Palliative Care Nursing: Coping with loss Flashcards
Nursing involvement in the care of the dying:
- Midwives
- Florence Nightingale (crimean war)
- “nursing sisters” of Canada
- Dame Cicely Saunders
Changing context of death:
- Early 1900 death occurred at home and was accepted as a natural necessary phenomenon.
- Advances in technology and knowledge have changed the demographics and patterns of dying: Death denial.
Death awareness: 4 point typology of death
Open awareness suspicion pretence close awareness.
Stage of dying:
denial, anger, bargaining, depression and acceptance
Death awareness caracteristics:
- Death denial and death awareness can co-exist.
- Medical technology has blurred the line between life and death
- Lack of attention to symptom management in medical education and practice
- Loss of extended family ties and community
- Strained and evasive relationships caused by our discomfort around dying and bereavement
Paliattive care approach:
- Provides relief from pain and other distressing symptoms.
- Affirms life and regards dying as a normal process
- Intends neither to hasten or postpone death
- integrates the psychological and spiritual aspects
- Offers support system to help pt live as actively as possible until death and to help family cope.
- Uses a team approach to adress patient/f needs
- Enhance quality of life
- Is applicable early in the course of illness with others therapy to prolong life like chomo, radiation therapy, include investigations and manage distressing clinical complications.
Palliative care is a balance act between:
End of life and acute curative care
3 broad areas embraced by palliative care:
- Science and technology of pain management and symptom control
- Knowledge of psychological, social and spiritual aspects of dying and grieving
- Self-knowledge on the part of caregivers, especially regarding personal attitudes toward death and loss.
Common areas of distress and opportunities for healing:
- Recognition of dying
- Mattering
- Belonging
- Control
Most of the deaths occurs on acute care units (80%) and are related with some issues for the p/f:
- No living Will
- No end of life discussions
- Aggressive tx right up until death.
Unrealistic goals or difficulties in reaching the goals can lead to:
-Stress
-a loss of ideals
-a dehumanization of care
MORAL DISTRESS
Reality of loss for the patient/f:
- Loss of physical abilities
- Loss of decision-making ability
- Loss of control
- Loss of life
Grief means:
The reaction to any loss
Bereavement means:
The state of having suffering a loss
Mourning means:
The intra-psychic and cultural processes that occur when one suffers a loss
