Chapter 28 Loss, Grief, and Dying.ppt

Learning Objectives Describe the definition of loss, grief, bereavement, euthanasia, dying Describe the role that denial, anger, bargaining, depression and acceptance serve. Discuss how to meet needs of the dying Clients Discuss :information sharing, how much and what to communicate, treating losses and fears, and maintaining hope. Discuss what you should do when your patient’s death is imminent. Objectives (cont’d) Discuss what you should do when you don’t know what to say. Discuss responses of the family, including anticipatory grief and phases of grief. Discuss what to say, and what not to say, to a grieving family. Explain the structure and function of Hospice. Definition of Loss Loss is defined as any change that reduce the probability of reaching some desired goal or that deprives a person suddenly of a valued possession or relationship. Loss is the deprivation of object, person, possession, or ideal that was considered valuable and had an investment of self. It may be actual, potential, or symbolic. The stages of loss( Lipowski 1969) Threat Loss Gain Insignificance Kubler-Ross 1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance Stage theories ... Don’t allow for individual differences May not be accurate May be harmful. We can help: Life review Create a legacy Increase control Pain management. Grief The subjective experience occurring after psychological recognition of loss Common grief reactions Shock Numbness Sadness Loneliness Anger Guilt Anxiety Helplessness Yearning for the deceased Relief Confusion Cognitive problems Loss of energy Shortness of breath Disrupted sleep Poor appetite Influences on Grief Processes Identity, role that deceased occupied in family Quality of relationship with deceased Gender, intellect, maturity Previous deaths or other losses Coping skills Sociocultural, religious/spiritual values Causes, circumstances of death Concurrent stresses. Mourning The process by which individuals strive to adapt to their loss and attenuat