Death & Dying
Overview
- Loss
- Hope
- Grief
- Death
- Nursing care
- Care of the nurse
Loss
- absence of an object, person, body parts or functioor emotion
- Five categorieso loss of external
o loss of a known environment
o loss of a significant other
o loss of an aspect of self
o loss of life
Grief, Mourning & Bereavement
- Bereavement- state of thought, feeling, and activity that follows loss
- Grief is a form of sorrow that follows the perception of anticipation of a loss
- Mourning- process that follows a loss and includes working through grief
- Many use these terms interchangeably
Theories of the Grieving Process
- All are similar
- People do not go thru stages or phases in order
- Move back and forth between phases
- Grieving is an individual process
- Each person experiences grieving differently
Assessment of Grief
- Explore the meaning of the loss
- Consider age, gender, and that grief is universal through all socioeconomic categories
- Consider the meaning of the relationship
- the more dependent the relationship, the more difficult the grieving
Grief Assessment
- Social support system
- Nature of the loss
- Cultural and spiritual beliefs
- Goals of the dying person
- Hope
Dysfunctional Grieving
- See text
- Be careful before labeling
- Consider support systems
- Degree of loss
Care of the Dying
- Nurse cares for the dying individual
- Care for the family
- Promote physical comfort
- Promote hope
- Assess spiritual needs/ comfort
Care of the Nurse
- Go through same processes
- Explore and express feelings
- Be open and honest
Hospice
- Intent is to treat the symptoms of disease to allow the terminally ill patient to die in as much comfort as possible
- Primary goal of team is to minimize patient's pain and maximize comfort
- Patient needs spiritual and emotional comfort
Spiritual Comfort
- Recognize spiritual issues
- Dialogue about spiritual issue
- Foster reconciliation
- Share near death experiences
Spiritual Comfort
- Recognize spiritual issues
- overt religious beliefs
- subtle issues of meaning, purpose, forgiveness, and transcendence- Dialogue about spiritual issues
- facilitate sharing
- explore meaning of life
Spiritual Comfort
- Foster reconciliation
- resolving relationships
- life review is encouraged to integrate life experiences so that meaning and forgiveness cabe found- Share near death experiences
- describe beautiful scene or sensing presence of benevolent being
Advance Directives
Purpose
Problems
Assisted Suicide
- Viewpoints
- ANA
- Other organizational standards
- DNR
- Terminal weaning
Factors affecting Grief & Death
- Developmental level
- experience
- age- Family role
- SES- may lack insurance/pension
- Cultural expression of grief
- Religion
Factors affecting Grief & Death
- Cause of death
- Spiritual Assessment Instrument
- Faith
- Importance and influence
- Community
- Address
Spiritual Assessment Instrument
- What is your faith or belief?
- Do you consider yourself spiritual or religious?- - What things do you believe in that give meaning to your life?
- Is it important to your life?
- What influence does it have on how you take care of yourself?
- Is it important to your life?
- What influence does it have on how you take care of yourself?
- How have your beliefs influenced your behavior during this illness?
- What role do your beliefs play in regaining your health?
Spiritual Assessment
- Are you part of a spiritual or religious community?
- Is this of support to you and how?
- Is there a person or group of people you really love or who are really important to you?
How would you like me to address these issues in your healthcare?