Loss, Grief, and Dying

What is mourning?

-action associated with grief

How do you provide post-mortem care?

-follow agency policies and respect cultural and spiritual preferences

What is hospice care?

-holistic care of dying patients

What is palliative care?

-holistic comfort care

What is bereavement?

-mourning and adjustment time following a loss

What is grief?

-physical, physiological, and spiritual responses to a loss

What is Loss?

-the undesired change or removal of a valued object, person, or situation

What are the physiological stages of dying?

1. 1-3 months prior to death 2. 1-2 weeks prior to death 3. days to hours prior to death 4. moments prior to death

What are the 5 stages of death and dying?

1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance

How do you facilitate grief?

1. expressing feelings 2. recalling memories 3. finding meaning

How can you help the family of a dying patient?

1. have the family help with care if possible 2. encourage questions 3. provide follow up for referrals if needed 4. encourage visit to the chapel or to talk with clergy 5. provide anticipatory guidance 6. acknowledge feelings of family 7. encourage coping mechanisms 8. remind family members and significant others to take care of themselves 9. teach what to expect and provide reassurance 10. ask directly if family wants to be present at time of death 11. at the moment of death do not intrude

What are the different categories of death?

1. historical definition 2. heart-lung death 3. whole-brain death 4. higher-brain death 5. uniform determination of death act

What do you assess about a terminally Ill client and family?

1. knowledge base 2. history of loss 3. coping abilities and support systems 4. meaning of the loss/illness 5. depression or grief 6. physical assessment 7. cultural and spiritual assessment

What must be included in caring for a dying patient?

1. meeting physiological needs 2. meeting psychological needs 3. addressing spiritual needs 4. addressing cultural needs

What are appropriate therapeutic communication strategies?

1. perfect your listening skills 2. encourage and accept expression of feelings 3. reassure their feelings are not wrong 4. respond to nonverbal cues with touch and eye contact 5. increase your self-awareness 6. continue to communicate even in a case of coma

How can you help the family after death?

1. provide emotional support immediately after death 2. provide grief education 3. help children deal with loss

What are factors affecting grief?

1. significance of the loss 2. support system 3. unresolved conflict 4. circumstances of the loss 5. previous loss 6. spiritual/cultural beliefs and practices 7. timelines of death 8. developmental stage of the bereaved

What are the types of grief?

1. uncomplicated 2. complicated -chronic -masked -delayed 3. disenfranchised 4. anticipatory

The client is dying of cancer and can no longer swallow. The son states to the nurse, "You MUST give dad some water, he always drank a lot of water." The nurse's best response is a."You sound very upset. Tell me more about your dad." b."Your father is dying from cancer and water will not stop this process." c."Research shows that withholding oral fluids decreases edema." d."I will call the physician and get orders to insert a nasogastric tube for the water."

Correct answer: A These are statements that will begin a therapeutic conversation and encourage the son to express his feelings about his father's impending death. Options B and C close communication and do not reflect caring. Option D is incorrect and does not address the underlying concern.

A young woman's fiancé died in a car accident one month prior to their wedding day. Since his death, she has become sexually promiscuous. What type of grief, if any, is the woman displaying? a.Chronic b.Disenfranchised c.Masked d.No grief

Correct answer: C The woman is expressing her grief through maladaptive behavior to mask her grief. There has only been a short period of time since her fiancé's death.

The student nurse has earned "A's" in all of her prerequisite courses. For the first exam in a nursing course, she earns a "D" and now feels that she may not be smart enough to become a nurse. What type of "loss" is the student experiencing? a.Actual loss b.External loss c.Physical loss d.Perceived loss

Correct answer: D The student's perception of herself as "not smart" is internal. Unless she chooses to share her grade with others, it cannot be "seen." This is not a "physical" loss.