Death and Bereavement: Somebody - PowerPoint PPT Presentation

Loading...

PPT – Death and Bereavement: Somebody PowerPoint presentation | free to view - id: 764808-MWFjY



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Death and Bereavement: Somebody

Description:

Title: Working with and Identifying the Needs of Dying and Bereaved Patients Author: Courtney Sutliff Last modified by: Jones, Karen S Created Date – PowerPoint PPT presentation

Number of Views:239
Avg rating:3.0/5.0
Slides: 42
Provided by: Courtn72
Category:

less

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

Title: Death and Bereavement: Somebody


1
Death and Bereavement Somebodys Gotta Talk
About it
  • Indiana University School of Social Work Alumni
    Conference

2
Why Do I Think Its Important for Social Workers
to Know These Basics?
  • I had patients die before and was lost
  • Were all going to encounter it in some way
    regardless of setting
  • Now that I work in hospice I think EVERYONE
    should know this stuff!

3
Why Are We So Hesitant to Discuss Death?
  • Cultural taboo
  • Forces us to face our own mortality
  • Fear of offending, scaring or angering our
    clients and families
  • What the heck are we supposed to say?
  • Lack of expertise

4
The Needs of the Dying
  • David Kessler
  • The best way to treat a dying patient is to
    remember that he or she is still a living
    patient
  • Focus on cure often ignores the spiritual,
    physical, emotional and cognitive aspects of
    dealing with a terminal illness/injury

5
The need to be treated as a living human being
  • The Needs of the Dying

6
The need to maintain a sense of hopefulness,
however changing its focus may be
  • The Needs of the Dying

7
The need to express feelings emotions about
death in ones own way
  • The Needs of the Dying

8
The Needs of the Dying
  • The need to participate in decisions concerning
    ones care
  • The need to have all questions answered honestly
    fully
  • The need for continuing medical care

9
The Needs of the Dying
  • The need to be free of physical pain
  • The need to be cared for by compassionate,
    sensitive knowledgeable people

10
The need to express feelings emotions about
pain in ones own way
  • The Needs of the Dying

11
The Needs of the Dying
  • The need to seek spirituality
  • The need to die in peace dignity
  • The need not to die alone
  • The need to know that the sanctity of the body
    will be respected after death

12
Spiritual Realm
  • Is there an afterlife? If so, what is it?
  • Deathbed visitations, hallucinations, hauntings,
    angels
  • Near death experiences

13
Symptoms of Dying
  • Increased sleeping
  • Decreased eating
  • Memory loss
  • Decreased urine
  • Difficulty with or changes in breathing
  • Death rattle
  • Agitation or restlessness
  • Involuntary sounds or movements
  • Skin color changes

14
Suffering
  • Can it be alleviated?
  • Is it valuable to the patient in some way?
  • Emotional, spiritual, mental or physical
  • Unfinished business
  • Suffering, if it is accepted together, borne
    together, is joy. Mother Teresa

15
Legacy Projects
  • Tailored to the patient
  • Patient directed
  • Often the role of the social worker
  • Can help with symptom control for some
  • Wide variety in size, scope, focus

16
Professional Interventions The Power of Presence
  • Concrete Interventions
  • Assessments
  • Clinical Interventions
  • Presence

17
Death Ideation vs Suicidal Ideation
  • Both can occur
  • Both require attention
  • Are not the same and should not be handled as such

18
What is Normal Grief? Physical Symptoms
  • Hyperactivity or under active
  • Chest pain
  • Headaches
  • Stomach pains/nausea
  • Change in appetite
  • Weight changes
  • Fatigue
  • Sleeping problems
  • Restlessness
  • Crying
  • Sighing
  • Shortness of breath
  • Tightness in the throat
  • Changes in coordination

19
What is Normal Grief? Emotional Symptoms
  • Numbness
  • Sadness
  • Anger
  • Fear
  • Relief
  • Irritability
  • Guilt
  • Longing
  • Anxiety
  • Meaningless
  • Apathy
  • Vulnerability
  • Abandonment
  • Loneliness

20
What is Normal Grief? Social Symptoms
  • Being overly sensitive
  • Becoming more dependent on others
  • Becoming withdrawn
  • Avoiding others
  • Lack of initiative
  • Lack of interest

21
What is Normal Grief? Behavioral Symptoms
  • Forgetfulness
  • Searching for the deceased
  • Slowed thinking process
  • Disturbing dreams
  • Sensing the deceased presence
  • Wandering aimlessly
  • Avoiding talking about it in fear of making
    others uncomfortable
  • Needing to retell the story of the loved ones
    death

22
Grief Theory
  • Freud pathological, get over it
  • Kubler-Ross five traditional stages
  • Bowlby and Parkes four phases attachment
    theory
  • Worden four tasks not stages
  • Wolfet companioning the bereaved
  • Neimeyer narrative and constructivist
  • Maciejewski et al recent Yale Bereavement Study

23
Primal Response
  • Grief served an evolutionary purpose
  • Fight or flight
  • Reactions trigger by reptilian parts of brain as
    with other traumatic experiences

24
Complicated Bereavement
  • When grief gets in the way of ones ability to
    accomplish required tasks of daily life
  • When symptoms of grief are severe and persistent
  • When one is unable to cope with the loss after an
    extended period of time.

25
Why Assess for Risk
  • You may be completely unaware of the losses that
    your patients are experiencing
  • Identify if somatic complaints are grief related
  • Identify supports that can be put into place
  • Implement appropriate medical interventions
  • Provide support and education

26
What Should a Risk Assessment Explore?
  • Loss history divorce, miscarriage, death,
    moving, job loss, etc.
  • Available supports emotional, spiritual,
    resources, within the community
  • Health history known medical and mental health
    concerns
  • Emotional stability level of dependence, anger,
    acceptance
  • Considerations for children
  • Circumstances surrounding death
  • Course of illness

27
When to Assess for Risk?
  • Time of diagnosis
  • When subsequent losses occur
  • Changes in prognosis or patients condition
  • When death occurs
  • After initial impact of death has sunk in
  • Frequent updates to assessment is ideal

28
When is it More Than Grief?
  • Diagnostic standards
  • Practical implications
  • Overlapping symptoms with depression, anxiety,
    attachment disorders, post traumatic stress
    disorder
  • Wishing for death

29
How Does Grief Impact Health?
  • Grief is stressful!
  • Exacerbates existing health concerns
  • May trigger previously unidentified medical
    problems
  • Can intensify mental health concerns
  • Behavioral implications that impact health

30
Anticipatory Grief
  • But the person isnt dead yet!
  • Can serve a very useful, protective purpose
  • Can help to identify problems that may be carried
    over to the typical course of bereavement

31
What Can We Do to Help the Bereaved?
  • Listen to the story even if you think you know
    the story
  • Dont try to plan solutions help to identify
    supports and resources instead
  • Be with the grieving
  • Ask meaningful questions
  • Try to be comfortable when discussing the loss
  • Be aware of non-verbal communication, word choice
    and tone of voice

32
What Can I Say?
  • I am so sorry for your loss.
  • I wish I had the right words. Please know I
    care.
  • I dont know how you feel, but I am here if I can
    help in any way.
  • You and your loved ones will be in my thoughts
    and prayers.
  • My favorite memory of him is
  • I am always just a phone call away.
  • We all need help at times like this. I am here
    for you.
  • I am usually up early and stay up late.
  • Dont talk Just be with them. Hugs can be very
    powerful.

33
What Not to Say
  • At least she lived a long life. Many people die
    young.
  • Hes in a better place.
  • She brought this on herself.
  • There is a reason for everything.
  • You can still have another child.
  • It was Gods will.
  • Youll get over it.
  • Shes better off this way.
  • Be strong.
  • Arent you over him yet? Hes been dead for a
    while now.
  • She was such a good person. God wanted her to be
    with Him.
  • You think thats bad? My loved one
  • It was her time.
  • It was just a miscarriage.
  • I know how you feel.
  • Tears wont bring him back.
  • Youre still young.

34
Encourage Self Care
  • Be patient with ones self
  • Ask for and accept help
  • Talk to others
  • Recognize that bad days will come
  • Rest
  • Schedule fun and rest
  • Journaling
  • Eat regularly
  • Schedule time with others
  • Exercise
  • Keep a routine
  • Engage in old or new hobbies
  • Welcome new experiences
  • Take care of something else a plant or pet for
    example
  • Drink plenty of water
  • Plan for alone time

35
Grief Impacts Professionals, Too!
  • Medical professionals are exposed to death and
    suffering more often
  • Loss is cumulative
  • Impacts personal and professional relationships
  • Your own self care is important!

36
What Can We Do To Better Support Professionals?
  • Reduce stigma associated with professional grief
  • Explore systemic changes that understand grief
    and offer supports
  • Model appropriate interactions with patients and
    families for others
  • Engage in good self care

37
Struggling and Need Help?
  • Natural sources of support formal and informal
    mentors, coworkers, family members
  • External resources community mental health
    providers, funeral homes, hospital or hospice
    providers
  • Reach out if you cant find a group that works
    for you help to make one. You cant be the only
    one!

38
Bibliography American Academy of Bereavement
Bereavement Facilitator Level 1 Training
Program. 2004 www.bereavementacademy.org B
rietbart, W., Gibson, C., Poppito, S., Berg, A.
Psychotherapeutic Interventions at the End of
Life A Focus on Meaning and Spirituality.
Can J Psychiatry, 2004 49 (6), 366-372. Bruce,
C. (2007). Helping patients, families,
caregivers, and physicians in the grieving
process. Journal of the American osteopath
association,107(12), 33-40. Campbell, K. (n.d.).
Grief and loss in medicine The role of
physicians in helping families find closure.
Retrieved from http//whvheart.com/grief-and-loss-
in-medicine-the-role-of-physicians-in-helping-fami
lies-find-closure Carmichael, M. (2005).
Bereavement assessment in palliative care -
identifying those "at risk". Scottish journal of
healthcare chaplaincy, 8(2), 21-25 Carroll, L.
Died of a broken heart? The science behind close
couple deaths. Today August 28,2013.
www.today.com/health/died-broken-heart-science-beh
ind-close-couple-deaths-8C11018276 Chassiakos,
Y. R. (2012, February 27). In practice Doctors
bury grief to help patients and families. Los
Angeles Times. Retrieved from www.latimes.com Doc
tors Feel Grief, Too. (2013, June 19). Retrieved
from http//www.adivsory.com/daily-briefing/2013/0
6/19/doctors-feel-grief-too
39
Doctors need support to help them deal with grief
and emotional disturbance they may experience.
(2007, September 13). Retrieved from
http//www.news-medical.net/news/2007/09/13/29791.
aspx Don, K. Spiritual Doorway in the Brain
The science of near-death experiences.
SalonJanuary 13, 2011. http//www.salon.com/2011
/01/13/near_death_experience_interview/ Duminiak,
C. Grief healing and the power of aferlife
signs. Open to hope April 3, 2013.
http//www.opentohope.com/grief-healing-and-the-po
wer-of-afterlife-signs/ Dyer, K. (2013, October
23). Understanding the impact of loss grief on
our patient's well being Learning how to take a
loss history. Retrieved from httpwww.mommd.com/lo
ss.shtml Granek, PhD, L., Tozer, MD, R.,
Mazzotta, MD, CCFP, MSc, P., Ramjuan, BHSc, A.,
Krzyzanowska, MD, MPH, M. (2012). Nature and
impact of grief over patient loss on oncologists'
personal and professional lives. Archives of
internal medicine, 172(12), 964-966. Hodgekiss,
A. You really CAN die of a broken heart
Surviving spouses have a 66 higher risk of
dying in the three months after their partners
death. Daily Mail November 15, 2013.
www.dailymail.co.uk/health/article-2507829/You-rea
lly-CAN-die-broken-heart-Surviving-spouses-66-high
er-risk- dying-months-partners-death.html
Johns Hopkins Medicine. Frequently asked
questions about broken heart syndrome.
www.hopkinsmedicine.org/asc/faqs.html Kessler,
D. The needs of the dying. Harper Collins New
York, NY 2001. Kessler, D. , Kubler-Ross, E.
On grief and grieving. Scribner New York, NY
2005. Kubler-Ross, E. Questions and answers on
death and dying. Collier Books New York, NY
1974.
40
Lee, T. Broken heart syndrome. Harvard
Medical School January 27, 2012.
www.intellihealth.com/article/broken-heart-syndrom
e?hdHealthy Physical stress of caregiving.
Retrieved from http//connect.legacy.com/inspire/p
age/show?id19840353APage3A252 Petersen,
Freya. Grief can trigger myocardial infarction,
or heart attack, study finds. Global
Post January 11, 2012. www.globalpost.com/dispat
ch/news/health/120111/myocardial-
infarction-grief/broken-heart/syndrome-cardio-us-n
ews Sansone, R. A., Sansone, L. A. (2012).
Physician grief with patient death. Innovations
in clinical neuroscience, 9(4), 22-26. Shepherd,
Rupert. A broken heart breaks your heart,
literally! Medical News Today 2012.
www.medicalnewstoday.com/articles/240135.php Symp
toms of grief. (n.d.). Retrieved from
http//www.griefwatch.com/symptoms-of-grief Thoma
, M. Cause of death Broken Heart (its an
actual syndrome, and can kill you). America
Blog October 31, 2013. http//americablog.com/
2013/10/you-can-literally-die-of-a-broken-heart.ht
ml Yahoo Answers. Can you die of a broken
heart? http//answers.yahoo.com/question/index
?qid20130827203107AAjQ4nl What Can I Say?.
(n.d.). Retrieved from http//www.griefjourney.com
/wp/what-we-offer/for-professionals-and-caregivers
/articles
41
Grief is like the ocean it comes in waves,
ebbing and flowing. Sometimes the water is calm,
and sometimes it is overwhelming. All we can do
is learn to swim. Vicki Harrison
About PowerShow.com