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