3. Objective
At the end of this presentation, student will be able
Defines terms related to loss and grieving
Assess the physiological signs of death.
Identify belief and attitude about death in relation to
age
Discuss the various ways of the helping dying patient
meet his/her physiological, spiritual and emotional
needs
Discuss care of the body after death
Discuss the legal implication of death
Describe how a nurse meets are dying patient’s
needs of comfort
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4. Cont.….
Discuss important factors in carrying for the body after
death
List changes that occur in the body after death
Discuss Kubbler-Ross theory to assess grieving
behaviors
Identify common manifestations of grief
Discuss the effect of multiple losses on the grief
process
Define postmortem care & their types
Apply the nursing process to grieving clients
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5. Loss
Loss is an actual or potential situations in which
something that is valued is changed or no longer
available.
TYPES
It has two general types
Actual loss
Perceived loss
Actual Loss
Actual loss is a loss that occurs when the insured
property is totally destroyed or is damaged in such a
way that it can be neither recovered nor repaired for
further use.
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6. Perceived Loss
Perceived loss are these two losses. A person
who loses an arm in car accidents suffers from
both of those losses because of the loss of the
arm & the loss that may be caused by an altered
self-image and the inability to return to his or her
job.
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7. Sources of loss
There are many sources of loss.
Aspect of self
External objects
Familiar Environment
Loved ones
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8. Grief
Grief is the total response to the emotional
experience related to loss.
Types of Grief:
They are three types of grief
Abbreviated Grief
Anticipatory Grief
Disenfranchised Grief
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9. Types
1: Abbreviated Grief:
It is brief but genuinely felt. This can occur when the
lost object is not significantly.
2: Anticipatory Grief:
Is experienced in advance of the event
3: Disenfranchised Grief:
Occur when a person is unable to acknowledge the
loss to others.
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11. Mourning
Mourning is the behavioral process
through which grief is eventually resolved
or altered ,it is influenced by culture,
spiritual beliefs and custom.
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14. Various ways of helping dying patient
meets his/ her physiological,
Emotional & spiritual Needs
Physiological Needs
Respect the goals. Likes and choice of the
dying patient.
Look after medical, emotional, social and
spiritual needs of the dying patient.
Support the needs of the family members
Help the patient gain access to needed
healthcare providers and appropriate settings.
Build ways to provide excellent end of life care.
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29. Types of postmortem
They are three types of postmortem.
Rigor mortis
Chemical changes causes muscles mass to
become rigid; looks like body is frozen in
place(fixed)
Small muscle go in to rigor first
Rigor usually occurs from head to toe.
Rigor = Rigid
Mortis= Death
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30. Algor mortis: Body cooling Rate
The body slowly cools once the heart stops
beating
Measuring body temperature can approximate the
time of death
Use liver temperature
Can be influenced by the environment or internal
condition
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31. Liver mortis
Reddish purple to purple coloration
In dependent areas
Accumulation of blood in small vessels
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32. Apply the Nursing process to
Grieving Clients
Assessment:
This policy directive makes a distinction
between the procedure for assessing
weather a person is a deceased
(verification of death) and issuing a
medical certificate of cause of death .
Verification of death is a clinical
assessment process under taken to
established that a person has dead
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33. Diagnosis:
The three essential findings in brain death are
comma, absence of brain stem reflexes , and
apnoea…
A patient deader mind to be brain dead is legally
and clinically dead.
The diagnosis of brain death is primarily clinical.
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34. Planning
Major goals of dying client are includes
maintaining personal control and accepting
declining health status.
(a) maintaining physiologic & psychological comfort
and
(b) Achieving a dignified & peaceful death
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35. Planning for Home care
A major factor in determining whether a person will
die in health care facility or at home is the
availability of willing and able caregiver.
Hospice staff & nurses will then conduct a full
assessment of the home and care providers skill
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36. Implementation
More specific responsibilities are the following:
To provide relief from loneliness fear & depression
To maintain the client sense of security, self
confidence, dignity & self worth
To maintain hope to help the client accept losses
To provide physical comfort.
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37. Evaluations
Evaluation activity may include the following:
Listing to the clients reports of feeling in control of
the environment surrounding death, such as:
control pain relief, visitation of the family & support
people, or treatment plan
Observing the client relationship the significant
others
Listing to the client thoughts and feelings related
to hopelessness or powerlessness.
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