death and dying Flashcards
What is the dominant medical model focused on?
cure
Necessary loss?
part of the maturation process – leaving home, changing schools etc
Actual loss?
any loss of a person or object that can no longer be felt, heard, known or experiences
Percieved loss?
any loss that is defined uniquely by the grieving person
Maturational loss?
any change in the developmental process that is normally expected during the lifetime.
Situational loss?
any sudden, unpredictable external event
What are inidividual pace and pattern of emotional response to loss or death based on?
- previous experiences
- coping strategies
- cultural expectations
- spiritual beliefs
Bereavement?
grief and mourning, state of having lost a SO to death. Non-linear
What is Bowlby’s attachment theory?
numbing, yearning & searching, disorganized & despair, reorganization
What are Worden’s 4 tasks?
- accept reality of loss;
- work through pain of grief;
- adjust to environment without deceased;
- emotionally relocate deceased & move on
what are the 4 different types of grief?
Normal
anticipatory
complicated
disenfranchised
Describe what normal grief is:
or uncomplicated – normal feelings, behaviours and reactions to loss, opportunity to develop adaptive coping strategies.
Describe what anticipatory grief is:
occurs before actual loss or death. Surviving members may exhibit few symptoms of grief once death occurs. Risks.
emotional response before actual death (terminal illness) by both person dying and family members. May have ambivalent feelings.
Describe what complicated grief is:
chronic (unresolved), delayed (maybe due to multiple losses), exaggerated, masked
significantly longer in duration and emotionally incapacitating. Contributing factors include history of depression, loss of a child, substance abuse, early death (in childhood of a parent or sibling), multiple losses, conflict. May also be an absence of grief in situations where it would be expected.
Describe what disenfranchised grief is:
when loss cannot always be openly acknowledged, socially sanctioned, or publicly shared due to stigmatization.
What understanding of death would a infant -5yo have?
Does not understand
Believes death is reversible
Separation from parents
What understanding of death would a 5-9yo have?
Understands death is final
May believe they are responsible, body parts
What understanding of death would a 9-12yo have?
Understands death is EOL
Begins to understand own mortality
What understanding of death would a 12-18yo have?
Fears a lingering death
Death can be defied
Not adult understanding yet
What understanding of death would a 18-45yo have?
Attitude towards death influenced by culture and religion, re-examine life
What understanding of death would a 45-65yo have?
Accepts own mortality
Experiences death of parents, friends etc.
Experiences peaks of death anxiety
What understanding of death would a 65yo+ have?
Fears prolonged illness
Multiple deaths
Sees death as having multiple meaning
What are the signs of approaching death?
Increased fatigue, breathlessness, drowsiness
Loss of appetite stops eating
May become delirious, anxious and agitated, or somnolent
Constipated
Sometimes changes are swift & progressive, others are slow & gradual
Longer sleeps or coma
Darker urine
Weaker (no ADL’s)
What are the signs of an immenently dying pt?
Loss of muscle tone
Slowing of circulation
Change in respirations - “Death rattle”
Family becomes emotionally & physically exhausted
Nurses give information & support, calm
Offer respite
