death/grief Flashcards
how many adults have chronic illness in the US?
129 million adults have 1 or more chronic illnesses, 42% of adults have 2 or more chronic illnesses
how many people die per year in the US?
3 million people die per year in US
what are the top three causes of death?
heart disease, cancer, and unintentional injuries
what is the expected life expectancy?
77.5 y/o
what is hospice care?
6 months to live, terminal illness, provided when treatment will no longer cure, interprofessional, holistic care thats treats the whole person including caregivers and family
what is palliative care?
holistic care provided throughput lifespan for clients experiencing illness, goal is to improve quality care, concentrated on lessening client suffering at end of life
what is the difference between hospice and palliative care?
palliative care is different from hospice care, as palliative care is provided
while the client is still engaging in curative treatment methods
what are some barriers to quality care at the end of life?
-failure to acknowledge the limits of medicine
-workforce that is too small to meet demands
-lack of training for healthcare providers
-hospice/palliative care services are poorly understood
-lack of research
-lack of payment models linked to quality measures
-rules and regulations
-denial of death
what are physiological changes?
physiological changes at the end
of life follow a familiar pattern of
signs and symptoms. The terminal
phase of a client’s life is
characteristically referred to as
“actively dying” or “imminent
death”
what is the “death rattle?”
retention of secretions in the
respiratory tract
dyspnea:
shortness of breath
cheyne-stokes respiration’s:
an irregular respiratory rate fluctuating
between several quick breaths and
periods of apnea
what happens to body temp when death is coming?
-ability of the nervous system to regulate body temperature diminishes, causing
clients to experience both increased and decreased temperature.
-also caused by infection, cancer, and cancer therapy.
-mottling occurs hours or days before death, with the upper and lower extremities
becoming cool to the touch. Mottling occurs as result of the heart’s inability to pump
blood effectively, leading to decreased blood perfusion throughout the body.
what happens to vision and hearing?
clients may experience hallucinations
or report hearing and seeing those
who have already died
dignity and death correlation
-dignity is regarded as an everyday necessity, essential to the well-being of
all clients. Most complaints related to nursing care at end of life are
associated with a lack of caring.
-as clients near the end of life, illness contributes to a loss of control, which
lessens their sense of dignity.
what is good death?
when a client is actively dying, health care providers, family, and
caregivers are responsible for providing a “good death” for the client, this
generally includes pain management, planning for death, closure at the
end of life, clear decision making, and being able to contribute to others.
advance directives indicate:
-who will make decisions for the patient in case the patient is unable.
-the kind of medical treatment the patient wants or doesn’t want.
-how comfortable the patient wants to be
-how the patient wants to be treated by others
-what the patient wants loved ones to know.
special orders:
-physician order for life-sustaining treatment form (POLST)
-allow natural death, do-not-resuscitate, or no-code orders
-comfort measures only
-terminal weaning
-voluntary stopping of eating and drinking (VSED)
-active and passive euthanasia
-palliative sedation
what does post mortem care include?
physical care of the body after death, includes washing the body,
accounting for the client’s
possessions, removing invasive
devices such as intravenous catheters
and indwelling catheters, and placing
identification tags in at least two areas
(toe, arm, outside of body bag, etc.), documenting the date
and time of death, the name of
anyone notified, location of
belongings, and where the client’s
body is moved (funeral home name)
post mortem care for the family:
-listen to family’s expressions of grief, loss, and helplessness.
-offer solace and support by being an attentive listener.
-arrange for family members to view the body.
-in the case of sudden death, provide a private place for family to begin
grieving.
-it is appropriate for the nurse to attend the funeral and make a follow-up
visit to the family.
true or false: it is voluntary to be an organ or tissue donor
true
can a nurse talk to the family about organ or tissue donations?
no, a nurse is not allowed to begin a
dialogue about organ or tissue donation
with the client or a family member. Only
health care professionals who have
completed a course provided or
endorsed by an organ procurement
organization (OPO) are permitted to
initiate the request of the client or
surrogate, nurses role is to assist families who are dealing with the hard decision
grief:
the feelings or reactions an individual has to a loss in one’s life, the loss that an individual endures is not necessarily related to a death, as grief can be experienced from any loss or personal
experiences
types of grief:
-normal: Also known as uncomplicated grief, is caused by the loss of
someone very close, through death or the ending of a relationship
-anticipatory: Grief that is experienced before the expected loss of
someone or something
-prolonged grief disorder (PGD): Previously known as complicated grief;
lasts >6 months and can be so significant, it affects the client’s ability to
function
-disenfranchised: Grief related to a relationship that does not coincide with
what is considered by society to be a recognized or justified loss
