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    Loss, Grief and Dying

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    Lliryc Sotnas Oleusnoc
    This document discusses types of loss, definitions of grief, bereavement, and mourning, models of the stages of grief, signs of impending death, definitions of death, components of a good death, principles of palliative care, advance directives, special orders, factors affecting grief and dying, developing trust with patients, needs of dying patients, and providing postmortem care of the body and family. It covers key topics related to loss, grief, dying, and end-of-life care.

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    Loss, Grief and Dying

    Uploaded by

    Lliryc Sotnas Oleusnoc
    158 views18 pages
    This document discusses types of loss, definitions of grief, bereavement, and mourning, models of the stages of grief, signs of impending death, definitions of death, components of a good death, principles of palliative care, advance directives, special orders, factors affecting grief and dying, developing trust with patients, needs of dying patients, and providing postmortem care of the body and family. It covers key topics related to loss, grief, dying, and end-of-life care.

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    Types of Loss, Stages of Grief and Dying

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    This document discusses types of loss, definitions of grief, bereavement, and mourning, models of the stages of grief, signs of impending death, definitions of death, components of a good death, principles of palliative care, advance directives, special orders, factors affecting grief and dying, developing trust with patients, needs of dying patients, and providing postmortem care of the body and family. It covers key topics related to loss, grief, dying, and end-of-life care.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    158 views18 pages

    Loss, Grief and Dying

    Uploaded by

    Lliryc Sotnas Oleusnoc
    This document discusses types of loss, definitions of grief, bereavement, and mourning, models of the stages of grief, signs of impending death, definitions of death, components of a good death, principles of palliative care, advance directives, special orders, factors affecting grief and dying, developing trust with patients, needs of dying patients, and providing postmortem care of the body and family. It covers key topics related to loss, grief, dying, and end-of-life care.

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    At a glance
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    The key takeaways are the different types of loss, definitions of grief, bereavement and mourning, and models of grief such as Engel's six stages of grief and Kubler-Ross' five stages of grief.

    The different types of loss discussed are actual loss, perceived loss, physical loss, psychological loss, maturational loss, situational loss, and anticipatory loss.

    Grief is defined as the emotional reaction to loss, bereavement is the state of grieving, and mourning is the acceptance of loss and learning to deal with it.

    Loss, Grief, and Dying

    by

    Dr. Cyrill S. Consuelo, RN, MAN, LPT, LLB


    Prof. Ma. Elena C. Diasen, RN, MSN
    Manila Central University
    College of Nursing
    Types of Loss
    • Actual loss — can be recognized by others
    • Perceived loss — is felt by person but intangible to others
    • Physical loss versus psychological loss
    • Maturational loss — experienced as a result of natural
    developmental process
    • Situational loss — experienced as a result of an
    unpredictable event
    • Anticipatory loss — loss has not yet taken place
    Definitions
    • Grief — emotional reaction to loss
    • Bereavement — state of grieving; person goes through
    grief reaction
    • Mourning — acceptance of loss; person learns to deal
    with loss
    Engel’s Six Stages of Grief
    • Shock and disbelief
    • Developing awareness
    • Restitution
    • Resolving the loss
    • Idealization
    • Outcome
    Kubler-Ross’s Five Stages of Grief
    • Denial and isolation
    • Anger
    • Bargaining
    • Depression
    • Acceptance
    Clinical signs of Impending Death
    • Inability to swallow
    • Pitting edema
    • Decreased gastrointestinal and urinary tract activity
    • Bowel and bladder incontinence
    • Loss of motion, sensation, reflexes
    • Elevated temperature, cold or clammy skin, cyanosis
    • Lowered blood pressure
    • Noisy or irregular respiration
    • Cheyne-Stokes respirations
    Three Definitions of Death
    • Traditional heart-lung — irreversible cessation of
    spontaneous respiration and circulation
    • Whole brain — irreversible cessation of all functions of
    the entire brain
    • Higher brain — irreversible loss of all “higher” brain
    function
    Components of a Good Death
    • Pain and symptom management
    • Clear decision-making
    • Preparation for death
    • Completion
    • Contributing to others
    • Affirmation of the whole person
    Five Principles of Palliative Care
    • Respects goals, likes, and choices of the dying person
    and his loved ones
    • Looks after the medical, emotional, social, and spiritual
    needs of the dying person
    • Supports the needs of family members
    • Helps to gain access to needed healthcare providers and
    care setting
    • Builds ways to provide excellent care at end of life
    Advance Directives
    • Decide who will make decisions for the patient in case he
    or she is unable.
    • Decide the kind of medical treatment the patient wants
    or doesn’t want.
    • Decide how comfortable the patient wants to be.
    • Decide how the patient will be treated by others.
    • Decide what the patient wants loved ones to know.
    Special Orders
    • Do-not-resuscitate (DNR) or no-code
    • Comfort measures only
    • Do-not-hospitalize
    Factors Affecting Grief and Dying
    • Developmental considerations
    • Family
    • Socioeconomic factors
    • Cultural influences
    • Religious influences
    • Causes of death
    Developing a Trusting Nurse-Patient
    Relationship
    • Explain the patient’s condition and treatment.
    • Teach self-care and promoting self-esteem.
    • Teach family members to assist in care.
    • Meet the needs of dying patient.
    • Meet family needs.
    Needs of Dying Patients
    • Physiological needs — physical needs, such as hygiene,
    pain control, nutritional needs
    • Psychological needs — patient needs control over fear of
    the unknown, pain, separation, leaving loved ones, loss
    of dignity, loss of control, unfinished business, isolation
    • Sexual needs — patient needs ways to be physically
    intimate that meets needs of both partners
    • Spiritual needs — patient needs to practice religious faith
    Providing Postmortem Care
    • Care of the body
    • Care of the family
    • Discharging legal responsibilities
    • Death certificate issued and signed
    • Labeling body
    • Reviewing organ donation arrangements if any
    • Care of other patients
    Postmortem Care of the Body
    • Prepare body for discharge.
    • Place body in anatomical position, replace dressings, and
    remove tubes (unless there is an autopsy scheduled).
    • Place identification tags on the body.
    • Follow local law if patient died of communicable disease.
    Postmortem Care of the Family
    • Listen to family’s expressions of grief, loss, and
    helplessness
    • Offer solace and support by being an attentive listener.
    • Arrange for family members to view the body.
    • In the case of sudden death, provide a private place for
    family to begin grieving.
    • It is appropriate for the nurse to attend the funeral and
    make a follow-up visit to the family.
    THANK YOU!

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