Exam4- Loss, Grief, and Dying Flashcards
what is loss?
the undesired changed or removal of a valued object, person, or situation
type of losses
- necessary loss
- actual loss
- perceived loss
- maturational or developmental loss
- situational loss
- anticipatory loss
a loss related to change that is part of the cycle of life that is anticipated but still can be intensely felt
necessary loss
any loss of a valued person, item, or status, such as loss of a job that can be recognized by others
actual loss
any loss defined by the person experiencing the loss and is not obvious to others (rejection, status)
perceived loss
any loss normally expected due to the developmental processing of life
maturational loss
any unanticipated loss caused by an external event (family loses home during tornado)
situational loss
experienced before the loss happens
anticipatory loss
what is grief?
physical, psychological, and spiritual responses to a loss
what is mourning?
action associated with grief
what is bereavement?
mourning and adjustment time following a loss
5 stages of grief (Kubler-Ross theory)
denial anger bargaining depression acceptance
what are the factors influencing loss and grief?
- current stages of development
- gender
- interpersonal relationships
- social support networks
- type and significance of loss
- culture and ethnicity
- spiritual and religious beliefs and practices
- prior experience with loss
- socioeconomic status
factors increasing risk for dysfunctional grieving
- being exceptionally dependent upon the deceased
- a person dying unexpectedly at a young age
- a person dying through violence
- inadequate coping skills
- lack of support systems
- lack of hope or preexisting mental health issues (depression or substance abuse)
- unresolved conflilct
- circumstances of the loss (guilt); suicide, homelessness
types of grief
- uncomplicated or normal
- anticipatory
- complicated- unresolved or chronic grief (feels stuck/can’t move on)
- disenfranchised- grief can’t be shared publicly (suicide, abortion)
ways to facilitate mourning
- grant time for the grieving process
- use therapeutic communication
- use active listening
- open-ended questions
- silence
- provide continuing support
- provide available community resources
- initiate referrals
palliative care (end-of-life care)
- planned holistic comfort care
- patient does NOT necessarily have to be “actively dying” but they’re also not getting better
- slow progressive disease
hospice care (end-of-life care)
-holistic care of dying pts
-MD certifies that pt is likely to die within 6 months
(eligibility for hospice insurance benefits)
-pt is terminal and chooses to end treatment
-focus is to support client toward a peaceful and dignified death
legal and ethical considerations
- advance directives
- DNR
- assisted suicide
- autopsy
- organ donation
power of attorney vs durable power of attorney
power of attorney does NOT give rights for healthcare decisions while durable power of attorney does
T/F: hearing is diminished when pt is approaching death
false; hearing is NOT diminished
touch can be diminished
signs of approaching death
- decreased LOC
- muscle relaxation of face
- inability to swallow
- labored breathing (Cheyne-Stokes)
- incontinence of bowel/bladder
- mottling
- decreased pulse and BP
- cool extremities
- pupils no longer reactive to light
- decreased urine output
care of the dying person
- meeting physiological needs (nutrition, oxygen, fluids, hygiene, control pain and nausea)
- meeting psychological needs
- addressing spiritual and cultural needs
historical definition of death
-cessation of flow/vital bodily fluids
