Loss Cycle Flashcards
1
Q
Loss Cycle - 4 stages
A
Shock
Distress
Disorganization
Acceptance
2
Q
Shock
A
- Sleep & appetite disturbance, numbness, irritable, physical effects
- Pt cannot relate to damage on their system
Intervention:
- Release of physical tension, normalize breathing pattern
- Introduce loss cycle
- Goal is patient safety
3
Q
Distress
A
- Emotional flood of feelings: anger, sadness, fear, difficulty coping, helpless – why me?
- Do they have someone they can talk to?
Interventions:
- Encourage expression of feelings into words
- Pain diary / medication monitor
- Goal is support and understanding for patient’s emotional hurt (i.e. verbalize back to pt “it sounds like you are really angry/sad” – allows pt to deal with/talk about stressors and move them through the loss cycle)
4
Q
Disorganization
A
- Depression, social withdrawal/isolation, difficulty with memory/concentration, feeling of “going crazy”, sudden ideation, hopelessness
- Pt may show up at wrong time for appointment / chronically late / can’t remember their appointment time, get lost driving to the clinic, ask them “do you ever feel like you are just going crazy?” pt loses ability for written word to be interpreted
- Neural disorganization, jar to the CNS whiplash, sudden strike to the system, i.e. fall, head does NOT have to be involved
- Make sure pt knows this is part of neural process, specialist may be able to help (neuropsychiatrist) – let pt know they are not alone, this is normal and happens all the time
Interventions
- Engage pt support system
- Set clear limits; contract, if needed, on special issues
- Provide information sources
- Goal is to assist pt to be active “within” current limits
5
Q
Acceptance
A
- Integration, positive feelings, lessons learned, future planning
Interventions:
- Summarize and review patient’s progress
- Reinforce gains and reflect remaining challenges through use of closing letter
- Pt is ready to take in a lot of information, ready for exercise program, ready to modify own HEP, come on time etc
