Stages of Grief
1st Stage of Grief
Denial
"I have said goodbye to my loved ones and I await death peacefully".
Acceptance
Your pt is having difficulty breathing.
Raise HOB to semi-fowler's, open a window, provide a fan if one available, report to nurse.
The primary focus of palliative care is...
Improve quality of life.
Your pt does not understand why his children are acting differently, one is throwing things and one is crying.
Explain that these emotions are natural and part of the grieving process and each person reacts differently.
2nd Stage
Anger
"I no longer sleep or eat, and I cry all of the time".
Depression
Your pt is nauseous.
Provide mouth care, provide cold foods, open a window, encourage fluids, provide food/drinks with ginger.
Palliative care prevents...
Frequent hospital visits.
We do this after someone passes away.
Provide post-mortem care.
3rd Stage
Bargaining
"The physician gave a diagnosis without explaining all the results. It's nonsense."
Denial
Your pt is sore.
Reposition, provide massage to area that is sore, provide warm blanket, respect their pace.
There is a myth related to palliative care... which leads to families not being open to it.
It does not hasten or prolong death.
You have to help your pt who is struggling psychologically.
Encourage to verbalize feelings, active listening, encourage to write out feelings, remain empathetic.
4th Stage
Depression
"I'm a believer, but not a practicing one. I've begun to go to church again, and I'm making promises to God so that my wishes may come true".
Bargaining
Your pt loss their appetite.
Ask their preferences, provide smaller portions, provide snacks throughout the day, encourage fluids, provide mouth care.
Certain things are managed very well...
Pain management and other distressing symptoms.
The family is grieving while the pt is still alive because they don't want to let them go and they verbalize this to you... Your response is..
To display understanding that this is a difficult situation.
5th Stage
Acceptance
"It's unfair: I'm much too young to die now!".
Anger
Your pt has a cough.
Open a window, provide a fan, raise HOB to semi-fowlers, encourage fluids, provide mouth care, encourage deep breathing exercises.
Families are supported in which way?
During the illness and the bereavement.
Everything your saying to the pt and family is good but not enough, therefore we intervene by...
Suggesting a support group for the pt & family.