Grief Process, Death and Dying - PowerPoint PPT Presentation

Loading...

PPT – Grief Process, Death and Dying PowerPoint presentation | free to download - id: 5d8cd4-NGYzM



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Grief Process, Death and Dying

Description:

Grief Process, Death and Dying Plaut & Roark ... and of psychological mechanisms for coping with death Thank you Roark, 2004 ... – PowerPoint PPT presentation

Number of Views:512
Avg rating:3.0/5.0
Slides: 34
Provided by: Mary171
Category:
Tags: coping | death | dying | grief | process | with

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Grief Process, Death and Dying


1
Grief Process, Death and Dying
  • Plaut
  • Roark

2
LOSS
  • Actual
  • Perceived
  • External Objects
  • Known Environment
  • Significant Other
  • Aspect of Self
  • Life

3
Kubler-Ross Stages of Grief
  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance

4
Death and Dying
  • Assisting the patient to Live well and Die
    well
  • What does this mean to you?

5
Common fears of the dying patient
  • Fear of Loneliness
  • Distancing by support people and caregivers can
    occur
  • Debilitation, pain, and incapacitation
  • Hospital, a place that can be very lonely
  • Fear of dying alone

6
Fears of the dying client
  • Fear of Sorrow
  • Sadness
  • Letting go of hopes, dreams, the future
  • Awareness of own mortality
  • Grief about future losses
  • Anticipatory grief that involves mourning, coping
    skills
  • Grief related to diagnosis that has a long term
    effect on the body such as cancer
  • Patient may feel well at time of diagnosis

7
Fears of the dying client
  • Fear of the unknown
  • Death is an unknown state
  • What will happen after death?
  • What will happen to loved ones, those left behind

8
Fears of the dying client
  • Loss of self concept and body integrity
  • Mutilation via therapy
  • Body image changes
  • Loss of role or status
  • Loss of standard of living

9
Fears of the dying client
  • Fear of Regression
  • Ego is threatened
  • Physical deterioration may occur
  • Mental deterioration may occur
  • Unable to care for self
  • Become dependent on others for care

10
Fears of the dying client
  • Fear of Loss of Self Control
  • Loose ability to control life decisions
  • Loose ability to control ADLs
  • Loss of control of body functions
  • Loss of control of emotions
  • Loss of independence

11
Fears of the dying client
  • Fear of Suffering and Pain
  • May be many different types of pain or suffering
    such as physical, emotional, social, or spiritual
    in nature
  • Altered relationships with others
  • Anxiety related to the disease and consequences
    of the disease

12
Childs Response to Illness and Death
  • Infant
  • Toddler
  • Preschool
  • School Aged
  • Adolescent

13
Cultural Backgrounds Affect Beliefs Concerning
Death
  • Beliefs, attitudes, and values that stem from the
    patients cultural background will strongly
    influence their reaction to loss, grief, and
    death
  • Expressions of grief are governed by what is
    acceptable by the family and within the cultural
    context
  • Comfort may be found through spiritual beliefs,
    and finding comfort in specific rites, rituals,
    and practices

14
Cultural Backgrounds Affect Beliefs Concerning
Death
  • Organized religious practices
  • Nurses need to be in tune with patients
    spiritual needs
  • Becoming familiar with cultural views will help
  • Can you name some cultural practices associated
    with loss, grief, and death?

15
Support the client
  • Nurses can help to identify coping mechanisms,
    and encourage effective coping mechanisms
  • Allow client/family to visit the chapel if
    desired
  • Allow family members around
  • Client may have problems with conflicting
    feelings that do not align with culture or
    religious practices-nurse can evaluate coping and
    guide the client to appropriate interventions

16
Role of the Chaplain
  • Can be a member of the health care team
  • Assist with religious practices
  • Perform rites
  • Provide prayer, support, and comfort
  • Assist with mobilizing other support systems that
    are important to the client
  • Support family members

17
Nurses response to the dying patient
  • Nurses grieve also
  • Nurses need to come to terms with personal
    meanings of life and death
  • Best prepared to work with terminal clients when
    the nurse has been given the time to come to
    terms with own mortality
  • Common feelings
  • Develop personal/professional support systems

18
Rationale for Communicating Truthfully about
Terminal Illness
  • Right to know
  • Time frame
  • Nurse needs to assess whether or not the
    patient/family have been told and what was told
    to them
  • THE PHYSICIAN WILL TELL THE CLIENT FIRST, NOT THE
    NURSE

19
Communicating Terminal Illness, continued
  • The nurse
  • Clarifies what was said
  • Listens to concerns
  • Fosters communication between MD, client, and
    family
  • Allows patient to express loss
  • Facilitate grief through nursing process
  • Be available for patient
  • Assist patient to identify needs/hopes for
    remainder of life
  • Connect patient with proper resources

20
List nursing strategies appropriate for grieving
persons
  • Open ended statements
  • Patient sets the pace
  • Accept any grief reaction
  • Be awarenurse may be target of anger
  • Remove barriers
  • Avoid giving advice
  • Allow patient to talk
  • Allow patient to express signs of hope
  • Support hope by helping focus

21
Assist Family to Grieve
  • Explain procedures and equipment
  • Prepare them about the dying process
  • Involve family and arrange for visitors
  • Encourage communication
  • Provide daily updates
  • Resources
  • Do not deliver bad news when only one family
    member is present

22
Choices of Care Setting
  • Families have choices of where to care for the
    dying loved one
  • Ask the patient and family preferences
  • Support whatever the choice
  • Hospital, Home/Hospice

23
Elements of Hospice Care
  • Home care coordinated with hospital
  • Control of symptoms holistically
  • Physician directed care
  • Utilization of variety of health care
    professionals
  • Bereavement follow up care
  • Acceptance based on need, not

24
Nursing strategies to meet physical and
psychosocial needs of the dying patient
  • Thorough pain control
  • Maintain independence
  • Prevent isolation
  • Spiritual comfort
  • Support the family

25
Signs/Symptoms of Approaching Death
  • Motion and sensation is gradually lost
  • Increase in temperature
  • Skin changes-cold, clammy
  • Pulse-irregular, and rapid
  • Respirations-strenuous, irregular, Cheyne stokes
  • Death rattle
  • Decrease Blood Pressure
  • Jaw and Facial muscles relax
  • MOST POSITIVE SIGN OF DEATHAbsence of brain
    waves (Need two MDs to sign off)

26
Nursing care after death
  • Autopsy examination performed after a persons
    death to confirm or determine cause of death
  • For tissue and organ removal
  • Keep CV system going
  • Call donor bank representative
  • Must be agreed on by all family members
  • Or, patient decision before death

27
Nursing care after death
  • Legally, a person is considered dead when there
    is a lack of brain waves even though other body
    organs continue to function
  • This definition allows for harvesting of organs
    and tissue for donation
  • Vital organs are heart, liver, kidney, lung,
    pancreas
  • Non-vital organs are eye corneas, long bones,
    middle ear bones, and skin

28
Deceased patient, before viewing the body
  • Check orders for special requests
  • Remove equipment
  • Remove supplies
  • Change soiled linens and cleanse patient
  • Use room deodorizer
  • Place patient in supine position, with small
    pillow under head
  • Insert dentures

29
Deceased patient, before viewing the body
continued
  • Remove valuables and give to family
  • Stay with family, if requested
  • After the family leaves
  • Tag patient according to hospital/agency policy
  • Wrap body in shroud
  • Put ID tag on shroud
  • Transfer to morgue
  • Document

30
Describe response of family to dying process
  • Related to cultural background
  • Unresolved grief issues
  • Emotions
  • Requests
  • Physical symptoms may occur
  • Reorganization
  • Individualized grief patterns

31
Behavioral responses that obstruct the expression
of grief
  • Sudden, unexpected death
  • Lengthy illness resulting in death
  • Loss of a child
  • Perception that the death was preventable
  • Unsteady relationship with deceased
  • Mental illness of survivor
  • Lack of social support

32
Thanatology
  • Thanatology study of death
  • The description of study of the phenomena of
    death, and of psychological mechanisms for coping
    with death

33
  • Thank you
About PowerShow.com