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Compassionate Care and Support for End-of-Life and Grieving Individuals

Explore hospice and palliative care practices, nursing goals, coping styles, grief reactions, and ways to help individuals cope with loss and grief. Learn about the Four Gifts of Resolving Relationships and the Dual-Process Model of Coping with Bereavement.

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Compassionate Care and Support for End-of-Life and Grieving Individuals

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  1. Care for the Dying and for Those Who Grieve CHAPTER 32

  2. Hospice and Palliative Care • Dr. Elisabeth Kübler-Ross • Goal is quality, compassionate care for people facing a life-limiting illness or injury • Team-oriented approach to expert medical care, pain management, and emotional and spiritual support • Tailored to patient’s needs and wishes • Support to patient's loved ones included

  3. Hospice Care • Available to everyone regardless of age, diagnosis, or the ability to pay • Requires a physician’s best clinical judgment that the patient is terminally ill with a life expectancy of 6 months or less • Patient chooses hospice care rather than curative treatment

  4. Nursing Goals in End-of-Life Care Practice the art of presence Assess for spiritual issues Provide palliative symptom management Become an effective communicator Counsel about anticipatory grieving Practice good self-care

  5. Nursing Goals in End-of-Life CareContinued • The Four Gifts of Resolving Relationships • Forgiveness • Love • Gratitude • Farewell

  6. Styles of Confronting the Prospect of Dying: Seven Motifs • Struggle – living and dying are a struggle • Dissonance – dying is not living • Endurance – triumph of inner strength • Incorporation – belief system accommodates death • Coping – working to find a new balance • Quest – seeking meaning in dying • Volatile – unresolved and unresigned

  7. Grief Reactions, Bereavement, and Mourning • Grief– the reaction to loss • Includes depressed mood, insomnia, anxiety, poor appetite, loss of interest, guilt, dreams about the deceased, poor concentration • Bereavement– period of grieving following a death • Mourning –things people do to cope with grief

  8. Dual-Process Model of Coping with Bereavement • Loss-oriented stressors – concentrating on the loss experience, feeling the pain of grief, remembering, and longing • Restoration-oriented stressors – overcoming loneliness, mastering skills and roles once performed by the deceased, finding a new identity, and facing practical details of life – Stroebe and Schut

  9. Four Tasks of Mourning • Accept the reality of the loss • Experience the pain of grief • Adjust to an environment without the loved one • Externally, internally, and spiritually • Relocate and memorialize the loved one

  10. Maladaptive Grieving Chronic grief Delayed grief Exaggerated grief Masked grief reactions

  11. Helping People Cope with Loss • Four constructs that support personal growth • Seeing some good resulting from the death • Continuing the connection with the deceased • Invoking intrinsic spirituality to understand the death and aftermath • Going forward with life

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