Dying and Grieving Flashcards
What does nursing care at the end of life entail?
Presence- see the patient not the disease,
address spiritual issues
nurse role is educator- need repeating many times, convey information slowly with presence write down and review often
counsel client and families during grieving
Anticipatory grieving
finalizing the connections with loved ones, spending time together, talking and making memories. This does not change the amount of emotions from the actual death but it can help work through feelings in the present and resolve unfished business.
What could the nurses do for a client who is grieving before death?
validate expressions of anticipatory grief, listen understand accept, explain, and be open to what they ar experiencing.
inform client and family about the disease and symptoms - physical as well as emotional- e.g mood swings, withdrawal, fatigue, vacillate between denial and acceptance. caregivers may have resentment and confusion.
explore ways of coping; being outside talking, writing
invite clients and families to deal with emotional issues - do not be surprised or have preconceived assumptions of how persons should act, help patients and families find their emotions.
Absent grief
person is unmoved and psychologically detached as they discuss loss
Delayed grief
grief postponed for days, months, years. often there is a trigger when the grief is finally felt.
Chronic grief
exaggerated grief and does not or can not resolved. e.g set a place at the table, keep a ‘shrine’, can also be from a chronic problem such as loved one in prison or with an incurable disease that carries a social stigma, child developmentally disabled
Distorted grief
emotional upheaval that does not allow the person to effectively live. anger and guilt are extremely high.
Converted grief
somatization disorder- preoccupation with physical or psychological symptoms that the person does not see as coming from their loss
Disenfranchised grief
grief that is experienced when a loss cannot be openly acknowledged, publicly mourned or supported,
what are the four gifts of resolving issues ?
Forgiveness, gratitude, love, farewell
Self care for hospice care nurse
maintain boundaries( do not internalize in yourself what is happening with clients/families)
talk with others on the team
protect private time( avoid working outside normal hours, take time off without interruptions), be humble, healthy balance in life ( vacations diet)
Mourn when touched( appropriate to attend wake or funeral of patients who we have become close to)
precautions that the nurse must apply in the end of life care.
be aware of personal reactions( when client is younger than you, resembles a significant other)
Struggle(confronting dying)
living and dying are a struggle( prolonged abuse, addiction)- no time to reassess lifelong conflicts, give basic safety caring affirmation and comfort.
Dissonance
dying is not living, do not seek meaning in death- manage pain and discomfort aggressively
Endurance
triumph of inner strength, continue with life/death on their own terms, strength in the face of adversity.. a character trait they take with them into the dying process- capitalize on their inner strength, do not mistake confidence with denial
