Loss and Maintaining Compassion Flashcards
What is the mortality rate for people living in Scotland and the UK
100% - we all die
What are the leading causes of death in Scotland?
Ischemic Heart Disease (6,615 - 11.3% male)
Dementia and Alzheimer’s (6,484 - 11.1% male)
Lung Cancer (3,980 - 6.8% male)
Cerebrovascular diseases - including stroke (3,831 - 6.5% male)
Chronic lower respiratory diseases - bronchitis and emphysema (3,469 - 5.9% male)
How many total deaths were there in 2018?
58,503 mainly 80 + (29,092)
How many COVID-19 deaths have there been in Scotland ?
8,319
Where did most deaths in 2018 occur?
Total deaths - 58,503
Hospital - 28,604 (49%)
At home / non-institution - 15,864 (27%)
Care home - 13,769 (24%)
Other - 266 (0.45%)
What are the 3 different death scenarios you get?
Gradual death - old age, chronic illness
Premature death - sudden, accidents
Catastrophic death - war, disaster, terrorist attack
How and when does sudden death happen?
- Often untimely (young people)
- Often traumatic (RTA, crime, suicide, violent)
- May be a time lapse between death and family involvement
- Always involve the Procurator Fiscal and Police (coroner in the rest of UK)
How has parent involvement in resuscitation changed now?
You now usually have parents in resus now so they can see everything that could be done was done, usually parents will call time and say stop
How did covid change the way we care for dying ones and support the bereaved ?
Covid change the way we care for dying ones and how we support the bereaved - such changes are both real and perceived;
- Working in the “unknown” and a lack of certainty and control
- Changes to traditional patterns of practice / working
- Clinical / ethical decision (e.g DNCPR / ITU)
- Use of technology - lack of human contact
- Disruption to education / training
- Disruption to personal life (holidays and time off)
How did covid change the way we care for dying ones and support the bereaved ?
Covid change the way we care for dying ones and how we support the bereaved - such changes are both real and perceived;
- Working in the “unknown” and a lack of certainty and control
- Changes to traditional patterns of practice / working
- Clinical / ethical decision (e.g DNCPR / ITU)
- Use of technology - lack of human contact
- Disruption to education / training
- Disruption to personal life (holidays and time off)
What are the basic principles unpinning end of life care (that still existed even in Covid times)?
Whilst many things have change - the basic principles unpinning end of life care remain;
- Dignity
- Compassion
- Respect
- Self care
What is the theory behind bereavement and grief
Theres a period of disorganisation - shock, numbness, denial
Theres extremes - searching, yarning, anger, protest
Resolution - reorganisation, resolution, acceptance
What is the dual process model of coping with Bereavement ?
The model shows of everyday life when bereaving and how it can vary between loss-oriented and resolution oriented (or should)….
If someone stays on the loss-oriented side and doesn’t go on to the restoration-oriented side then they are depressed and intervention will be needed
What are normal reactions to death?
When talking about dying, death and bereavement we’re not talking about a condition or a problem; but talking about an experience shaped by our own experience
Its normal for people to express;
- A sense of unreality or helplessness
- Strong emotions; anger, crying, guilt - ‘if only’
- Blame at HCP’s
- Blame at other family members
Tried is normal and we need to ‘normalise’ the journey for the bereaved !
What questions or comments will patients make - usually at the most unexpected times?
- “Ive had enough, its time I was gone”
- Have much longer do you think I’ve got?
- I wish I could just go now (This needs better pain management !!!)
- Do you think i’ll make it to Christmas (Don’t know, why don’t we start doing a memory box, writing cards now, notes for wedding days!
