Loss, grieving and death

Grief that is brief but genuinely felt

Abbreviated grief

What are the two types of loss

Actual loss and preceived loss

The overall goals for clients grieving the loss of body function or a body part are to:

Adjust to the changed ability and redirect both physical and emotional energy into rehabilitation

Grief experienced in advance of the event

Anticipatory grief

Loss that is experienced before the loss actually occurs

Anticipatory loss

Subjective response experienced by the surviving loved ones

Bereavement

Client is not made aware of impending death

Closed awareness

Grief that occurs when a person is unable to acknowledge the loss to other people such as an abortion or giving child up for adoption

Disenfranchised grief

What has been shown to facilitate the grieving process for families

Encouraging them to view the body with or without the nurse present

Care provided in the final weeks before death

End-of-life care

Stages or phases of grieving which include: shock and disbelief, developing awareness, restitution, resolving the loss l, idealization and outcome

Engels stages of grieving

Total response to the emotional experience related to loss

Grief

What are the diagnoses for grieving?

Grieving or complicated grieving/risk for complicated grieving

Cessation of the apical pulse, respiration's and blood pressure

Heart-lung death

Care that focuses on support and care of the dying person and family with the goal of facilitating a peaceful and dignified death

Hospice

Stages or phases of grief that include denial, anger, bargaining, depression and acceptance

Kübler-Ross stages of grieving

Discoloration appearing in the lowermost or dependent areas of the body

Livor mortis

Loss that results in changes of a persons body image, even though the loss may not be obvious such as a face scarred from a burn, or emotional loss

Losing an aspect of self

Losses that include tangible items or inanimate objects that have importance to the person such as money, burnt down house, or pets

Loss of external objects

Loss that refers to separation of an environment such as a child leaving home to go to school

Loss of familiar environment

What are signs of impending clinical death

Loss of muscle tone, slowing of the circulation, changes in respiration and sensory impairment

What are the major goals for dying clients

Maintaining physiological and psychosocial comfort and achieving a dignified and peaceful death

Person designated to complete a bath of the dead body

Mortician or undertaker

Behavioral process through which grief is eventually resolved or altered

Mourning

The client, family, and health care personnel know that the prognosis is terminal, but do not talk about it and make an effort not to raise the subject

Mutual pretense

Nursing assessment of the client experiencing a loss includes what three major components?

Nursing history, assessment of personal coping resources and physical assessment

The client and others know about the impending death and feel comfortable discussing it even though it is difficult

Open awareness

Stiffening of the body that occurs about 2 to 4 hours after death

Rigor mortis

Stage or phases of grief that include shock, awareness of loss, conservation/withdrawal, healing:the turning point, and renewal

Sanders phases of bereavement

Large piece of plastic or cotton material the dead body is enclosed in

Shroud

What are the indications of death

Total lack of response to external stimuli, no muscular movement (especially breathing), no reflexes, flat encephalogram (brain waves)

What are more specific responsibilities for nurses when assisting dying clients

-minimize loneliness, fear and depression -maintain clients sense of security, self confidence, dignity and self worth -help the client except losses -provide physical comfort

Another definition of death which occurs when the higher brain center, the cerebral cortex is irreversibly destroyed which holds the capacity for thought, voluntary action, and movement

Cerebral death or higher brain death

Grief that occurs when the strategies to cope with the loss are maladaptive and out of proportion or inconsistent with cultural, religious or age appropriate norms.

Complicated grief

What are factors that influence the loss and grieving responses

Age, culture, gender, socioeconomic status, support system, significance of loss, and cause or loss of death

The gradual decrease of the body's temperature after death

Algor mortis

Characteristics of the diagnosis grieving include what

Denial, anger, despair, feelings of worthlessness, crying and inability to concentrate