Sherpath Ch 36: Loss and Grief Flashcards
caregiver assessment includes
General health checkup
Focused assessment of physical, mental, or emotional symptoms
Assessment of nutritional status
Sleep evaluation
Examination of the caregiver’s ability to maintain work and family roles
Evaluation of the caregiver’s maintenance of dental and visual health
Assessment of social network
Evaluation of support systems
Grief Assessment tool: TIME
Toolkit of Instruments to Measure End-of-Life Care (TIME). The Toolkit has patient-focused, family-centered instruments that assist in assessing the needs of terminally ill patients and grieving families.
Physical changes as the end of life approaches include
Weakness and fatigue
Increased drowsiness and sleeping with decreased responsiveness
Decreased oral intake
Decreased swallowing reflex
Surges of energy as transitioning to death
Changes in bowel and bladder function: constipation, diarrhea, and incontinence
Impending death in the last days or hours is manifested by the following symptoms
Decreased urine output
Circulatory changes in extremities, nose, and fingers, with color changes such as cyanosis, pallor, or mottling
Vital sign changes: decreased blood pressure and increased or decreased pulse rate
Changes in breathing patterns: periods of apnea that increase with time, labored or irregular breathing, or Cheyne-Stokes breathing (periods of apnea alternating with period of fast breathing)
Pulmonary congestion or “death rattle” from the inability to clear the throat or swallow secretions
Signs and symptoms of death typically include
No heartbeat or respirations
Involuntary release of stool and urine as muscles relax
No verbal response or response to touch
Body temperature slowly decreases
Partially shut eyelids; jaw may drop with the mouth open
Color of skin pales and then turns bluish or waxen as blood settles
Rigor mortis, or stiffening of the joints, after a period of time
Dysfunctional grieving occurs when
the patient is unable to move through the process of grief in a healthy manner
Complicated grief
is a type of dysfunctional grief and includes masked grief, chronic grief, delayed grief, and exaggerated grief. Loss associated with unexpected death, suicide, homicide, accidental death, prior multiple losses or stressors, or death of a child often place the grieving person at risk for complicated grief
Masked Grief
Behavior that interferes with normal day-to-day life; this person is unaware that his or her behavior conceals the grief process.
Chronic Grief
Normal grief reactions that continue over a long period with no progress toward feeling better
Delayed Grief
Postponed grief as the person avoids the reality and pain of the loss
Exaggerated Grief
Maladaptive or self-destructive behavior such as drug and alcohol abuse
