death and dying

Question 1

What is the dominant medical model focused on?

Answer 1

cure

Question 2

Necessary loss?

Answer 2

part of the maturation process – leaving home, changing schools etc

Question 3

Actual loss?

Answer 3

any loss of a person or object that can no longer be felt, heard, known or experiences

Question 4

Percieved loss?

Answer 4

any loss that is defined uniquely by the grieving person

Question 5

Maturational loss?

Answer 5

any change in the developmental process that is normally expected during the lifetime.

Question 6

Situational loss?

Answer 6

any sudden, unpredictable external event

Question 7

What are inidividual pace and pattern of emotional response to loss or death based on?

Answer 7

• previous experiences
• coping strategies
• cultural expectations
• spiritual beliefs

Question 8

Bereavement?

Answer 8

grief and mourning, state of having lost a SO to death. Non-linear

Question 9

What is Bowlby’s attachment theory?

Answer 9

numbing, yearning & searching, disorganized & despair, reorganization

Question 10

What are Worden’s 4 tasks?

Answer 10

• accept reality of loss;
• work through pain of grief;
• adjust to environment without deceased;
• emotionally relocate deceased & move on

Question 11

what are the 4 different types of grief?

Answer 11

Normal
anticipatory
complicated
disenfranchised

Question 12

Describe what normal grief is:

Answer 12

or uncomplicated – normal feelings, behaviours and reactions to loss, opportunity to develop adaptive coping strategies.

Question 13

Describe what anticipatory grief is:

Answer 13

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.

Question 14

Describe what complicated grief is:

Answer 14

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.

Question 15

Describe what disenfranchised grief is:

Answer 15

when loss cannot always be openly acknowledged, socially sanctioned, or publicly shared due to stigmatization.

Question 16

What understanding of death would a infant -5yo have?

Answer 16

Does not understand
Believes death is reversible
Separation from parents

Question 17

What understanding of death would a 5-9yo have?

Answer 17

Understands death is final

May believe they are responsible, body parts

Question 18

What understanding of death would a 9-12yo have?

Answer 18

Understands death is EOL

Begins to understand own mortality

Question 19

What understanding of death would a 12-18yo have?

Answer 19

Fears a lingering death
Death can be defied
Not adult understanding yet

Question 20

What understanding of death would a 18-45yo have?

Answer 20

Attitude towards death influenced by culture and religion, re-examine life

Question 21

What understanding of death would a 45-65yo have?

Answer 21

Accepts own mortality
Experiences death of parents, friends etc.
Experiences peaks of death anxiety

Question 22

What understanding of death would a 65yo+ have?

Answer 22

Fears prolonged illness
Multiple deaths
Sees death as having multiple meaning

Question 23

What are the signs of approaching death?

Answer 23

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)

Question 24

What are the signs of an immenently dying pt?

Answer 24

Loss of muscle tone
Slowing of circulation
Change in respirations - “Death rattle”
Family becomes emotionally & physically exhausted
Nurses give information & support, calm
Offer respite

Question 25

How is death dx?

Answer 25

• unresponsive and unreceptive
• no movements and no breathing
• no reflexes
• a flat EEG
• no circulation to or within the brain