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Flashcards in Death and Dying Deck (17)
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1
Q

Tasks of grief for those who experience loss:

A

Accept the reality
Experience the pain of the loss
Adjust to the environment without the deceased
Emotionally relocate the deceased and move on with life

2
Q

Stages of grief:

A

DABDA

Denial
Anger
Bargaining
Depression
Acceptance
3
Q

Types of complicated grief and a description.

A

CEMD

Chronic - occurs longer than 6 months

Exaggerated - characterized by risk behaviors and disabling symptoms

Masked - symptoms of grief absent or only apparent due to unrelated factors

Delayed - grief appears years after loss

4
Q

Risk factors that can complicate grief: (6 things)

A
  1. The specifics of the loss and who deceased (i.e. Loss of a child)
  2. Nature of the attachment (i.e. Dependent partner)
  3. Mode of loss or death (i.e. Sudden death)
  4. Historical antecedents and personality variables (i.e. Psychiatric illness, Several losses)
  5. Social Factors (i.e. Estrangement and geographical separation)
  6. Concurrent stressors (i.e. Economic reversals)
5
Q

The _____% of Medicare patients with _______ chronic conditions account for _____% of all Medicare spending.

A

23%; > 4; 68%

6
Q

What did the SUPPORT trial show?

A

A significant number of patients don’t have their wishes known, don’t have their wishes implemented, and experience pain. Many did not want to be coded but this information was unknown by doctors.

7
Q

Consequences to family members of patients that die in the ICU.

A
  1. Increased risk of MI or sudden cardiac death
  2. Increased risk of death due to emotional strain for caregivers
  3. ICU care of patient was associated with a 5X family risk of PTSD
  4. Hospital care associated with 8.8 X family risk of prolonged grief disorder
8
Q

Barriers to communication due to the patient and family:

A
  1. Cultural beliefs on disclosure of information
  2. Unrealistic expectations of the healthcare system especially in a culture which “denies death”
  3. Societal values on the dying process
  4. Trust
  5. Lack of advanced directives and burden of decision making on families
9
Q

What is the burn out rate in palliative care?

A

61%

10
Q

What is the burnout rate in general medicine?

A

45%

11
Q

______% of all Medicare spending is for the _____% of patients who are in their final year of life

A

25%; 5%

12
Q

Caregivers are _______ more likely to suffer major depression 6 months after a patient’s death in the ICU.

A

3X

13
Q

Describe findings of the Aetna experiments.

A

Aetna understood that many terminally ill patients wanted to maintain curative treatment, so they gave them the option to maintain treatment and receive hospice services. Patient enrollment in the concurrent care program jumped from 26 - 70%. Additionally, ER visits dropped, hospital and ICU use dropped by two-thirds, and costs fell by 25%. They figured these changes were due to patient access to a knowledgeable individual to speak with about daily needs.

14
Q

Two most common symptoms of depression and anxiety.

A

Dyspnea and pain

15
Q

RULE for motivational interviewing.

A

Resist righting
understand
listen
empower

16
Q

Empathetic component of interviewing, NURSE

A
Name
Understand
Respect
Support
Explore
17
Q

SPIKE during the interview.

A

1) Setting up the interview
2) Assessing the patient’s Perception
3) Obtaining the Patient’s Invitation
4) Give the Knowledge to the patient
5) Addressing the patient’s Emotions with Empathetic responses