Exam 18: Loss, Grief and the Dying Patient
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Thanatologists | identify stages of grief and dying
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Kubler-Ross: Stages of Grief/Dying | Denial.
Anger.
Bargaining.
Depression.
Acceptance.
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Denial: reaction | "No, not me."
Description: Individual acts as though nothing has happened and may refuse to believe or understand loss has occurred.
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Anger: reaction | "Why me?"
Description: Individual resists the loss and may strike out at everyone and everything.
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Bargaining: Reaction | "Yes, but..."
Description: Individual postpones awareness of reality of the loss and may try to deal in a subtle or overt way as though the loss can be prevented.
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Depression: reaction | "Yes, me."
Description: Individual feels overwhelmingly lonely and withdraws from interpersonal reaction.
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Acceptance: Reaction | "I am ready."
Description: Individual accepts the loss and looks into the future.
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Types of Eutanasia | Passive Euthanasia.
Active Euthanasia.
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Passive Euthanasia | Death occurs as a result of withholding treatment that might extend life, such as medication, life-support or feeding tubes
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Active Euthanasia | An action taken deliberately with the purpose of shortening life to end suffering or to carry out the wishes of the terminally ill
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Do Not Resuscitate (DNR) | (1) No cardiopulmonary resuscitation performed for a patient; this is the explicit desire of the patient/family in consultation with the doctor.
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Advanced Directives | Signed and witnessed providing specific instructions for health care treatment in the event that a person is unable to make those decisions at the time they are needed
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Patient Self-Determination Act | Requires healthcare institutions to provide written information to patients concerning the patient’s rights under state law to make decisions, including the right to refuse treatment and formulate advanced directives
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Living Will | Legal document that describes in detail what medical care a person wants if they are terminally ill.
Two witnesses are required, neither may be a relative or physician.
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Durable Power of Attorney | Designates an agent, surrogate, or proxy to make healthcare decisions on the patient’s behalf based on the patient’s wishes. Legally prepared, signed and witnessed document that must be notarized.
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