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Death and dying-1






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Death and dying-1 Death and dying-1 Presentation Transcript

  • Death and Dying Nur 448
  • Definitions
    • Terminally ill
    • Imminently dying
  • … in Modern Society
    • The Death-Dying Relationship
    • Dying: Denial and Beyond Denial
  • … Fears of the Patient
    • Fear of Isolation
    • Fear of Pain
    • Fear of Dependence
    • Fear of Death Itself
      • Death and Immortality
      • Death as the End
  • Stages of Dying
    • Denial and isolation
    • Anger
    • Bargaining
    • Depression
    • Acceptance
  • Setting Treatment Priorities
    • Information sharing
    • Responsivity and responsibility
    • How much and what kind?
    • Treating losses and fears
    • Maintaining hope
  • When Death Is Imminent
    • Maximizing comfort
    • Saying good-bye
    • Accepting rejection
  • When You Don ’t Know What To Say
    • Avoid rote responses – each person is unique.
    • Avoid common greetings (e.g. “ Hi! How are you?).
    • Be sincere, genuine and honest. Admit you don ’ t know what to say.
    • Don ’ t be afraid to discuss death.
  • When You Don ’t Know What To Say
    • Don ’ t lecture or preach.
    • Let the person talk.
    • Ask what you can do and do it. Keep your promises.
    • Watch your tone of voice. Avoid “ cutesy ” baby talk and condescension.
    • Don ’ t abandon the patient.
  • Responses of the Patient ’s Family
    • Anticipatory grief
    • Phases of grief
      • Shock and numbness
      • Yearning and searching
      • Disorganization and despair
      • Reorganization
  • What to Say to the Family
    • How are you doing with all of this?
    • What can I do for you?
    • You must really be hurting
    • You must feel angry
    • This must be hard for you
    • Take all the time you need
    • Thank you for sharing your feelings
  • What NOT to Say
    • I understand how you feel
    • Death was a blessing
    • It was God ’ s will
    • It all happened for the best
    • You ’ re still young
    • Be strong!
    • You have your whole life ahead of you
    • You ’ ll feel worse before you feel better
    • You can have other children
    • You can always remarry
    • Call me when I can help
    • Something good will come out of this
    • At least you have another child
    • He/she led a full life
    • It ’ s time to put it behind you now
  • Hospice
    • Cares for people approaching death
    • Respects and values the dignity and worth of each person
    • Philosophy is to cherish and emphasize life
  • Hospice Services
    • Interdisciplinary approach
    • Palliative care
    • Pain management
    • Support for family (respite care)
    • Death with dignity
    • Grief and bereavement
    • Funeral and memorial planning
  • Hospice Personnel
    • Case manager
    • Nurses
    • Home health aides and homemaker services
    • Social workers
    • Spiritual counselors
    • Volunteers
    • Medical director and attending physician
    • Dietitians
    • PT, OT, ST
  • Preparing for Death – Advanced Directives
    • Health Care Surrogate
    • Living Will
    • Legal Proxy
  • Everyone should have a living will Preparing a Living Will