Lecture #9 - Coping with loss Flashcards
Anticipatory mourning (retrospective qualitative study) 5 majors processes?
1) Realization: lead to changed relationships
2) Caretaking: Caregivers personal needs and emotions on hold
3) Presence: Importance of being present for dying person. More about being there then doing things.
4) Finding meaning: Acceptance
5) Transitioning: Emotional shifting/numbing + fatigue.
Anticipatory mourning (retrospective qualitative study) implication for HCP?
1) Awareness change in family roles/relationship that can cause strain on family
2) Complex demands on caregivers and need for accurate info.: physical Sx, what to expect, how to treat/management pain and other Sx.
3) Anticipate support resources needs
Parke’s (1972,1986) trad. model of grief four phases? Problem?
1) Shock and numbness
2) Yearning and searching
3) Disorganization and Despair
4) Reorganization and recovery: Moving on with life
Problem: Seeing grief as a problem instead of a natural process
Stroebe dual process model (1998)?
Challenges and oscillating from Loss-oriented activities to Restoration-oriented activities
Walter (1996) new model of grief from a sociological perspective?
Grief is about integrating the memory of the dead, the relationship continues.
Risk factors associated with poor grief outcomes?
- dependent relation
- multiple previous bereavement
- mental illness
- low self-esteem
- unexpected death
- Elder male widower
- level of perceived social support
- stress from other aspects of life
Early 1900 death…
Happened in homes and was accepted as natural precess
Glaser & Strauss (1965), Death Awareness four point typology.
- open awareness (Everyone know and acknowledge pt is dying)
- suspicion (pt suspect they are dying),
- Pretence (everyone know pt is dying, but pretend otherwise), 4.closed awareness (pt not aware they are dying),
Kubler-Ross (1969): stages of dying?
- Denial
- Anger
- Bargain
- Depression
- Acceptance
WHO (1998) def. of Palliative care?
Approach that improve the life quality of pt and families through prevention and relief of suffering.
Sante Publique Qc from 1997 to 2001, where people dyed the most?
70% in hospital
8% home
18% CHSLD
2% Palliative care facilities
3 broad area embraced by Palliative Care?
- Science of pain management/Sx control
- Knowledge of psy, so, spiri aspects of dying/grieving
- Caregivers self-knowledge
Robert Pope foundation lessons learned for being at the bedside of dying pts?
- Sx management priority #1
- Sometimes, will feel empty at bedside
- Sit, don’t stand
- Sometimes saying nothing is the best thing
- Empathize w/o carrying the pain
- People will carry memory of dying pt forever
- Good nurse starts with being compassionate human
- Every death is unique
- death = Moment in time. Dying is process which a person is still living.
Grief def:
This is a process. The reaction to any loss. Its about finding meaningful ways to continue the relationship with the deceased.
Bereavement def:
State of having suffered a loss
