HKU SPCAE COMMUNITY COLLEGECCST 4076Basic Clinical Nursing
LOSS, GRIEVING & DEATH
Learning Outcomes1.Describe types and sources of losses.2.Discuss selected frameworks for identifying stages ofgrieving.3.Identify clinical symptoms of grief.4.Discuss factors affecting a grief response.5.Identify measures that facilitate the grieving process.
Learning Outcomes6.List clinical signs of impending and actual death.7.Describe the process of helping clients die with dignity.8.Describe the role of the nurse in working with familiesor caregivers of dying clients.9.Describe nursing measures for care of the body afterdeath.
LOSS & GRIEVING
Grieving is a normal response to a loss•Grieving is a normal, complex process that includesemotional, physical, spiritual, social and intellectualresponses and behaviors by which individuals,families, and communities incorporate a loss intotheir daily livesNational North American Nursing DiagnosisAssociation International
Types of Loss•Actual–Recognized by others•Perceived–Experienced by one person but cannot be verified by others•Anticipatory–Experienced before loss occurs–Can be actual or perceived
Types of Loss (cont'd)•Situational–i.e., Loss of job, death of child•Developmental–i.e., Departure of children from home
Sources of Loss•Aspect self•External objects•Familiar environment•Loved ones
Kübler-Ross Stages of Dying•Denial•Anger•Bargaining•Depression•AcceptanceNote: NOT HAPPENING IN SEQUENCE
Engel Stages of Grieving•Shock and disbelief•Developing awareness•Restitution•Resolving the loss•Idealization•Outcome
Coping with death and dying•Coping consists of the cognitive & behavioral efforts tomanage specific external and/or internal demands that areappraised as taxing or exceeding one’s resources. (Lazarus& Folkman, 1984)•Four tasks of coping in death & dying: physical,psychosocial, emotional & spiritual (Corr, 2000)
Appropriate death by Weisman•Four criteria for“anappropriatedeath”: theperson’sinternalconflictshouldbereducedtominimal;theindividual’spersonal sense of identity should be sustained;criticalrelationshipsshouldbepreservedorevenenhanced; and the person should be encouraged to set andattempt to reach meaningful goals (Weisman in DeSpelder& Strickland, 2003).