The Child with Life-threatening Injury or Illness, End of life care and Bereavement Flashcards
The childs experience (take into consideration )
- level of understanding
- pain, anxiety, withdrawn
- ICU -sensory overload
- hopeless and depressed
The parents experience
- fear, crying, outburst, anger
- family crisis
- ineffective coping skills
- physical separation
- anticipatory mourning
- stages of grief
The siblings experience
- feels left out
- may “act out”
- feelings of guilt
- vulnerable
The nurse role
- Preparation for painful experiences, psychosocial needs, support after control, facilitate play
- monitor noise levels, provide information, build trust, allow visits
Death and dying
- Part of the life cycle
- many versions of loss for the child
- developmental age (of the child)
Infant (w/death)
- perceives as separation/abandonment
- routine change upsetting
- senses emotions
- feeding and sleeping issues
TO HELP
- provide secure environment
- return to routine
- soothing and cuddling
Toddler (w/death )
- cant distinguish death and temporary separation
- separation anxiety
- regression
- feeding and sleeping issues
- fearful, clingy
TO HELP
- tolerance to regression
- distraction
- parental involvement
- return to routine
Preschoolers ( w/death )
- believe death is temporary
- seen as punishment
- magical thinkers
- regression
- ask a lot of questions
TO HELP
- tolerance to regression
- consistent and honest answers
- pictures, flowers, cemetery visits
- return to routines
School Age (w/ death )
- understands permanence of death
- realize own mortality
- psychosomatic complaints ( HA, belly aches)
- feelings of guilt or blame
TO HELP
- reassurance about not being abandoned
- support groups
- return to routines
- answer questions honestly
Adolescent (w/deaths)
- full understanding of death
- Illness and death relationship ( illness doesnt necessarily mean death )
- Invisibility “risky behaviors”
- anger, guilt
- comfort from friends
- increase in risk-taking behaviors
TO HELP
- encourage open communication
- keepsakes
- stress release, still need routines
- support groups and group therapies w/ peers
Dealing w/ childs death ( their own death )
- Infants + toddlers : dont understand their own death
- Preschoolers: recognize bodily changes, see others reactions
- School age: aware of impending death
- Adolescents: aware of death
Nursing: body image concerns
Palliative care
- team approach
- manage chronic condition
- can help w/ 1. transition to death, 2. manage pain
- familial guidance (resources)
Hospice care
- for the terminally ill ( 6 months or less to live )
- focus is on the quality of life
- comfort (pain meds)
- family support
- do not resuscitate
- AND= allow natural death
Unexpected Death
- allow parents to see resuscitative efforts
- intense, prolonged, grieving
- guilt
- compassion, privacy
- siblings, extended family
Nursing role
- Psychosocial: answer questions, be honest, open and consistent
- Physiologic: pain management, hygiene, nutrition concerns for pt +family sleep
- psychologic: allow time for questions
- Spiritual and culture: tend to cultural needs
- care switches to family once pt, dies
