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G&D chapter 14

Death and Dying

Loss an encounter that one faces during the course of his or her life
Grief the feeling tone or the outward expression in response to a loss
Anticipatory grief a reaction to an expected loss, such as in terminal illness
Maladaptive grief responses usually exhibit an exaggerated, lengthy, unpredictable course that results in unresolved conflicts
Mourning the natural process that one goes through following a major loss
Bereavement a state of having sustained a loss
Kubler-Ross’s stages loss and grief
does denial occur? when the patient or family member believes that the doctor has made a mistake in the diagnosis and that death will not occur; with unexpected death
What does denial allow? time to deal with the full implication of the prognosis or the death
Third phase of Bowlby’s Stages of Separation Detachment: the child appears disinterested in the mother when she returns, indicates child’s attempt to reorganize and resign to the loss
Physical loss readily evident and visisble; i.e. death of a spouse, parent, child, or other close person
Nursing care when an infant dies close to term allow the parents the opportunity to see and possibly hold their child; tell them what to expect to see and be sensitive to whether they want to be alone or not
School-age children’s concept of death? have a capacity to understand the finality of death, often associate death with an accident, illness, or old age
Christian Science religious beliefs and practices visit from the Christian science reader. No last rites are performed and autopsies are forbidden
Eastern Orthodoxy religious beliefs and practices last rites are given to raise hope and courage and offer peace to the sick and dying
Buddhism religious beliefs and practices at death the body is left undisturbed for 8 hours. The body is cleansed, and then dressed in new clothing and jewelry. Cremation usually takes place within 7 days after death
Judaism religious beliefs and practices presence of Rabbi is desired; autopsy and cremation are forbidden
Physical signs of approaching death withdraw, focus inward, decrease in senses, some are quiet and still whereas others are restless and agitated, Cheyne-Stokes respirations, BP drops and P slows, bowel and bladder control weakens, less alert and aware, loss of heat
Remember ask open-ended question; be nonjudgmental
Ask what are your concerns?
Determine what is important for them at this time?
Always ensure privacy
Try to determine level of knowledge
Attempt to support and acknowledge feelings
Don’t use clichés (such as “He is better off”)
What does a durable power of attorney for health care do? makes the client’s wishes known and carries out some decisions regarding to the client’s medical care in the event that the client can no longer express themselves
Euthanasia assisted suicide; “mercy killing”; refers to the deliberate ending of one’s life and the withholding of treatment
Goal of hospice care promoting comfort
what are adolescents' concept of death? seen as a distant possibility because they believe that they are invincible and hearty
Created by: laotracuata