Understanding Loss
This is the experience of being separated from someone or something meaningful.
Loss
Crying, sadness, anger, withdrawal, and searching are examples of these.
Behaviors associated with loss
This type of grief occurs before an expected loss.
Anticipatory grief
Culture may influence rituals, decision-making, mourning, care of the body, emotional expression, and beliefs about this life event.
Death
Comfort, dignity, symptom control, respect for wishes, and peace are features of this concept.
A good death
This type of loss is recognized by others, such as death, limb loss, or job loss.
Actual loss
This stage involves difficulty accepting the reality of the loss.
Denial
This type of grief is a normal process of emotional adjustment after loss.
Healthy grief
This is the best nursing approach when unsure about a client’s cultural death practices.
Ask the client or family about their preference
This type of care focuses on comfort and quality of life when cure is no longer the goal.
Hospice care
This type of loss may not be obvious to others but is real to the client, such as loss of hope or confidence.
Perceived loss
This stage may include “Why me?” or anger toward healthcare staff, family, God, or the illness.
Anger
This type of grief is prolonged, delayed, intensified, or significantly interferes with functioning over time.
Unresolved grief
Increased fatigue, decreased appetite, more sleeping, weakness, and withdrawal may occur in this stage of dying.
The early stage
Pain, dyspnea, nausea, anxiety, secretions, constipation, and restlessness are examples of these hospice concerns.
Symptoms requiring management
This is why nurses should not decide how important a loss “should” be.
Loss is personal and depends on the meaning to the client
This stage involves trying to negotiate or make deals to avoid or reverse the loss.
Bargaining
A potentially fatal illness differs from a terminal diagnosis because this may still be possible.
Survival, cure, remission, recovery
Mottled skin, cool extremities, irregular breathing, apnea, and decreased responsiveness may occur during this stage.
Active dying
Teaching families about decreased intake, breathing changes, medications, mouth care, and when to call hospice is part of this nursing role.
Family teaching or caregiver support
Loss can affect independence, identity, health, role, fertility, mobility, career, home, and these future expectations.
This stage means the client begins to acknowledge reality and adapt, not that they are happy about the loss.
Acceptance
With a terminal diagnosis, the focus often shifts from cure to this.
Comfort, quality of life, dignity, and symptom control
Cheyne-Stokes respirations refer to this type of breathing pattern.
Irregular breathing with periods of apnea
A dying client has decreased intake, increasing sleep, irregular respirations, and cool extremities. The family is worried the client is “starving.” The nurse explains expected changes, provides mouth care, manages symptoms, and supports the family.
Hospice nursing support during the dying process