Loss, Death and Grief - PowerPoint PPT Presentation

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Loss, Death and Grief

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K bler-Ross's Five Stages of Dying. THE GRIEF PROCESS (Table 29-2) Types of Grief. Normal ... client to return to optimal physical and emotional functioning ... – PowerPoint PPT presentation

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Title: Loss, Death and Grief


1
Loss, Death and Grief
2
LOSS
  • Necessary
  • Actual
  • Perceived
  • Maturational
  • Situational

3
GRIEF
  • Emotional response to loss
  • Unique and individualized
  • Based on personal experiences, cultural
    expectations and spiritual beliefs

4
Mourning
  • The outward, social expression of a loss
  • Involves working through the grief until an
    individual accepts and adapts to his/her
    expectations to go on in life without what was
    lost

5
Bereavement
  • Involves grief and mourning
  • Inner feelings and outward reactions of the
    survivors
  • A process
  • Not linear
  • Does not proceed in sequential stages
  • May take many years to effectively heal and learn
    to live with a loss

6
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7
Types of Grief
  • Normal
  • Anticipatory
  • Complicated
  • Disenfranchised

8
Factors Influencing Loss and Grief
  • Human development
  • Psychosocial perspectives
  • Socioeconomic status
  • Personal relationships
  • Nature of loss
  • Culture and ethnicity
  • Spiritual beliefs

9
Coping with Grief and Loss
  • What must we know about the person?

10
  • What is Hope?
  • Why is it important?

11
Grief and the Nursing Process
  • Assessment
  • Assess actual reaction
  • Identify type and stage of grief
  • Communication is essential
  • Grief reaction is individualized, but one or more
    common symptoms are often experienced (Box 29-4)
  • Identify factors that affect grief (Table 29-3)
  • Discuss End-of-Life issues with client and family
  • Identify client expectations
  • Assess your own emotional well-being and
    involvement

12
Nursing Diagnoses
  • Anxiety
  • Caregiver Role Strain
  • Compromised Family Coping
  • Ineffective Community Coping
  • Ineffective Denial
  • Fear
  • Anticipatory Grieving
  • Dysfunctional Grieving
  • Hopelessness
  • Powerlessness
  • Social Isolation
  • Spiritual Distress
  • Readiness for Enhanced Spiritual Well-being

13
Planning
  • Grief is therapeutic and necessary
  • Set goals and outcomes
  • Set priorities
  • Influenced by client expectations, clinical
    condition, and client preferences
  • Ensure continuity of care

14
Implementation
  • Goal enabling client to return to optimal
    physical and emotional functioning
  • Select interventions that help individual cope
    with stressors and move toward healthy grief
    resolution
  • Therapeutic communication is essential
  • Acknowledge clients/familys grief
  • Be aware that behaviors may change
  • Promote Hope (p. 584-585)
  • Facilitate Mourning (p. 585)

15
Evaluation
  • How do you evaluate your plan of care for the
    grieving or dying patient?

16
Palliative Care
  • Provide relief from pain and other distressing
    symptoms
  • Affirm life and regard dying as a normal process
  • Neither hasten or postpone death
  • Integrate psychological and spiritual aspects of
    client care
  • Offer a support system
  • to assist client to live as actively as possible
    until death
  • to help families cope during clients illness and
    their bereavement
  • Enhance quality of life

17
Skills Necessary for Palliative Care
  • Establishing caring/trusting relationship
  • Comprehensive assessment of symptoms
  • Promote clients self-esteem and protect clients
    dignity
  • Attend to appearance of client and environment
  • Allow client to make care decisions
  • Keep client and family well informed
  • Provide privacy during procedures or when client
    and family need time together
  • Prevent abandonment and isolation
  • Support grieving family

18
Hospice Care
  • Alternative care delivery model
  • Generally less than 6 months to live
  • Family centered care with goal of keeping client
    comfortable and maintaining satisfactory
    lifestyle until death
  • Nurses role
  • to be open to client desires and meet the wishes
    of the dying client
  • to involve family as active participants

19
Postmortem Care
  • Know the policy/protocol of your facility
  • Validation of death
  • Documentation
  • Care of body (Box 29-9)
  • Organ or tissue donation procedures
  • When coroner must be notified
  • Voluntary vs. mandatory autopsy
  • Tend to the body with sensitivity and dignity
    (must be aware of religious or cultural beliefs
    of deceased)
  • Family becomes primary client after death occurs

20
The Grieving Nurse
  • Once rapport and a trusting relationship is
    established with a client it is normal to
    experience feelings of loss and sadness when they
    die.
  • Coping
  • Attend viewing
  • Write a letter of sympathy
  • Acknowledge and accept the grieving process
  • Develop support system
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