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Loss, Death, and Grief
Transcript of Loss, Death, and Grief
Grief is the emotional response to a loss. The expression of grief varies according to individual and culture. What do you know about cultural expression of grief?
Through the Patient's Eyes
Patients with advanced chronic illness and their families face end of life care decisions.
Necessary Loss: divorce, death, loss of independence. Changes that are part of life, not always negative
Maturational loss: form of necessary loss, includes ALL normally expected life changes. Kids move out, transition from grade school to middle school...
Situational loss: Sudden and unpredicted. Does not always have to be a death, injury with physical changes, loss of functional status.
Actual Loss: occurs when a person can no longer feel, hear, see, or know a person or object. Loss of body part, death of a loved one
Perceived Loss: uniquely defined by an individual experiencing loss. may not be obvious to others
Each person responds to loss differently... and people with chronic illness, disabilities, and/or hospitalizations experience multiple losses, why??
Normal grief: common universal reaction. people may feel anger, disbelief, depression.
Anticipatory grief: unconscious process of disengaging or "letting go" before a loved one passes. How do you see anticipatory grief impacting patient care?
Ambiguous loss: the lost person is present but not psychologically available. OR the person is gone (kidnapping, POW). Why is ambiguous loss hard to process? How do you see this playing out in your patient care?
Theories of grief and mourning. Why are theories important?
Kubler-Ross stages of dying
Families should be allowed to make decisions and have open conversations. Unfortunately, many of these conversations happen late.
family members are dealing with death and loss at different rates. how does this impact patient care and communication?
What is the difference between palliative care and hospice?
Palliative care focuses on the prevention, relief, reduction, or soothing of symptoms. This may happen even while receiving treatment for the disease.
Hospice is a model of care for dying patients and their families. Priority is managing pain/symptoms, comfort, QOL, spiritual needs
Patients are typically placed on hospice when they have 6-12 months to live
many patients and their loved ones prefer to die at home compared to a hospital/nursing home. How can you help patients who want to die at home?
What is IOPO?
There are federal laws regulating organ donation, and transplant coordinators (many times) address donation concerns
Who needs an autopsy?
how does this impact EOL care?
How would you provide EOL care to a: