Term
| describe the hospice and palliative care treatment model |
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Definition
| this model asserts that dying persons and their families have the right to receive honest answers for difficult questions, have control over as much of their medical care and living situation as possible, have advance directives completed and followed, including instructions to suspend or withhold curative efforts, receive excellent palliative care and be comfortable, and be perceived as fully deserving of dignity and human worth. |
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Term
| Who identified distinctive phases, or cycles, in people's responses to terminal illness: denial, anger, bargaining, depression, and acceptance. |
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Definition
| , Dr. Elisabeth Kübler-Ross |
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Term
| describe hospice and palliative care |
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Definition
| it is a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient's needs and wishes. Support is provided to the patient's loved ones as well. At the center of hospice and palliative care is the belief that each of us has the right to die pain-free and with dignity. |
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Term
| what does the current Medicare Hospice Benefit entail? |
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Definition
| two initial 90-day benefit periods followed by an unlimited number of 60-day periods, each requiring physician recertification. |
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Term
| what are the 4 levels of care with the medicare hospice benefits? |
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Definition
| routine home care, continuous home care (with short-term, around-the-clock nursing care at home), inpatient respite care, and general inpatient care for acute symptom management. |
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Term
| what is "Whole-person care” |
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Definition
| seeing the patient first and foremost as a human being and being attentive to all aspects of suffering. |
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Term
| what are the two essential skills to the "Art of Presence"? |
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Definition
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Term
| What are some appropriate questions to ask when talking to a patient in hospice care? |
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Definition
• Would you tell me what this is like for you?
• How do you see your condition right now?
• Where do you see things going?
• Are you worried about anything?
• What are you hoping for? |
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Term
| what are the guidelines to assessing spirituality in your hospice patient? |
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Definition
start the conversation
Remember that this is the patient's story.
Refer to a counselor with spiritual expertise
Hear unspoken questions.
Be empowered by the process |
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Term
| what 2 factors make things better for patients during times of stress in the hospice setting? |
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Definition
| (1) the ability to have—or believe one can have—some control over the situation and (2) the ability to predict changes. |
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Term
| experts believe that the same information must be repeated how many times for a patient to remember it, while under stress? |
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Definition
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Term
| what is anticipatory grief or anticipatory mourning |
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Definition
| This type of grief is anticipatory in the sense that a future loss is being mourned in advance as people acknowledge the importance of the dying person, adjust their lives to accommodate the intervening time, and foresee how their futures will be altered by the loss. |
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Term
| what are the interventions that can help the patient/family during times of anticipatory grief? |
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Definition
Validate expressions of anticipatory grief.
Inform patients and families about the disease and its symptoms.
Invite patients and families to deal with emotional issues.
• Acknowledge the losses and changes in their lives.
• Explore ways of coping. |
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Term
| What are "Four Gifts of Resolving Relationships"? |
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Definition
| forgiveness, love, gratitude, and farewell |
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Term
| what are “seven cohesive patterns characterizing the ways in which participants viewed the prospect of their own death”? |
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Definition
1. Struggle: Living and dying are a struggle.
2. Dissonance: Dying is not living.
3. Endurance: Triumph of inner strength.
4. Incorporation: Belief system accommodates death.
5. Coping: Working to find a new balance.
6. Quest: Seeking meaning in dying.
7. Volatile: Unresolved and unresigned. |
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Term
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Definition
| individual's reactions to loss. Normal grief reactions include depressed mood, insomnia, anxiety, poor appetite, loss of interest, guilt, dreams about the deceased, and poor concentration. Psychological states include shock, denial, and yearning or searching for the deceased |
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Term
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Definition
| derived from the Old English word berafian, meaning “to rob,” is the period of grieving following a death |
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Term
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Definition
| refers to things people do to cope with their grief, including shared, social expressions of grief, such as funerals and bereavement groups. Everyone grieves, but not everyone engages in the work of mourning. |
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Term
| what are Kübler-Ross's 5 stages of dying? |
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Definition
| denial, anger, bargaining, depression, and acceptance |
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Term
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Definition
| alternating between the two spheres of coping ( loss orientation and restoration orientation) |
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Term
| J. William Worden organizes aspects of mourning into what four tasks? |
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Definition
(1) accept the reality of the loss, (2) experience the pain of grief,
(3) adjust to an environment without the loved one (externally, internally, and spiritually), and
(4) relocate and memorialize the loved one. |
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Term
| what are some factors that can complicate bereavement? |
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Definition
• Heavy emotional dependence on the deceased
• Unresolved conflicts between the bereaved and the deceased
• Young age of the deceased (often the most profound loss) or of the bereaved
• Lack of a meaningful relationship or support system
• A history of previous losses
• A lack of sound coping skills
• A death that was associated with a cultural stigma (e.g., acquired immunodeficiency syndrome, suicide)
• A death that was unexpected or associated with violence (e.g., murder, suicide)
• A history of depression, drug or alcohol abuse, or other psychiatric illness |
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Term
| what is disenfranchised grief? |
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Definition
| the grief a person experiences when they incur a loss that is not and cannot be openly acknowledged, publicly mourned, or socially supported. |
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Term
1. The nurse is caring for a patient who is grieving. The patient has stated she is angry that she has been diagnosed with terminal cancer. Which behavior should the nurse anticipate next as the patient reconciles her anger?
1. Denial that she has cancer
2. Depression over the diagnosis of cancer
3. Acceptance that her cancer is a reality
4. Begging God to remove the cancer from her body |
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Definition
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Term
2. The nurse is planning hospice care for a dying patient. Which outcome is most appropriate?
1. Patient will regain health
2. Patient will remain pain-free
3. Patient will not fear death
4. Patient will decline all medications |
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Definition
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Term
3. Which patient statement regarding spirituality would require further nursing teaching?
1. “I am not religious, so therefore I am not spiritual.”
2. “Death scares me.”
3. “My family is what gives my life meaning.”
4. “I believe in a higher power.” |
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Definition
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Term
4. The nurse identifies that a patient is experiencing dysfunctional grieving related to the loss of her spouse. Which evaluation finding would indicate that a treatment plan is appropriate? The patient:
1. no longer thinks of her spouse.
2. copes without the need for a support system.
3. states she should have taken her spouse to the doctor more often.
4. laughs occasionally with her grandchildren. |
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Definition
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Term
5. The nurse is caring for a patient whose partner—with whom she was having an affair—died suddenly after a myocardial infarction. The patient had told no one about the affair, so no friends or family were aware that she experienced a loss. How should the nurse document the patient's grieving?
1. Disenfranchised grief
2. Dysfunctional grief
3. Maladaptive grief
4. Normal bereavement |
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Definition
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