Grief Loss Death Lecture Flashcards
Define abbreviated grief
Briefly experienced but genuinely felt (normal type of grief)
Define anticipatory grief
Experienced before the event (wife who grieves before her sick husband dies)
Define complicated grief
Unhealthy grief, unresolved chronic grief, inhibited delayed, exaggerated
This is grief that is prolonged and severe.
Define disenfranchised grief
The individual is unable to acknowledge the loss of others (emotions are felt privately, just NOT expressed in public)
What are the Kubler-Ross stages of grieving?
Denial
Anger
Bargaining
Depression
Acceptance
In the Kubler-Ross stage of denial, what is occurring?
The pt refuses to believe that the loss is happening
In the Kubler-Ross stage of anger, what is occurring?
The pt or family May feel direct anger toward the nurse and staff about things that typically would not bother them
In the Kubler-Ross stage of bargaining, what is occurring?
Tries to bargain to avoid loss
In the Kubler-Ross stage of depression, what is occurring?
The pt realizes their impending death, grieves over what happened and cannot be
In the Kubler-Ross stage of acceptance, what is occurring?
THIS IS THE MOST ACTIVE PHASE
Pt comes to terms with loss
May have decreased interest in surroundings and support people.
Factors that influence the loss and grief responses is a persons age (development stage), what is affected during early/ middle adulthood?
Responses to loss are influenced by past experiences with loss (loss of parents- self esteem gets changed because support is gone)
Factors that influence the loss and grief responses is a persons age (development stage), what is affected during late adulthood?
Loss of friends, spouse, functions (mobility)
Widows and widowers deal with loss differently.
Factors that influence the loss and grief responses is a persons socioeconomic status, what is affected during this?
Type of insurance can help those left behind a choice on how to deal with the loss.
also effects how many people you have for your support system
Factors that influence the loss and grief responses is a persons support system, what is affected during this?
The people closest to the pt may withdrawal from the grieving individual. They may be seen when the loss is first know but then will return to normal activities.
Factors that influence the loss and grief responses is a persons cause of death, what is affected during this?
Individual or societal views influence grief response.
Ex: child dying of leukemia vs. someone who died of aids
Some deaths are viewed as clean (positive) or dirty (negative)
Describe death related legal issues: Advanced Health Care Directives
A document describing PTs preferences of future tx. The pts will appoint a proxy to make healthcare decisions when the pt is unable to do so.
Describe death related legal issues:
Physician Orders for Life Sustaining Treatment (POLST)
Document for PTs seriously ill (serious, progressive, chronic disease) signed by: pt, PCP, and decision maker.
Specifies current tx, resuscitation orders, medical interventions, comfort measures, non invasive airway etc.
stays with the pt through all levels of care.
Describe death related legal issues: DNR
This means to allow natural death (AND)
Describe death related legal issues: euthanasia
Active euthanasia is when a lethal dose of medication is administered to the pt BY THE PHYSICIAN
Describe death related legal issues: Medical Assistance In Dying (MAID)
Self-administered lethal dose of medication
List the three states of awareness shared by the dying person and their family
Closed awareness
Mutual awareness
Open awareness
Describe closed awareness
The pt is not made aware of their impending death. Family thinks the pt will recover or they don’t understand why the pt is ill.
The PCP may not want to communicate dx or prognosis to pt.
Describe mutual pretense
The pt, family and PCP all agree that the prognosis is terminal but make EFFORT NOT TO TALK ABOUT it the subject.
Describe open awareness
The pt family and PCP know about impending death and are comfortable talking about it. The pt gets to participate in end of life decisions (funeral arrangements)
Describe what hospice does
Supports the pt who has a chronic illness (terminal) and cannot recover.
Hospice care it about the quality of life and takes PTs off most of their medications.
Describe what palliative care does
It is for PTs who are seriously I’ll but not terminal.
Can be accessed anytime.
This is about the comfort of care. (Person-family approach)
When a pt is dying, which of their 5 senses is last to go?
Their hearing
