greatest opportunity we as physicians have in handling matters of dying patients?
To let them know they are dying so that they can begin the process of accepting it
What are the key spiritual tasks for the dying?
- Find meaning of their life
- Close relationships (thank you, forgive me, I forgive you, I love you, good bye)
- Figure out the legacy they leave behind (did it matter that I lived?)
What should we as physicians do when someone if facing fragility?
Reduce their expectation of medicine
What should we as physicians do when someone if facing Decline?
Maximize their independence
What should we as physicians do when someone if facing Disability?
Teach how to cope with dependence
What should we as physicians do when someone if facing failing health?
Prepare them for death
What should we as physicians do when someone is actively dying?
Prepare them for death
What should we as physicians do when the patient dies?
Mourn with the family
