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