Lecture 8: Bereavement Flashcards
What is bad news to a patient?
Likely to drastically alter patient’s view of his/her future
Causes cognitive, behavioral, or emotional deficit in person.
Decreased hope of patient or family’s quality of life.
What is the MUM effect?
Reluctance to give bad news to patients/families.
Do patients and families want to hear bad news usually?
Yes ):
What is the SPIKES protocol?
Setup
Perception
Invitation
Knowledge
Empathize
Summarize and Strategize
What is Setup in SPIKES?
Comfortable environment
Who else does the patient want there?
Time management
What is Perception in SPIKES?
What does the patient/family already know?
Opportunity to correct misunderstandings
Gauging pt’s level of readiness to discuss diagnosis
What is Invitation in SPIKES?
How much does the patient want to know?
Is there anyone the patient would like to know, or to use as a liaison?
If he or she feels that “ignorance is bliss”?
What is Knowledge in SPIKES?
Impart knowledge about condition
Do not minimize severity of situation
What is Empathize in SPIKES?
Acknowledge patient/family emotions
Sample remarks to show empathy
What is Summarize/Strategize in SPIKES?
Summarize information given
Strategize next steps
What are some emotions patients feel when given bad news?
Fear
Anger
Sadness
Shame
Relief
What is death?
Cessation of vital functions.
IRREVERSIBLE cessation of all functions, INCLUDING BRAIN
What is dying?
Process of losing vital functions.
What are some signs of impending death?
Decreased bodily functions
Bedbound/profound weakness
Emotional distance, decreased conversation
Cool/mottled extremities, death rattle.
What is bereavement?
Reaction to the loss of a close relationship.
State of being deprived of someone by death.
What is grief?
Emotional response caused by loss of a close relationship.
What is mourning?
The psychological process by which the bereaved person undoes his or her bonds to the decreased and settles with his or her personal grief.
What are the 5 stages of a patient’s reaction to impending death?
- Shock and Denial
- Anger
- Bargaining
- Depression
- Acceptance