13 end of life care

•Any potential, actual, or perceived situation when valued object or person changed or not accessible

–Occurs as person moves from one developmental stage to another

–Occurs in response to external events generally beyond person’s control

major category of loss

•Series of intense psychological responses occurring after loss
•Necessary, normal, natural, and adaptive responses

–Period of grief
–Integration and resolution of loss

–Period of grief after death of loved one

STAGES OF GREIF

–Painful experience that begins when person consciously realizes full meaning of loss

May last days to one month or more –Person may describe feeling emotional numbness

types of greif

–Normally follows fairly predictable significant loss

–Occurs before expected loss
–Ie: terminally ill patient, expected move

–Intense, persistent pattern that does not result in reconciliation of feelings

–Not openly acknowledged, socially sanctioned, or publicly shared

provides legal means for people to specify circumstances under which life-sustaining measures should or should not be rendered

–Written instruction of client wishes
–Includes durable power of attorney for health care and living will

5 stages of dying...E. K. ROSS

end of life care focus

•Relief of symptoms
•Goal:
–Assure quality of life

•Care for terminally ill
•When aggressive treatment no longer option or client refuses further care
•Often in home or hospice setting without technology to prolong dying
•Interdisciplinary program

•Lungs cannot provide adequate gas diffusion
•Heart and blood vessels unable to maintain adequate tissue perfusion
•Brain ceases to regulate vital centers
•Cheyne-Stokes respirations and “death rattles” occur

•No response to name, touch, or environmental sound
•Eyes fixed on certain spot
•No eye-blinking in response to touch or air movement over eyes
•Release of bowel and bladder contents
•Absence of heartbeat
•Cessation of respirations
•Mottling of skin
•Eyelids remaining slightly open
•Jaw relaxation and slight opening of mouth

–Unresolved sadness
–May lead to burnout

s/s of shadow grief