T3: Blueprint: Grief Flashcards Preview

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Flashcards in T3: Blueprint: Grief Deck (46):
1

The experience of separation from something of personal importance

Loss

2

T/F: Loss is anything that is perceived as such by the individual.

True

3

What are some notable forms of loss?

-Sig other (person or pet)---through death, divorce, separation
-Illness/debilitating conditions
EX: diabetes, stroke, cancer, RA, MS, Alzheimer, hearing/vision loss, SC/head injuries
-Developmental/maturation changes (menopause, andropause, infertility, empty nest, aging, impotence, hysterectomy)
-Decrease in self esteem due to inability to meet self expectations/expectations of others (loss of potential hopes and dreams)
-Personal possessions that symbolize familiarity and security

4

Deep mental and emotional anguish that is a response to the subjective experience of loss of something significant

Grief

5

The physiological process (or stages) through which the individual passes on the way to successful adaptation to the loss of a valued object

Mourning

6

Grief may be viewed as the subjective states that accompany _____, or the emotional work in the ____

accompany mourning, or the emotional work in the mourning process

7

Grief work and the process of mourning are collectively referred to as the ___

Grief response

8

A part of the life cycle, anticipated by may still be intensely felt

Necessary loss

Ex: retirement, menopause

9

Significant other/personal possessions (actual loss): any loss of a valued person or item. Ex?

Loss of house (item)
Retirement
Loss of fam member or pet

10

Any loss defined by a client that is not obvious to others

Decrease in self esteem or expectations (perceived loss)----no one can see/understand the loss

11

Losses normally expected due to the developmental processes of life

Developmental changes (maturation)
-Not being able to move around like normal

12

Unanticipated loss caused by an external event

Illness or debilitating condition (situational loss)
-Loss of job

13

Grief: subjective or objective

Subjective

14

Mourning

Psychological prices through which individual pass on way to successful adaptation to the loss

15

Normal grief is complicated or uncomplicated?

Uncomplicated

16

What are emotions of normal grief?

Anger
Resentment
Withdrawal
Hopelessness
Guilt

17

Normal grief should change to acceptance with time. How long?

Some get here by 6 months or after

18

What are somatic complaints of normal grief?

Chest pain
Palpitations
Headaches
Nausea
Changes in sleep
Fatigue

19

"Letting go" of an object or person before the loss

Anticipatiry grief

20

What are examples of when family may experience anticipatory grief?

Terminal illness
Nursing homes

21

What are feelings for anticipatory grief?

Anger
Sadness
Anxiety---intensifies as it becomes imminent

22

Difficult progression through the expected changes of the grieving process

Dysfunctional grief

23

Dysfunctional grief: Work of grief is _____ and clinical manifestations are more ____. Ex?

Prolonged; sever
Ex: depression, exacerbation of a disorder, may develop suicidal ideation, guilt, low self esteem; somatic complains persist of an extended amount of time

24

An experienced loss that cannot be publicly shared or it is not socially acceptable. Ex?

Disenfranchised grief

Ex: Death bc suicide

25

Loss shared by a community or group of individuals

Grief experienced by public tragedy

9/11--Paris attacks-->Terrorists
Assignations
Natural disasters
Work/school shootings

26

What are 3 types of maladaptive responses to grief?

1. Delayed (inhibited) grief
2. Distorted (exaggerated) grief
3. Chronic (prolonged) grief

27

Maladaptive responses to grief: Delayed (inhibited)
1. ___ of grief when it would normally be expected
2. Cultural influences like "____" can cause this delayed response
3. MOST COMMONLY OCCURS due to ??
4. Can it manifest later in life? How?

1. ABSENCE of grief when it would normally be expected
2. Cultural influences like "KEEP A STIFF UPPER LIP" can cause this delayed response
3. Most commonly occurs due to: AMBIVALENT feelings toward the lost person
4. Yes it can manifest later in life---anxiety/panic attacks

28

Maladaptive response to grief: Distorted (exaggerated)

1. All symptoms associated w/ normal grief but ____
2. An ____ of grief to the point the person is overwhelmed and is unable to manage ___
3. Individual remains fixed in the ______
4. Anger turned inward leads to ____

1. All symptoms associated w/ normal grief but EXAGGERATED
2. An INTENSIFICATION of grief to the point the person is overwhelmed and is unable to manage ADLs
3. Individual remains fixed in the ANGER STAGE!!!
4. Anger turned inward leads to DEPRESSION

29

Maladaptive responses to grief: Chronic (prolonged)

1. Response that can take ____ to resolve
2. Disabling behaviors preventing ___
3. Behaviors aimed at keeping loved one alive. How?

1. Response that can take YEARS to resolve
2. Disabling behaviors preventing ADLs
3. Behaviors aimed at keeping loved one alive. How?
-Keeping room exactly the same
-Setting place for loved one at table
-Not giving away their belongings

30

What are Kubler Ross 5 stages of grief?

Denial
Anger
Bargaining
Depression
Acceptance

31

What are Worden's 4 tasks?

Task 1: Accepting reality of loss
Task 2: Using coping mechanisms to experience emotional pain of the loss
Task 3: Changing environment to accommodate absence of deceases (stop setting table place for them; pack up their belongings)
Task 4: Finding a meaningful connection w/ the lost entity while learning to live again (EX: MADD--mothers who lost child to drunk driver)

32

What does TEAR stand for?

To accept the reality of the lost
Experience the pain of loss
Adjust to the new environment w/o the lost object
Reinvest in the new reality

33

What are some factors that influence grief and coping?

-Current stage of dev.
-Interpersonal relationships/support network
-Type of loss
-Culture and ethnicity
-Spiritual/religious
-Socioeconomic status

34

Risk for complicated grieving r/t loss of a valued entity/concept; loss of a loved one

Why do we assess clients stage in grief process?

Accurate baseline data are required to provide appropriate assistance

35

Risk for complicated grieving r/t loss of a valued entity/concept; loss of a loved one

Why should we develop trust? What do we show

Trust provides the basis for a therapeutic relationship

Show EMPATHY, concern, and unconditional positive regard

36

Risk for complicated grieving r/t loss of a valued entity/concept; loss of a loved one

We need to help the client actualize the loss by talking about it. What kind of questions can we as to do this? What does this help do?

Questions: When did it happen? How did it happen? etc

Reviewing events of loss helps the client com to full awareness of the loss

37

Risk for complicated grieving r/t loss of a valued entity/concept; loss of a loved one

We need to help the client identify and express feelings. What are some of the more problematic feelings?

-Anger: many people won't admit to this, believing it is unjustified/inappropriate
-Guilt: Prolongs grieving
-Anxiety/helplessness: May have fears he/she can't carry on alone


*Until the client can recognize and accept their personal feelings regarding the loss, grief work cannot progress

38

Risk for complicated grieving r/t loss of a valued entity/concept; loss of a loved one

We need to interpret normal behaviors associated w/ grieving and provide client with adequate time to grieve. Why is it important to understand the grief process?

Help prevent feelings of guilt generated by these responses---individuals need adequate time to adjust to the loss and all its ramifications---this involves getting past bday and anniversaries of which the deceased was a part

39

Risk for complicated grieving r/t loss of a valued entity/concept; loss of a loved one

We need to provide continuing support. If this isn't possible by nurse, then offer support groups. Why is this helpful?

Emotional support systems facilities the grief process

40

Risk for complicated grieving r/t loss of a valued entity/concept; loss of a loved one

Identify pathological defenses the client may be using. Ex?

Drug/alcohol use
Somatic complains
Social isolation

Assit client why these aren't healthy---bereavement process is impaired by behaviors that mask the pain of loss

41

Risk for complicated grieving r/t loss of a valued entity/concept; loss of a loved one

Encourage the client to make an honest review of the relationship with lost entity. What is a good way to do this?

Journaling--when client can see + and - aspects r/t loss, grieving process will be complete

42

Risk for spiritual distress r/t complicated grief process

How should we be toward our client?

Accepting and nonjudgemental when client expreses anger and bitterness toward God
*stay with client


nurses prescent and non-judgmental attitude increase clients feelings of self worth and promote trust in relationship!

43

Risk for spiritual distress r/t complicated grief process

Encourage the client to ventilate feelings r/t meaning of own existence in the face of current loss. The client may believe he/she ______. What can provide relief?

Believe he/she cannot go on living w/o lost entity

Catharsis can provide relief and put life back into realistic perspective

44

Risk for spiritual distress r/t complicated grief process

Should we encourage the client to reach out to previously used religious practices for support?

Yes, client may find comfort in religious rituals which with he/she is familiar

45

Risk for spiritual distress r/t complicated grief process

Assure client that he/she is not alone when feeling inadequate in the search for life answers. Why do we do this?

Validation of clients feelings and assurance that they are SHARED by others offer ENCOURAGEMENT and and AFFIRMATION of acceptability

46

Risk for spiritual distress r/t complicated grief process

If the client wants contact with a spiritual leader, do we oblige?

Yes, spiritual leaders serve to provide relief from spiritual distress and often can do so when other support persons cannot