Death and Dying

Question 1

Sense of satisfaction that lifes productive

Answer 1

Integrity

Question 2

Loss of hope and sense that life has no purpose

Answer 2

Despair

Question 3

Knowing the true doctor-patient relationship

Answer 3

acceptance that death is part of life and doesn’t shy away from emotional pain of loss

Question 4

Death is where:

Answer 4

Philosophy
Spirituality
Medicine

Question 5

Free from avoidable distress and suffering for pts, family and care givers

Answer 5

Good death

Question 6

Study of Death and Dying

Answer 6

Thanatology

Question 7

Dr. Kubler -Ross studied

Answer 7

Stages of dying

• reactions of patients with terminal illness and pts seldom and follow a regular series of responses
• no sequences of stages established

Question 8

Five stages

Answer 8

Denial
Anger
Bargaining
Depression
Acceptance

Question 9

Death is to be avoided, not natural, death is failure of medical care and is negative reflection on doctor

Answer 9

Physician Barrier

Question 10

What makes up a good death

Answer 10

no prolongued
pain and symptoms controlled
not a burder to others
control over decision making and strengthening relatioships

Question 11

People want to die where:

end up dying?

Answer 11

prefer home but most end up dying in hospital and some nursing home. NO one wants to die in a nursing home

Question 12

intentional, unintentional, subintentional

Answer 12

circumstnces of dying

Question 13

A pts choice about end of life care

Answer 13

advance directive

Question 14

Advance directive is legally binding

Answer 14

yes

Question 15

Includes

Answer 15

living wills, health care proxy, DNR

Question 16

What do hospitals use w/out advance directives

Answer 16

ethics committee

Question 17

Is AMA okay with euthanasia?

Answer 17

nope

Question 18

Legal and ethical to provide medically needed analgesia to terminally ill pt even if it shortens life

Answer 18

Euthanasia

Question 19

Findings of death with dignity law

Answer 19

physcians more involved
no flood of people to die
people did so bc wanted control and independence
36% didn’t even fill prescription

Question 20

Pallative care is/not hospice

Answer 20

NOT

Question 21

Goals of pallitive care

Answer 21

provide RELIEF from suffering
comfort
pain management
CAN and SHOULD co-exsit with life prolounging interventions

Question 22

Hospice

Answer 22

as person is nearing end of life
helps make decisions how and where to die
forgoes life prolonguing tx in favor of quiality

Question 23

Necessities for hospice admission

Answer 23

recommendation of personal physician
left expectancy of 6 months or less
no longer seeking cure
desire to stay out of hospital

Question 24

Goals of hospice

Answer 24

provide physical, emotional, social support
support familiy and loved ones
assit pts to live with dignity and comfort as they cope with end of life issues

Question 25

Changes weeks/days before death

Answer 25

tired, refuse food and drink, decreased reserve for activity, change vitals, change in cognition, "last hoorah'

Question 26

Unresponsive, bluish with cold hands and feet, decreaesd blood pressure, decreased breathing, "Death Rattle"

Answer 26

final hours of life

Question 27

Lack of reflexes so swallowing reflex is less

Answer 27

death rattle

Question 28

Two ways to Grieve

Answer 28

laughter and crying

Question 29

Normal grief lasts

Answer 29

12-24 months

Question 30

FEELING of loss

Answer 30

Grief

Question 31

PROCESS of resolving grief

Answer 31

Mourning

Question 32

the STATEof mourning the death of a loved one

Answer 32

Bereavement

Question 33

well defined syndrome w/ known etiology and predictable symtoms Causes distress and dysfunction associated with complications

Answer 33

Grief

Question 34

State of being deprived State of Mourning loss of loved one Seems interchangable with mourning

Answer 34

Bereavement

Question 35

Causes loss of loved one to be more painful | Grief is the price we pay

Answer 35

Attachment Theory

Question 36

T/F grief is multifaceted

Answer 36

T

Question 37

How long does shock/denial last

Answer 37

2-3 months

Question 38

how long does intense concern last

Answer 38

6 months - 1 yr and cant focus on stuff

Question 39

Includes anger, guild, sadness, anxiety

Answer 39

Despair/Depression

Question 40

When you reorganize thoughts... accomidation and assimilate information

Answer 40

Recovery

Question 41

Numb, cyring, sighning, sense of unreality, denial disbelief... which stage?

Answer 41

Denial/Shock | Phase 1

Question 42

Anger/Sadness/Guilt/Dreams/Insomnia/anorexia/anhedonia/weak/fatigued

Answer 42

Phase 2: preoccupation with deceased and intense concern

Question 43

Can think about past with pleausure, regain interest in activites and forms new relationships

Answer 43

Phase 3: Resolution

Question 44

% that go on to complicated grief

Answer 44

10-20%

Question 45

can treat prolounged grief as...

Answer 45

PTSD

Question 46

When does complicated grief occur?

Answer 46

follows sudden or tragic death and survivors get stuck in phase of grief

Question 47

men/women more at risk

Answer 47

men..young men

Question 48

PGD

Answer 48

prolounged grief disorder

Question 49

symptoms of PGD

Answer 49

extreme focus on loss intense longing for what is lost numb/withdrawn/life is meaningless/irritable lack of trust/ trouble accepting loss

Question 50

Increased risk for these with PGD

Answer 50

depression, anxiety, substance abuse, mortality rate

Question 51

2 months of depression is major predictor of:

Answer 51

Cardiac problems and impaired immune response increased suicide and accidents poor self care

Question 52

Grief is normal and has how many phases

Answer 52

3 Denial/shock intense concern/preoccupation/ Resolution

Question 53

What occurs in final hours of life

Answer 53

loss of swallow and cough reflexes