final study guide

final study guide - 1) Review the philosophy Rethinking a...

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1) Review the philosophy “Rethinking a good death,” and discuss characteristics of a Hospice. Note specifically the ways in which this organization gives patients more control. Review the Smith & Ransford study on grief resolution among the bereaved in Hospice and Hospital settings. Include the research design and what was found in this study. (lecture and “Grief Resolution” study in Reader) “good death” – person quietly slips away and does not bother anyone -silent, stoical slipping away w/ the dying person causing no stress/turmoil for others -dying person is free to make demands of people and loved ones -able to talk openly, engage in a life review -whatever dying person wants should be honored and should be able to take care of unfinished business -hospice – a social organization that embraces the philosophy “Rethinking a good death.” -a program which provides palliative and supportive care for terminally ill patients -began mid 1960s in England – originally was for cancer patients, then AIDS patients -an organized program of care for the dying and his/her entire family – care extends through the mourning process Characteristics of hospice : (KOFF) -death w/ dignity -focus on patient’s needs -express any emotion w/out fear -palliative (pain control) care rather than curative care -alleviating/controlling pain -hospitals provide curative care -Loraine Smith – “hospice mix” = morphine + cherry -must find the right balance of pain medication so patient can greet and meet w/ visitors; being conscious while dealing w/ pain -giving control back to the patient -encouraged to take control of his/her life -significance of time -hospice should give care now -do whatever patients want; “do it now!” -eliminate isolation in dying; someone should be with patient until time of death -importance of family unit/all significant others -includes close friends -can be care in a separate building, attached to a hospital, or care brought to the home -kids are allowed at any time -no specific “visiting hours” -collapse of hierarchy (much more egalitarian) -relationships between nurses and doctors more carefree -more humanitarian, higher interpersonal skills -help patient w/ unfinished business -financial clean-up -typing up loose ends with enemies, family, friends, etc. : Grief Resolution in Hospice and Hospital Wards -research design – longitudinal study comparing two settings: hospice inpatient facility and an acute care hospital oncology ward
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-fieldwork done at first in the hospice and hospital oncology units – in order to gain knowledge of staff-patient routines and to better understand the reactions of family members prior to and during the death of the patient -informal visits, interviews w/ patients, families, staff members, attended and observed staff meetings -longitudinal – two time periods studied – at 6 and 12 months (study conducted in 1983) -central thesis – social organizations of routines and practices toward the dying patient impacts
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final study guide - 1) Review the philosophy Rethinking a...

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