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Behavioral Health > Death & Grief > Flashcards

Death & Grief Flashcards

1
Q

Define Bereavement

A

Situation in which someone who is close dies

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2
Q

Define Grief

A

natural response to bereavement

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3
Q

Define Complicated Grief

A

Form of acute grief that is usually prolonged, intense, and disabling

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4
Q

Define Mourning

A

Process of adapting to a loss & integrating grief

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5
Q

Hallmark of Grief

A

Intense focus on thoughts & memories of the deceased person, accompanied by sadness and yearning

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6
Q

Non-bereavement Losses

A 
Separation through divorce
Pet
Job
Property 
Community
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7
Q

Symptoms of Grief due to Separation Distress

A

Yearning for & seeking proximity to the deceased
Loneliness
Crying, sadness, and other painful emotion
Somatic symptoms
Hallucinations of deceased person

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8
Q

Symptoms of Grief due to a Trauma/Stress Reaction

A

Disbelief & shock
Numbness
Impaired attention, concentration, or memory

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9
Q

Other Symptoms of Grief

A

Difficult to feel connected & withdraw
Transiently wish they had died with their loved one or instead of deceased
Thoughts & images of the deceased occur frequently

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10
Q

Grief Course

A

Time-limited
Adapting occurs within 6 months
Restoration of ongoing life within 6-12 months
Can return for “big” events

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11
Q

Types of Bereavement Loss

A

Type of relationship lost (survival guilt)
Sudden lost (homicide/suicide)
Chronic illness
Terminal illness

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12
Q

Associated Psychotherapy to Bereavement

A 
Major depression
Anxiety disorder
PTSD
Suicidality
Other mental disorders (sleep, somatoform, substance, eating)
Complicated grief
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13
Q

Management of Grief & Bereavement

A

Summon families prior to expected death
Grief counseling
Support from family, friends, & clergy
Remind family to maintain regular patterns of activity, sleep, exercise, & nutrition
Send condolence letter

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14
Q

Risk Factors for Complicated Grief

A 
Older age (>61)
Female
Low SES
Non-Caucasion
Prior psych history
Death of spouse, child, young person
Sudden death
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15
Q

Acute Grief Clinical Features

A

Separation distress
Inhibition exploration of the world
Traumatic distress

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16
Q

Complicated Grief Clinical Features

A

Maladaptive rumination about circumstances of the death
Intense emotional and/or physical reactions
Dysfunctional behaviors
Inadequate regulation of emotions

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17
Q

Most Common Symptoms of Complicated Grief

A

Yearning

Feeling upset by memories of deceased

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18
Q

Risk of Suicidality in Complicated Grief

A

Greater number of years elapsed since death

Depression & anxiety

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19
Q

Adverse Consequences of Complicated Grief

A

Increase use of ETOH & tobacco
Poor QOL
General medical illness & suicide

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20
Q

Course of Complicated Grief

A

Symptoms last at least 1 month after 6 months of bereavement who are significantly & functionally impaired
Seek treatment on average 2-4 years after loss

21
Q

Assessment of Complicated Grief

A 
H&P
Mental status exam
Labs: CBC, CMP, UA, TSH
Address suicide risk
Brief Grief Questionnaire
22
Q

Diagnostic Criteria for Complicated Grief

A

Experience death of loved on for >6 months
Persistent, intense yearning for deceased
Frequent preoccupying thoughts about deceased
Frequent intense feelings of loneliness or that life is meaningless without deceased
Recurrent thought that it is unfair to live without deceased; urge to join deceased
Frequent troubling rumination about circumstances of death
Recurrent disbelief or inability to accept death
Persistently feeling shocked, stunned, dazed, or numb since death
Anger or bitterness about death
Intense emotional or physiologic reactions to reminders of loss
Marked change in behavior

23
Q

Goals of Management of Complicated Grief

A

Relief of rumination, excessive proximity seeking & avoidance behavior
Improve emotion regulation
Accepting finality
Feeling of enduring connection to deceased
Ability to envision life with the possibility of happiness
Engagement satisfying activities & relationships

24
Q

Treatment for Complicated Grief

A

CBT

25
Q

Define Death

A

Absolute cessation of vital functions

26
Q

Signs of Death

A 
Cessation of breathing
Cardiac arrest
Palor mortis: paleness
Livor mortis: blood settles to dependent parts
Algo mortis: decrease in body temp
Rigor mortis: limbs become stiff
Decomposition
27
Q

Define Terminal State

A

Disease felt to be fatal

Life expectancy

28
Q

Physiologic Changes While Dying

A

Increasing weakness, fatigue
Decreasing appetite/food intake
Decreasing blood perfusion
Neurologic dysfunction

29
Q

Signs of Increasing Weakness & Fatigue

A

Decreased ability to move

Increased risk of pressure ulcers & need for care

30
Q

Signs of Decreasing Appetite & Food Intake

A

Fear of giving in & starving
Food nauseating
Aspiration

31
Q

Signs of Decreasing Blood Perfusion

A 
Tachycardia
Hypotension
Peripheral cooling
Cyanosis
Mottling of skin
Diminished urine output
32
Q

Signs of Neurologic Dysfunction

A 
Decreasing level of consciousness
Terminal delirium
Changes in respiration
Inability to swallow
Sphincter control lost
33
Q

Signs of Active Dying

A 
No intake of food or water
Sunken cheeks
Respiratory mandibular movement
Dramatic skin color changes
Rattles in chest
34
Q

Signs in the Last 48 Hours

A 
Orderly loss of senses
Noisy, moist breathing
Urinary incontinence or retention
Pain
Dyspnea
Restlessness & agitation
Twitching of body
N/V
Sweating
35
Q

Hospice Care

A

Focuses on caring, not curing

36
Q

Services Provided by Hospice Care

A

Manages patient’s pain & symptoms
Assists patient with emotional, psychological, & spiritual aspect of dying
Provide needed drugs, medical supplies, & equipment

37
Q

Guidelines for the Family When A Patient is Dying

A

Signs of increasing Pain
Close to death do not feel hungry or thirsty
Breathing may become noisy & congested
Hearing is last sense to go

38
Q

Children

A

Separation similar to sleep

39
Q

5-10 Year Olds Attitude Towards Death

A

Sense of inevitable human mortality

Fear that parents will die & they will be abandoned

40
Q

Adolescents Attitude Towards Death

A

Death is inevitable & final

Broad range of emotions

41
Q

Adults Attitude Towards Death

A

Accept their time has come
Talk/joke openly about dying
Sense of integrity or despair

42
Q

How to Convey Bad News

A

Prepare
Be calm & clear
Arrange follow-up for family members

43
Q

5 Stages of Grief

A 
Denial
Anger
Bargaining
Depression
Acceptance
44
Q

Stages of Grief: Denial

A

Normal reaction to overwhelming emotions

Defense mechanism

45
Q

Stages of Grief: Anger

A

Reality & pain re-emerge
Intense emotion deflected from vulnerable core & expressed as anger
Know person isn’t to blame but resent person causing pain or leaving

46
Q

Stages of Grief: Bargaining

A

Normal reaction to feelings of helplessness & vulnerability to gain control
Make deal with God or higher power to postpone the inevitable

47
Q

Stages of Grief: Depression

A

Feel like we don’t care about anything & wish life would hurry and pass on by

48
Q

2 Types of Depression with Grief

A

Reaction to practical implications relating to the loss

Quiet preparation to separate & bid loved one farewell

49
Q

Stages of Grief: Acceptance

A

Withdrawal & calm

Ready to move on

Behavioral Health (25 decks)

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