Grief and Bereavement Quiz

Ebersole and Hess' Gerontological Nursing & Healthy Aging in Canada 3rd Edition

• This is a three-edition textbook focusing on gerontological nursing and healthy aging in Canada.
• Authors are Veronique Boscart, Lynn McCleary, Linda Sheiban Taucar, Theris A. Touhy, and Kathleen Jett.
• Copyright is held by Elsevier Inc. in 2023.

Chapter 27: Comfort, Palliative Care, Death, and Loss

• The chapter covers comfort, palliative care, death, and loss within the context of gerontological nursing.

Learning Objectives (1 of 2)

• Differentiate between loss and grief
• Explain different types of grief and dynamics of grieving process
• Explain the nursing competencies required for effectively intervening in older adult grief and bereavement
• Describe the principles of hospice palliative care

Learning Objectives (2 of 2)

• Identify and discuss the needs of dying individuals and appropriate interventions
• Explain the nurse's role and responsibility in advance directives
• Explain the nurse's role in medical assistance in dying (MAID)

The Grieving Process (1 of 2)

• Acute grief is characterized by physical and psychological manifestations felt when loss is first experienced.
• A middle phase involves the impact of grief (like despair and depression) on daily function
• There's a concluding phase where individuals adjust to life without the lost element.

The Grieving Process (2 of 2)

• Worden's Model of Bereavement outlines four tasks: accepting loss, coping with emotional pain, adjusting to life without the lost person, and finding enduring connection with the deceased.
• Loss Response Model uses a systems approach to structure nursing interventions.

Types of Grief

• Anticipatory grief
• Acute grief
• Persistent or complicated grief
• Disenfranchised grief

Stages of Grief

• The seven stages of grief are: shock, denial, anger, bargaining, depression, testing, and acceptance.

Death of a Child or Grandchild

• Loss of a child or grandchild later in life can produce conflicting emotions in older adults.
• There's a tension between remaining strong for family members and grieving one's own loss.
• Older adults may struggle to endure the grief associated with losing younger family members.

Implications for Gerontological Nursing and Healthy Aging: Assessment

• Assess individuals likely to cope effectively versus those at risk for ineffective coping so that appropriate interventions can be planned.
• Question patients about recent life events, life values, and relationships that relate to both gain and loss.

Implications for Gerontological Nursing and Healthy Aging: Interventions

• Establish rapport and be ready to listen to facilitate conversations about loss and grief.
• Offer support and direction to the grieving person.
• Encourage storytelling and exploration of relationships.

Countercoping

• Strategies for handling emotional distress include clarification and control, collaboration, directed relief, and cooling off.

Dying, Death, and Palliative Care: Conceptual Models

• The living-dying interval begins with the realization of impending death for the dying person, and lasts until their physiological death
• Most of the dying period takes place in the chronic phase.

Implications for Gerontological Nursing

• Nurses must understand how illnesses manifest in varying trajectories like a short period of decline, long-term limitations with exacerbations or prolonged dwindling over years.

The Six Cs Approach

• Six critical elements to palliative care: care, control, composure, communication, continuity, and closure.

Care and Life Partners, Family, and Loved Ones

• Helpful nursing actions for newly bereaved individuals: keeping them informed, offering support, providing comfort, knowing their names, and encouraging family support.

Hospice Palliative Care

• Hospice palliative care is an approach that improves the quality of life for those with life-threatening illnesses by addressing physical, psychosocial, and spiritual concerns effectively.
• The approach emphasizes whole-person health, relieving suffering, and improving quality of life and dying.
• Hospice palliative care relies on interprofessional teamwork involving patients, families, formal and informal caregivers.

Dying and the Nurse

• Caring for older adults needs knowledge about the grieving and dying processes and skills in palliative care and symptom management.
• Working with those dying requires inner strength.
• Nurses may need to share the dying person's story to health professionals and informal supports.
• Successful nurses maintain professional awareness and prioritize the patient's human dignity and worth.

Decision Making at the End of Life (1 of 2)

• Legal, ethical, medical and personal considerations in end-of-life decision making for older adults/patients.
• Nurses must understand legal requirements relevant to their jurisdictions for end-of-life decision making and ensure care aligns with cultural practices
• In June 2016, Canada passed Bill C-14 legalizing MAID (Medical Assistance in Dying)

Decision Making at the End of Life (2 of 2)

• Advance care planning is the process of planning for periods when individuals lose the capacity to make important medical decisions.
• Planning includes defining treatment wishes, choosing a substitute decision maker to participate in decision making, and communication with this decision maker.

This quiz explores key concepts in grief and bereavement, focusing on Worden’s Model and the various stages of grief. Questions cover topics such as types of grief, roles of healthcare professionals, and emotional challenges faced by individuals experiencing loss. Test your knowledge on this sensitive but important subject.