Week 12: Loss, Death And Palliative Care

Question 1

The Loss Response Model uses

Answer 1

Can be used to improve understanding of grieving and to assist nurses in caring/comforting those who have experienced or are experiencing loss.

Question 2

Loss Response Model

Answer 2

..

Question 3

Types of Grief

Answer 3

• Anticipatory Grief
• Acute Grief
• Shadow Grief
• Complicated Grief
• Disenfranchised Grief

Question 4

Factors Affecting Coping with Loss

Answer 4

• Many factors affect the ability too cope with loss and grief.
• Identifying those with better coping skills.
• “Good coppers” acknowledge the loss and try to make sense of it.

Question 5

Grief: The goal of the nurse

Answer 5

The goal is not to prevent grief but to support those who are coping with grief and facilitate the return of stability to the system each time a new loss occurs.

Question 6

Goal of grief assessment

Answer 6

Is to differentiate those who are likely to cope effectively from those who are less likely so that appropriate interventions can be planned.

Question 7

Grief Interventions

Answer 7

• Help grieves move through the impact of loss to reestablishment of new memories
• Searching for meaning
• Engaging emotions
• Informing others

Question 8

The 6 C’s: Needs of the Dying

Answer 8

1. Care
2. Control
3. Composure
4. Communication
5. Continuity
6. Closure

Question 9

Spirituality and Dying

Answer 9

Deals with the transcendental or existential relationship between the dying person and another - between the person and his or her god or the person and significant others

Question 10

Death and Hope

Answer 10

As death approaches, the hope may be for a good death, one that is symptom free.

Question 11

Promoting equilibrium for the family

Answer 11

Include actions that empower the family to cope with the death, in a manner consistent with their traditions

Question 12

Palliative Care

Answer 12

an approach to care which improves the quality of life of patients and their families facing life-threatening illness, through prevention, assessment, and treatment of pain and other physical, psychological, and spiritual problems

Question 13

Providing Palliative Care Through Hospice

Answer 13

• Care provided is palliative within the specific context of a signed agreement between the individual and organization in which the person has elected to receive care-only therapy for an identified diagnosis.
• Limited to those for whom two physicians have agreed that the person has a prognosis of 6 months or less to live.
• The majority of hospice care is provided in people’s homes to support an identified informal caregiver.
• Unprecedented contribution of hospice is provision of comfort for those dying and support of those close to them.

Question 14

Decision-making at the end of life

Answer 14

Decision-making about life-prolonging procedures when death is inevitable is a legal, ethical, medical, and professional issue faced by gerontological nurses

Question 15

Living Wills

Answer 15

Advanced directive that is specifically related to a situation in which a person is facing terminal illness and unable to speak for him or herself

Question 16

Nursing Responsibilities for End of Life

Answer 16

• Serve as a resource person to discuss many of the questions people have about EOL decision-making, especially how these affect their care.
• May be responsible to inquire about the presence of an existing advance directive, to offer and explain the option and to ensure the existing advance directive still reflects a person’s wishes.
• Advocates for the self-determination of all patients to best possible extent, even those with limited cognitive function.

Question 17

Palliative sedation

Answer 17

Terminal or palliative sedation with the intent to provide comfort but go no further.