End of Life Flashcards
1
Q
What are the top causes of mortality in infants?
A
- Congenital anomalies
- Low birth weight
- SIDS
2
Q
Around what age do children understand death?
A
Around age 9
3
Q
What are some interventions for dying children and their families?
A
- Be honest and encourage honesty
- Answer questions (only answer what is being asked)
- Give permission to ask questions (only if you can follow through)
- Use books and toys to facilitate expression
4
Q
Describe palliative care
A
Palliative care is care that accompanies the patient throughotu their jouney from diagnosis and hope for cure to hospice and hope for a cure
This type of care focuses on the releif of symptoms
5
Q
Describe hospice care
A
Hospice care is an acknowledgement that the person has exhaused all medical treatments and has had enough
The patient is in the last 6 months of their life
6
Q
What are some symptoms that death is near in children?
A
- Withdrawl - talking and interacting less. No playing, more sleeping. Older children may begin giving things away
- Food - loss of appetitie
- Disorientation - Mostly sleeping, can be awakened. Agitated restless
- Decreased urine output
- Sudden surge of energy
7
Q
Describe the care of a child after death
A
- Allow family to remain with the child as long as desired
- Ask if they want to hold the child
- Be aware of cultural practices and anticipate them
- Wash body, remove equipment, and change the bed
- Offer quiet support
- Validate the child’s life
8
Q
Describe a toddlers concept of death
A
- The egocentricity of toddlers makes it impossible for them to comprehend the absence of life.
- They perceive events only in terms of their own frame of reference: living.
- Instead of understanding death, this age group is affected more about any change in lifestyle
9
Q
Describe a toddler’s reaction to death
A
- With the death of someone they may continue to act as though the person is alive
- Ritualism is important, a change in lifestyle could be anxiety producing.
- Reacts more to the pain and discomfort of a serious illness than to the probable fatal prognosis
- They react to parental anxiety and sadness
10
Q
What are some interventions to help toddlers understand death?
A
- Help the parents deal with their feelings, allowing them more emotional reserve to meet the needs of their children
- Encourage parents to be as near to the child as possible
- Maintain as normal an environment as possible to retain ritualism
- If a parent has died, make sure there is someone there for the child as a consistent caregiver
11
Q
Describe a preschool child’s concept of death
A
- They believe their thoughts are sufficient to cause death; they end up feeling guilt, shame, and punishment
- Their egocentricity implies a tremendous sense of self-power and omnipotence
- They usually have some sense of the meaning of death
- Death is seen as a departure, a kind of sleep
- Death is seen as temporary and gradual
- There is no understanding of the universality of death and the inevitability of death.
12
Q
Describe a preschooler’s reaction to death
A
- If they become seriously ill, they conceive of the illness as a punishment for their thought or actions
- They may feel guilty and responsible for the death of a sibling
- Their greatest fear concerning death is separation from their parents
- They may engage in activities that seem strange or abnormal to adults
- They have fewer defense mechanisms to deal with loss, so they may react to a less significant loss with more outward grief than to the loss of a significant person.
- Reactions such as jiggling, joking, attracting attention, or regressing to earlier developmental skills indicate children’s need to distance themselves from tremendous loss
13
Q
What are some interventions to help preschooler’s with death?
A
- Help parents deal with their feelings, allowing them more emotional reserve to meet the needs of their children
- Help parents understand behavioral reactions of their children
- Encourage parents to remain near the child as much as possible, to minimize the child’s great fear of separation from parents
- Establish a consistent caregiver
14
Q
Describe a school-age child’s concept of death
A
- These children still associate misdeeds or bad thoughts with causing death and feel intense guilt and responsibility for the event
- Because of their higher cognitive abilities, they respond well to logical explanations and comprehend figurative meanings of words
- They have a deeper understanding of death in a concrete sense
- They particularly fear the mutilation and punishment they associate with death
- They personify death as the devil, a monster, or the bogeyman
- They may have naturalistic physiologic explanations of death
- By age 9 or 10 children have an adult concept of death; realizing that death is inevitable, universal, and irreversible.
15
Q
Describe a school age child’s reaction to death
A
- Because of their increased ability to comprehend they may have more fears:
- The reason for the illness
- communicability of the disease to others
- consequences of the disease
- the process of dying and death itself
- Fear of the unknown, which is greater than the fear of the known
- The realization of death is a tremendous threat to their sense of security and ego strength
- They are more likely to exhibit fear through verbal uncooperative ness rather than actual physical aggression
- They may be interested in post death services
- They may be inquisitive about what happens to the body
