Spirituality, sexuality and caring for the carer in palliative care 2 Flashcards
Therapeutic use of self meaning
By “being there” for the patient, the nurse reinforces that the patient is a unique
person, and will receive support and care through human contact.
There are 4 psychosocial themes in the nurse-patient relationship in palliative care:
knowing the patient,
preserving hope,
easing the struggle and
providing for privacy.
Prior experiences with death can affect the nurse’s ability to care for a patient, so the
nurse needs to have some personal reflection in order to provide care for the dying
patient.
Hope is the feeling
that what is wanted can be had or that events can turn
out for the best.
What place does hope have in the dying patient?
Hope is individual.
It becomes more focussed in the dying patient.
The nurse plays a unique role in enabling hope in the dying patient.
Hope Acknowledge
individual uniqueness.
Avoid “hopeless” statements: “nothing more can be done”.
A crucial factor in the nourishment of hope is to grant that person control.
Allow him/her to express their hopes.
Give them information about their illness so that they can make their own choices.
Give them the freedom of choice to make decisions with regard to their care
Bereavement
refers to the entire experience of family
members and friends surrounding the loss of a loved one.
It includes the anticipation, death and the subsequent
adjustment to living without that loved one.
Remember, two of the core values of the WHO’s definition
of palliative care refers to bereavement.
“Palliative Care
offers a
support system to help the family cope during the
patients illness and in their own bereavement;
uses a team approach to address the needs of patients
and their families, including bereavement counselling, if
indicated”
Grief
While bereavement is the experience, grief is how this loss affects the individual.
There are many ways a person can show grief.
Grief can be seen as cognitive, emotional and social.
Culture can play a large role in the expressions of grief
How do people express grief?
Everyone is different.
No-one can tell someone how to experience grief.
Emotional signs of grief are depression, anxiety, guilt, anger,
loneliness.
Cognitive signs are thinking about that person all the time, a
sense that the dead person is still around, denial and disbelief.
Social signs may be withdrawal, overactivity.
Physical signs may be loss of appetite, insomnia, susceptibility
to illness, distractibility.
These are all normal signs.
Normal “Grief
There is no evidence that grief counselling improves
outcomes for people who experience normal grieving.
There are some factors that may allow people to grieve
more easily:
1. The knowledge that the loved one died peacefully.
2. An optimistic personality in the bereaved person.
3. Secure relationships with family and friends.
Complex grief
Some people may experience complex or chronic grief.
Risk factors for this are traumatic, unexpected death, painful
death and death of a child.
Other risk factors are existing depression and mental health
issues, co-existing stressors like financial problems, multiple
losses.
Prior to loss, these risk factors should be identified and
patient’s families referred for specialist counselling to prevent
complex grief issues.
The signs of complex grief
are social and occupational
dysfunction lasting longer than 6 months, difficulty with
moving on and signs of depression.
These bereaved people need to be referred for
specialist grief counselling.
