Chapter 032

download report

Transcript Chapter 032

Care for the Dying and for Those Who Grieve

CHAPTER 32 Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.

1

Hospice and Palliative Care

• • • • •

Dr. Elisabeth Kübler-Ross Goal is quality, compassionate care for people facing a life-limiting illness or injury Team-oriented approach to expert medical care, pain management, and emotional and spiritual support Tailored to patient’s needs and wishes Support to patient's loved ones included Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.

2

Hospice Care

Available to everyone regardless of age, diagnosis, or the ability to pay

Requires a physician’s best clinical judgment that the patient is terminally ill with a life expectancy of 6 months or less

Patient chooses hospice care rather than curative treatment Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.

3

Nursing Goals in End-of-Life Care Practice the art of presence

Assess for spiritual issues

Provide palliative symptom management

Become an effective communicator

Counsel about anticipatory grieving

Practice good self-care Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.

4

Nursing Goals in End-of-Life Care

Continued

The Four Gifts of Resolving Relationships

Forgiveness

Love

Gratitude

Farewell Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.

5

Styles of Confronting the Prospect of Dying: Seven Motifs 5.

6.

7.

1.

2.

3.

4.

Struggle – living and dying are a struggle Dissonance – dying is not living Endurance – triumph of inner strength Incorporation – belief system accommodates death Coping – working to find a new balance Quest – seeking meaning in dying Volatile – unresolved and unresigned Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.

6

Grief Reactions, Bereavement, and Mourning

• •

Grief – the reaction to loss

Includes depressed mood, insomnia, anxiety, poor appetite, loss of interest, guilt, dreams about the deceased, poor concentration Bereavement – period of grieving following a death

Mourning – things people do to cope with grief Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.

7

Dual-Process Model of Coping with Bereavement

Loss-oriented stressors – concentrating on the loss experience, feeling the pain of grief, remembering, and longing

Restoration-oriented stressors – overcoming loneliness, mastering skills and roles once performed by the deceased, finding a new identity, and facing practical details of life – Stroebe and Schut Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.

8

Four Tasks of Mourning

Accept the reality of the loss

Experience the pain of grief

Adjust to an environment without the loved one

Externally, internally, and spiritually

Relocate and memorialize the loved one Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.

9

Maladaptive Grieving

Chronic grief

Delayed grief

Exaggerated grief

Masked grief reactions Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.

10

Helping People Cope with Loss

Four constructs that support personal growth

Seeing some good resulting from the death

Continuing the connection with the deceased

Invoking intrinsic spirituality to understand the death and aftermath

Going forward with life Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.

11